Almost a year into the global pandemic, doctors and scientists are grappling with a puzzling phenomenon.
It’s not a mutant strain, or side effect of the vaccine, but a devastating second act of coronavirus that is crippling patients — many of them young — who weren’t struck down by the disease when first diagnosed.
Weeks or months after they were expected to recover, many are battling COVID-19 complications that are impacting their whole body, from severe fatigue and memory lapses to digestive problems, erratic heart rates, fluctuating blood pressure and hair loss.
For most people whose experience with the virus — which has now infected more than 98 million worldwide and killed at least 2.1 million — wasn’t severe after their initial diagnosis, doctors assume recovery will take about two weeks.
And then there are the “long haulers”, suffering a condition experts have deemed “post-acute COVID” or “chronic COVID”.
“Usually, the patients with bad disease are most likely to have persistent symptoms, but COVID doesn’t work like that,” Oxford University professor of primary care, Trisha Greenhalgh, told The Wall Street Journal.
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The lead author of an August BMJstudy, Professor Greenhalgh was among the first to define chronic COVID-19 patients as those whose symptoms span multiple organ systems and last more than 12 weeks.
“The disease itself is not that bad” for them, she explained, yet cognitive issues and heart problems sometimes persist for months.
While other viral outbreaks — including ebola and the Spanish flu — have been associated with long-term symptoms, what sets COVID-19 apart is the far-reaching nature of its effects in the body, impacting not just the lungs (where it stems from), but the heart, kidneys, nervous and digestive systems.
“I haven’t really seen any other illness that affects so many different organ systems in as many different ways as COVID does,” medical director for Mount Sinai Health System’s Centre for Post-COVID Care in New York, Zijian Chen, told the WSJ.
“We thought it was a virus that, once it does what it does, you recover and you go back to normal.”
When that isn’t the case, he added, it “is really scary”.
While estimates about the percentage of virus patients experiencing long-haul symptoms ranges widely, a recent survey of more than 4000 people found that about 10 per cent of those aged 18 to 49 still struggled with symptoms a month after becoming sick.
Of all age groups, 4.5 per cent had symptoms for more than two months, while 2.3 per cent experienced symptoms more than three months after they first tested positive.
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One explanation for what’s causing the virus’ second act is that inflammation continues to affect organs or the nervous system even after it’s gone, researchers said.
“Even those who had no symptoms and were young and fit … even in those patients we saw abnormalities,” director of the University Hospital Frankfurt’s Institute for Experimental and Translational Cardiovascular Imaging, Eike Nagel, said.
A study he led looked at 100 COVID-19 patients two months after getting sick, and found that 78 had “abnormal findings” on cardiac imaging, while 60 had heart-muscle inflammation.
Inflammation from the virus could also be disrupting the functioning of the vagus nerve — responsible for relaying messages to the lungs, gut and heart — director of rehabilitation innovation at New York’s Mount Sinai Health System, Dr David Putrino, said.
Of greater concern, Dr Putrino said, is that long haulers won’t get better on their own, and could need at least six months of structured rehabilitation.
“What tends to happen to people who don’t get treatment and don’t get the recognition they need is they slump down to a new normal of function,” he said.
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“You don’t realise how lucky you are with your health until you don’t have it,” 43-year-old lawyer, Elizabeth Moore, told the publication. Since contracting COVID-19 last March, she has struggled with memory problems and gastrointestinal issues, losing almost 14kg.
At the end of April, “I thought I beat this thing. I was ecstatic,” she said. But after testing positive for coronavirus antibodies in May, Ms Moore said her health took a sharp turn for the worse, leading to tachycardia (racing heartbeat) and fluctuations in her blood pressure.
While those symptoms have improved, the mother-of-three is still dealing with the gastrointestinal problems and a recent test found her stomach lining is inflamed.
“I feel like there has to be some sort of next step,” she told the WSJ. “Because I’m not ready to accept this as my new reality.”
