COVID-19 Alerts: Recovered Patients Could Suffer Chronic Health Effects For The Rest Of Their Lives

COVID-19 Alerts: To date more than 1.6 million individuals around the world have been deemed ‘recovered’ from the SARS-CoV-2 coronavirus infection. However conquering the initial sickness may be just the first of many battles for those who have survived.
 
So far many recovered individuals report breathlessness, fatigue and body pain months after first becoming infected.


 
New research studies conducted in Hong Kong and Wuhan, China show that survivors grapple with poorer functioning in their lungs, heart and liver. And that may be the tip of the iceberg.
 
The SARS-Cov-2 coronavirus is now known to attack many parts of the human body beyond the respiratory system, causing damage from the eyes to the toes, the gastrointestinal tract including the liver, to the kidneys, the nervous system and even the testes of males. Patients' immune systems can go into overdrive to fight off the infection, compounding the damage done.
 
Though medical researchers are just only starting to track the long-term health of ‘recovered’ patients, past epidemics caused by similar viruses show that the aftermath can last more than a decade.
 
In one past study, survivors of severe acute respiratory syndrome, or Sars, suffered lung infections, higher cholesterol levels and were falling sick more frequently than others for as long as 12 years after the epidemic coursed through Asia, killing almost 800 people. https://www.nature.com/articles/s41598-017-09536-z and https://www.nature.com/articles/s41413-020-0084-5
 
The Sars 2003 epidemic infected about 8,000 people. However with more than 4.3 million and more every day infected by the SARS-CoV-2coronavirus, the long-term damage to health could strain social safety nets and health-care infrastructures for years to come as well as have implications for economies and companies.
 
This grim prospect led Dr Nicholas Hart, the British doctor who treated Prime Minister Boris Johnson, to call the virus "this generation's polio" - a disease that could leave many marked by its scars and reshape global health care.
 
Dr Kimberly Powers, an epidemiologist at the University of North Carolina at Chapel Hill, who is developing models on the virus's spread to inform public-health efforts said, "What these chronic issues ultimately look like  and how many patients ultimately experience them  will have huge implications for patients, the doctors who treat them, and the health systems around them."

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Dr Owen Tsang, the medical director of the infectious disease center at Princess Margaret Hospital said that Hong Kong's hospital authority has been monitoring a group of Covid-19 patients for up to two months since they were released. They found about half of the 20 survivors had lung function below the normal range.
 
It was observed that the diffusing capacity of their lungs ie how well oxygen and carbon dioxide transfers between the lungs and blood, remained below healthy levels.
 
In another study of blood samples from 25 recovered patients in Wuhan, the city where the virus was first detected, found that they had not fully recovered normal functioning regardless of the severity of their coronavirus symptoms. https://www.medrxiv.org/content/10.1101/2020.04.05.20053819v3
 
Yet in another study, CT scans taken over a month of 90 Wuhan coronavirus patients found that of the 70 discharged from the hospital, 66 had mild to substantial residual lung abnormalities on their last CT scans, which showed ground-glass opacity. https://pubs.rsna.org/doi/full/10.1148/radiol.2020200843
 
Also chronic cardiac complications could arise in patients even after recovery as a result of persistent inflammation, according to a research by physicians at the Cedars-Sinai Medical Centre in Los Angeles. They based their analysis on patient data from Italy and China. https://www.ahajournals.org/doi/pdf/10.1161/CIRCRESAHA.120.317055
 
In order to find details on how Covid-19 may leave its mark, medical researchers are looking to the experience of Sars. Some survivors suffered long-term effects years after they first succumbed to the disease, which is part of the same family as the new coronavirus.
 
Medical researchers in China analyzed 25 Sars patients 12 years after they contracted the virus, contrasting their results with a control group who were not infected with Sars. The research found that more than half of the recovered patients suffered another lung infection since their bout with Sars and also had higher cholesterol levels.
 
However, more than 50 percent of the patients had at least five colds in the previous year a characteristic no one in the control group shared. https://www.nature.com/articles/s41598-017-09536-z
 
Significantly these data demonstrated that the recovered Sars patients had a poor quality of life 12 years following recovery, and were susceptible to inflammation, tumours, and glucose and lipid metabolic disorders.”
 
It was observed that among survivors of the Sars outbreak of 2003, chronic fatigue and impaired lung function have been found in follow-up studies after two to four years.
 
COVID-19 is so new that no one is able to tell what is the percentage of patients who will recover, what is the percentage of patients who will not recover and have long-term sequel.
 
Constant tracking and figuring out how Covid-19 affects the body even after recovery could inform governments budgeting for social safety nets, doctors that see patients long term, and businesses as they set policies such as sick and disability leave. These issues could be even more crucial as public health officials say there's a possibility the virus may become a seasonal affliction.
 
Also countries and companies looking to get people back to work will need to understand how and if Covid-19 affects human health in the long run and its scope.
 
Dr Jessica Justman, a professor of medicine in epidemiology at Columbia University said, "There is such a wide range in the way the illness affects people. The various stakeholders need solid data to help them understand the breadth and duration of long term effects."
 
Large-scale studies in virus hot spots are needed to separate the physical legacy of the virus from how patients feel immediately after fighting off the infection.
 
Importantly, it will be crucial for scientists to track and quantify how Covid-19 affects such factors as oxygenation and breathing rate, said Dr Roberto Bruzzone, a visiting professor at the University of Hong Kong, whose research focuses on cell biology.
 
Health authorities, hospitals and researchers will have begun patient registries to start gathering data to study survivors over time as well.
 
Dr Bruzzone said, "We need an epidemiological study that may be feasible in places like Wuhan, New York City, Milan or Paris where there has been a huge group of infections with a wide variety of symptoms.”
 
All recovered patients on their own should keep on going for regular health checks and also get their doctors to conduct various test on areas most vulnerable such as the lungs, liver, gastrointestinal tract, nervous system, kidneys etc and also to report any sudden abnormalities.
 
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