Long COVID-19 Health Complications Are Real And Are Becoming More Concerning As Cases Rise Exponentially. More Urgent Research Required!

A new study cum review by researchers from the University of Columbia and Harvard University shows that Long COVID health issues are fast rising and becoming an issue that could soon also start overburdening the healthcare systems across the world. The study was published in the peer reviewed journal: Nature
https://www.nature.com/articles/s41591-021-01283-z


 
In the COVID-19 pandemic has so far killed more than 2.73 million people and infected more than 124 million people globally according to official figures. In reality the figures could be much far higher and some have even speculated that at least 15 of the global population could now be infected with the SARS-CoV-2 coronavirus.
 
There are now millions of people left  with lingering symptoms or completely new symptoms weeks after so called COVID-19 recovery.
 
However to date, much is still unknown about what causes these symptoms and how long they last. But with nearly 740,000 cases of COVID reported in New York City since last March--and nearly 30 million million in the United States  as of now, doctors are increasingly seeing these "long-haulers" in their practices.
 
Dr Ani Nalbandian, MD, Cardiology Fellow at Vagelos College of Physicians and Surgeons, Columbia University told Thailand Medical News, “Over the course of the summer, we started getting a sense of what issues these people were having. We felt that a review of all these possible issues would be important not only for health care providers but also for patients. It's important for patients to know that what they're experiencing may be a consequence of COVID-19 infection and that they are not alone in experiencing lingering effects of COVID-19 infection."
 
Dr Nalbandian is the study author of a new review of post-acute COVID-19 along with co-first author Dr Kartik Sehgal, MD, a prominent medical oncologist at Harvard Medical School and Dana Farber Cancer Institute.
 
Both spearheaded the review effort, bringing together more than 30 experts from Columbia and other medical centers hit by the initial wave of Long COVID patients.
 
The study summarizes what the doctors were seeing in their own patients and what others had reported in the literature. The experts represented a wide range of fields, including neurology, cardiology, and nephrology.
 
Dr Nalbandian and Dr Elaine Y. Wan, MD, the Esther Aboodi Assistant Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia University, the review's senior author, highlight the symptoms that patients and providers should know about COVID-19 long haulers.
 
More Than Cognitive Or Mental Issues and Brain Fog
 
The review found that chest pain has been reported in up to 20% of COVID-19 survivors two months after recovery from the infection, COVID-19 can unveil previously unrecognized cases of diabetes, and a few percentage of patients experience strokes, pulmonary embolisms, and other complications from blood clots.
 
Dr Wan's speciality is electrophysiology, and during the pandemic she and her colleagues published more than 10 articles about COVID and heart arrhythmias.
 
Dr Nalbandian commented, "Arrhythmias can lead to stroke, heart failure, and long-lasting damage to the heart,and that's something that patients may not be aware of. In addition, multiple organs may be affected simultaneously. If you go to a cardiologist, the cardiologist may just focus on the heart, but we need to think of the whole person since COVID is potentially affecting many organs, especially in those who have been hospitalized."
 
Everyone Who HAs Been Infected Is Susceptible Ie Asymptomatic, Mild, Moderate or Severe Infections.
 
Dr Wan added, “, Although most people who experience long-term symptoms may have had health issues before contracting the virus or they developed very severe illness during COVID-19 infection. But really, any of these issues can happen to any patient who had COVID-19. For example, we've seen young patients without prior medical illness who developed autonomic dysfunction and fast heart rates after COVID-19. It's not just the most vulnerable who have issues after COVID."
 
Dr Nalbandian added, "There really is a post-COVID syndrome and it doesn't always correlate with the severity of the acute COVID infection itself."
 
It was found that the majority of COVID patients never come to the hospital for treatment.
 
Dr Nalbandian said, "We may not be checking in on these patients with the same urgency, but they shouldn't be forgotten.”
 
Long COVID-19 Symptoms Can Appear Weeks, Months After Recovery
 
Dr Wan cautioned, "I have seen young patients, weeks even months after COVID-19 infection, and they've suddenly developed new onset of heart racing, palpitations, and chronic fatigue.”
 
Some other patients complain weeks later of new chest discomfort or difficulty with decision making, memory, and concentration.
 
Dr Wan further added, "When we think of COVID-19, we think of mostly a respiratory illness. But even after they've recovered from their respiratory illness, they may still have other clinical symptoms due to issues with other organ systems."
 
A Dire Need For Specialized Long COVID Clinic.
 
Dr Wan said, "COVID-19 is the first infectious disease that I've come across that has such an effect on a wide variety of organs. It's changed my clinical practice. No matter what the patient comes in for, I now ask if they ever had COVID-19 infection. It changes the possible range of diagnoses."
 
Dr Nalbandian said, "Based on this review, all of us recognized that there needs to be interdisciplinary care to treat patients longitudinally. Care for patients with COVID-19 should not conclude at the time of hospital discharge."
 
In order to provide interdisciplinary care, health care systems should establish dedicated "Long COVID-19 Clinics.
 
Such Long COVID clinics have already debuted in Italy.
 
Dr Nalbandian says setting up such clinics in the United States has been difficult since physicians are still busy taking care of new COVID patients as subsequent waves come in.
 
Dr Nalbandian sqaid, "Clinics could prioritize follow-up care for those at high risk for post-acute COVID-19 and those with the highest burden of persistent symptoms."
 
All Long COVID Sufferers Need To Be More Vocal
 
Dr Nalbandian says many patients have complained that their doctors don't recognize that their symptoms may be related to COVID, and that's one reason she and her co-authors organized the review.
 
Dr Nalbandian said, "Here in New York, we're seeing patients who have been struggling for weeks and months looking for doctors who are knowledgeable. Physicians should be attentive, legitimize patient concerns, and thoroughly document the symptoms."
 
“Long COVID patients should not be afraid to be vocal about their symptoms. Get in touch with your doctors even if you're not sure if your symptoms are lingering from your COVID infection.The situation is still fluid and we're learning more every month," said Dr Nalbandian.
 
Important Need To Join Patient Advocacy Groups And Clinical Trials
 
To date the work of certain new patient advocacy groups has helped identify persistent symptoms and was instrumental in highlighting the persistence of symptoms among those who didn't require hospitalization.
 
Dr Nalbandian stressed, "Active engagement with these groups is crucial, along with participation in clinical trials for longitudinal assessment."
 
“Although the medical community now has a better grasp of the constellation of the long-term symptoms that occur after COVID, we don't know the duration and the long term complications," Dr Nalbandian added.
 
Dr Nalbandian said,”In order to learn more, we need to refer patients to trials, and we've listed many active research studies in our review.Health care providers are still overburdened taking care of patients with acute COVID, but that's a collective responsibility of the medical community at large."
 
Wary Of Health Policy Makers Obstructing Critical Care Needed For Follow Ups Checks On Recovered COVID-19 Patients  To Monitor And Treat Long COVID
 
There are some health care policy makers who have double roles as physicians who are trying to prevent mandatory or routine check-ups for recovered COVID-19 patients so that the healthcare system is not put under pressure and are hence trying to downplay on Long COVID-19 issues. Concerned doctors and long COVID-19 patients should be wary of such individuals.
 
An example of such health policy individuals is a professor from Harvard Medical who has not been involved directly with any COVID-19 or Long COVID-19 research but is making public statements about Long-COVID and trying to downplay the seriousness of Long COVID-19. https://www.statnews.com/2021/03/22/we-need-to-start-thinking-more-critically-speaking-cautiously-long-covid/
 
For more on Long COVID-19 keep on logging to Thailand Medical News or a new site: www.longcovid.news which will be up and running in about a month time.