COVID Long Haulers – Long-Term Effects COVID-19

Because COVID-19 first appeared in late 2019, much remains to be learned about its short and long-term effects on health. As the pandemic progresses, we have learned that there are numerous ways the infection can impact a person’s health. And in addition to the lungs, it has also been shown that COVID-19 can affect many other organs in the body to varying degrees.

Most people recover and return to normal health following COVID-19 whereas others, experience symptoms that linger for weeks or even months following initial infection. Those who did not require hospitalization are not immune from persistent symptoms as even patients with mild cases of COVID can have long lasting effects. The Centers for Disease Control continues to research how common symptoms are, those most likely to suffer from them, and if the symptoms will resolve eventually.

Long-term symptoms that are most commonly reported include:

  • Fatigue
  • Cough
  • Shortness of breath
  • Chest pain
  • Joint and muscle pain
  • Trouble concentrating and focusing (sometimes called “brain fog”)
  • Depression
  • Headaches
  • Intermittent fever
  • Pounding or rapid heartbeat (heart palpitations)

Given that some experience symptoms that last months after initial COVID infection, there is growing concern that long-term complications could arise. COVID-19 can impact multiple organ systems throughout the body so this article will examine how the virus impacts them in the long term.

Cardiovascular System

Even in patients without pre-existing heart disease, growing evidence suggests that COVID-19 does some damage to the heart. An inflammation of the heart muscles, myocarditis is one such complication that has been tied to COVID-19 infection. Healthcare professionals are concerned that complications like this, could lead to a potential increase in instances of heart failure.
Data shows that almost a quarter of hospitalized COVID-19 patients have been diagnosed with cardiovascular complications and those complications have contributed to approximately 40% of all coronavirus-related deaths. However, recent studies suggest that heart damage may be more prevalent amongst those infected with COVID. One such study in JAMA Cardiology that analyzed autopsies of 39 COVID patients, identified heart infections in patients that had not previously been diagnosed with cardiovascular issues while sick.

In a separate JAMA Cardiology study, cardiac MRIs of 100 patients that recovered from COVID-19 within the past two to three months were reviewed. Heart abnormalities were found in 78% of recovered patients with 60% showing ongoing myocardial inflammation. The same study also found elevated levels of the enzyme troponin, a heart damage indicator, in 76% of the patients tested though, heart function generally appeared to be maintained. Hospitalization was not required for most of the participants in the study.

For those recovering from COVID-19, the following symptoms should be monitored for and if they are experienced, a physician or cardiologist should be contacted promptly:

  • Extreme or frequent shortness of breath with exertion
  • Chest pains
  • Swelling in the ankles
  • Irregular heartrate
  • Heart palpitations
  • Lightheadedness
  • Dizzy spells

Respiratory System

Just as other respiratory illnesses can, COVID-19 has the potential to cause long-lasting damage to the lungs. One complication that can arise from a COVID-19 infection is pneumonia that causes the lungs to fill with fluid and become inflamed. This can lead to breathing trouble that in some instances, will require supplemental oxygen or hospitalization for a ventilator. The pneumonia associated with COVID-19 tends to affect both lungs and can result in breathing trouble that could take months to remedy.

As COVID pneumonia advances, the small blood vessels in the lungs leak fluid into the air sacs. Shortness of breath eventually sets in and a type of lung failure called acute respiratory distress syndrome (ARDS) can develop. Often unable to breath unassisted, ARDS patients may need a ventilator to circulate oxygen throughout their body. ARDS can be fatal and those that recover from it, may have scarring of the lungs.

Sepsis is also a potential pulmonary complication that could arise from a severe COVID-19 infection. Sepsis occurs when an infection spreads throughout the bloodstream leading to tissue damage wherever it goes. The body systems are designed to work in unison but when sepsis occurs, the organs fail to cooperate and can begin to systematically shut down.

Renal System

Kidney damage is another side effect of severe COVID-19 regardless of any pre-existing kidney conditions existing prior to infection. Early data suggests that as many as 30% of patients that were hospitalized due to COVID-19 developed moderate to severe kidney injuries. Kidney problems for COVID-19 patients manifest through abnormal blood work and as high protein levels in the urine.
COVID infects kidney cells which have receptors that the virus to attaches to, invades, and replicates. The cells of the heart and lungs have similar receptors where COVID has also been known to cause damage. Kidney problems in COVID patients could also be attributed to low oxygen levels in the blood, commonly associated with pneumonia seen with severe cases of the virus.
In some cases, COVID related kidney damage is so severe that it requires dialysis. With COVID-19 cases surging in certain areas, some hospitals have been overwhelmed and reported shortages of the sterile fluids and machines required to perform kidney procedures. To date, it is not yet known if kidney function will be regained for people with COVID-19 related kidney damage.

Neurological System

When COVID-19 first broke out, the primary focus of doctors was on keeping patients breathing and treating any lung or circulatory system damage. But even early on, evidence was mounting that the virus had neurological effects. Some patients hospitalized with COVID were experiencing confusion, agitation, disorientation while others suffered from brain inflammation and swelling.
Now included amongst the list of neurological issues are brain hemorrhages, memory loss, and stroke. Other serious diseases can cause such issues but with the volume of COVID-19 cases, thousands or tens of thousands of people could develop these symptoms and face lifelong complications as a result. Less commonly, complications like anxiety, peripheral nerve damage, and post-traumatic stress disorder have been reported.

The reason why the brain is affected from COVID-19 remains one of the most pressing questions facing neuroscientists.

What Types of Symptoms do COVID Long Haulers Experience?