Three years after the first infection, the SARS-CoV-2 virus could continue to wreak havoc in the body of patients. Doctors believe that people with severe forms of COVID-19 should be monitored in the long term.
The effects of Covid-19, three years after infection – Photo Shutterstock
A new study by Washington University School of Medicine in St. Louis and the US Veterans Health Care System present important findings about Long COVID, offering both good news and not so good news.
Specifically, patients who were hospitalized in the first 30 days after infection with COVID-19 have a 29% higher risk of death in the third year compared to those who did not have the virus. In fact, even people with mild forms of COVID-19 continue to experience new health problems related to the infection three years later.
On the other hand, for those who did not require hospitalization, the risk of death decreases significantly one year after infection. This category represents the majority of people who have had COVID-19.
The research, published in the journal Nature Medicine, tracked the effects of the virus on people's health three years after they were infected with the original SARS-CoV-2 strain in 2020. Nearly 20 million Americans were infected in 2020, and 10% of them are battling Long COVID, according to the CDC.
“We don't know for sure why the effects of the virus persist for so long. Possibly related to viral persistence, chronic inflammation, immune dysfunction, or all of the above. We tend to think of infections as mainly short-term illnesses, with health effects occurring around the time of infection. Our data challenge this notion. I believe that the disease of COVID-19 continues to teach us – and this is an important new lesson – that a brief, seemingly harmless or benign encounter with the virus can nevertheless lead to health problems years later,” lead author Dr. Ziyad Al-Aly, a clinical epidemiologist at the University of Washington, a recognized world leader in COVID research, said in a statement.
Health problems years later
Previous research has shown that the disease COVID-19 can affect almost every organ, contributing to diseases of the lungs, heart, brain and other systems. However, long-term studies are limited.
Dr. Al-Aly and his team analyzed millions of medical records of American veterans to fill this gap. Specifically, the study, conducted between March 1, 2020 and December 31, 2020, included: more than 114,000 veterans with mild COVID-19, more than 20,000 hospitalized patients with COVID-19, and 5.2 million veterans without COVID-19.
The findings show that hospitalized patients had a 34% increased risk of health problems in the third year after infection, down from 182% in the first year and 57% in the second year. At the same time, non-hospitalized patients had a 5% increased risk of prolonged COVID, i.e. 41 additional health problems per 1,000 people. Long-term effects were mainly related to the gastrointestinal, pulmonary and neurological systems.
Three years after infection, COVID-19 contributed 10 years of healthy life lost per 1,000 people, comparable to stroke. In fact, the WHO recently warned that the COVID-19 pandemic reduced life expectancy, globally, by almost two years in the period 2019-2021.
“In just two years, the COVID-19 pandemic has erased a decade of progress in life expectancy“, emphasized the Director General of the WHO, Dr. Tedros Adhanom Ghebreyesus.
Dr. Al-Aly highlights the importance of continued patient monitoring and research to better understand prolonged COVID and improve care for those affected.
“The fact that a mild infection with SARS-CoV-2 can lead to new health problems three years later is a sobering finding. The problem is even worse for people with severe SARS-CoV-2 infection. It is very worrying that the burden of disease among hospitalized people is astronomically higher. The disease COVID-19 is a serious threat to people's long-term health and well-being and should not be trivialized. Even three years from now, you may have forgotten about COVID-19, but COVID hasn't forgotten about you“, he specified.
Estimates of prolonged COVID may evolve with post-2020 data, as vaccines and antivirals were not available then. The analysis does not include later variants such as Omicron or Delta.
“People might think that they got out of trouble, because they had the virus and had no health problems. But three years after infection, the virus could still wreak havoc and cause disease or conditions in the intestines, lungs or brain“, concluded the American expert.
Long-term monitoring
For his part, doctor Virgil Musta, from the “Victor Babeş” Infectious Diseases Hospital in Timisoara, confirms that patients with severe forms of COVID-19 must be monitored in the long term according to post-COVID manifestations (nervous system, cardiac, etc. .).
“Now, the manifestations of long COVID can be both on the nervous and cardiac systems, and others. Depending on these and the pathology triggered post-COVID, the patient must be consulted by the doctors in the respective specialties in order to keep under control the pathology that appeared or decompensated during the COVID period”explained Dr. Virgil Musta for “The Truth”.
At the same time, the doctor emphasizes the importance of the vaccine: “The vaccine lessens the long-term effects of COVID. There are fewer cases, but also deaths, deaths occur only in people with important comorbidities. There are complications too pathologies also triggered by the vaccine, but statistically, the pathology resulting from the disease is significantly greater than that resulting from the vaccine, and the severity is also greater. In other words, there is also a risk of triggering other pathologies, especially on the immune mechanisms of patients who take the vaccine, but the statistically significant COVID gives more complications and pathologies“, adds Dr. Virgil Musta.
Although the virus has lost its strength, post-Covid syndrome frequently affects people, regardless of risk factors, and can have severe manifestations.
“It is true that, on the one hand, the risk of death, during the acute period of the disease, has decreased, because the forms are no longer so severe. The last omicron strains give severe forms only in people with low immunity and important associated pathology, such as, for example, neoplasia or diabetics with heart failure, so people who have a high associated pathological load. On the other hand, the post-COVID syndrome occurs frequently in people with both risk factors and without risk factors, following the acute illness, and which, in certain people, manifests itself over a long period of time, sometimes with severe forms of evolving disease. That is why, in these people who present, on the one hand, the post-COVID syndrome and risk factors, the disease triggered or accentuated as a result of COVID decompensates and over time, can lead to deaths, more frequently than in people who do not they had COVID. Most of the post-COVID complications are related to the immune disorders and the inflammatory syndrome that appeared during the acute period of the disease. Related to the persistence of the virus, there are contradictory discussions, there are authors who support the idea of a chronic disease with the persistence of the virus that produces inflammatory changes, others have no proof of the persistence of the virus and deny this possibility.”, explains the doctor from the “Victor Babeş” Infectious Diseases Hospital in Timisoara.
COVID-19 in Romania
In the first year of the pandemic, 2020, more than 623,000 cases of infected people were confirmed in our country, almost 550,000 patients were declared cured, and 15,469 people died.
That year, thousands of people were admitted to hospitals in Romania, and over a thousand were in intensive care.
Today, four years after that moment, we still have weeks where there are more than 100 cases, even though not so many tests are being carried out. More precisely, last week, between May 20 and 26, the Ministry of Health reported 167 new cases of infected people. Of these, 34 people with COVID-19 were hospitalized in specialized health units, and two were in ATI wards. At the same time, the National Institute of Public Health announced last week two deaths (a man and a woman), in the over 80 age category. All patients had comorbidities, and one was vaccinated against COVID, stated the INSP.
