The health issues that an episode of COVID-19 sometimes leaves in its wake can be embarrassing, frightening, and quite mysterious. New research confirms that they can also be deadly.
AND study published Wednesday by the Centers for Disease Control and Prevention revealed that between January 2020 and June 2022, the long COVID was implicated in at least 3,544 deaths in the United States alone.
For memory :
8:43 a.m. on December 14, 2022An earlier version of this headline said the country’s long COVID death toll exceeded 4,000; the toll is over 3,500.
The study authors acknowledge that their tally of long-term COVID-related deaths is likely a significant undercount of people whose deaths were caused, at least in part, by the lingering effects of COVID-19. It represents only a fraction – less than 0.4% – of the more than one million pandemic deaths that occurred during the study period in the United States.
But the new research is helping to accumulate evidence that the COVID-19 toll doesn’t always end in a negative test. And it suggests that for many patients, new symptoms of poor health – from anxiety and difficulty sleeping to heart arrhythmias and blood clots – may have unrecognized roots in a previous coronavirus infection.
Sometimes these symptoms come from infections that patients didn’t even know they had.
“Viruses have long-term consequences,” said Dr. Ziyad Al-Alya physician with the St. Louis Veterans Health Care System who has studied the downstream health effects of an encounter with the SARS-CoV-2 virus.
“We’re pretty good at capturing acute illnesses,” he added. But researchers and medical professionals have a “major blind spot” when it comes to anticipating and detecting the longer-term fallout from a viral infection, he said.
Al-Aly, who was not involved in the new CDC research, teaches epidemiology at Washington University in St. Louis. He led a recent study that detected large increases in 20 cardiovascular diagnoses in patients over the year following infection with the virus that causes COVID.
The CDC report offers “a gross underestimate” of deaths likely attributable to long COVID, Al-Aly said. But, he added, it is clear that with greater awareness and a better accounting system, researchers might begin to understand how often viral infections sow the seeds of future illnesses.
For much of the time period covered by the new study, the lingering health effects of COVID-19 were not a well-defined syndrome. Scientists have come to know it as post-acute sequelae of COVID, or PASC, and the feds started a program to study it in February 2021.
In October 2021, the US government created a unique medical code to identify PASC in medical records. But the cause of PASC’s many symptoms often goes unnoticed, and American doctors continue do not use evenly the medical identification code.
So, to capture deaths in which PASC likely played a contributing role, researchers at the CDC’s National Center for Health Statistics had to search for clues buried in the language of death certificates. They started with 1,021,487 US death certificates indicating COVID-19 as the primary cause. Then they scanned each of the references to ‘chronic COVID’, ‘long COVID’, ‘long-haul COVID’ or ‘post-COVID syndrome’ – all terms that have been widely used to describe the motley set of afflictions. that some patients have suffered following they had apparently recovered from the disease.
An exact description of PASC — which most medical professionals now refer to as long COVID — continues to evolve. Its characteristic symptoms are fatigue, cough, chest pain or shortness of breath, muscle weakness, brain fog, palpitations, and anxiety or depression.
The World Health Organization reports that regarding 1 in 4 people who have had COVID-19 continue to have at least one symptom one month following diagnosis, and that regarding 1 in 10 have persistent symptoms following 12 weeks. In the USA, 7.5% of people who said they had persistent effects of COVID-19 reported three months following their recovery.
Scientists are racing to understand the long cause of COVID. A conjecture is that the syndrome is caused by residual viral debris that continues to activate and/or deplete the immune system. Another attributes it to a virus that hides and replicates undetected in organs where the immune system cannot reach it.
The simplest explanation — that a severe case of COVID-19 causes lasting organ damage — doesn’t explain why people who are barely ill sometimes end up with long COVID.
The new research found that a post-infection spiral to death was more easily detected in the elderly: just over 78% of death certificates that listed long COVID as a possible contributor were for patients aged 65 and over. more.
While women are believed to develop long COVIDs more frequently than men, the study found that death certificates citing long COVIDs were slightly more likely to name men (51.5%) than women. (48.5%).
During the pandemic, the list of organs that might be affected by COVID has grown, giving the picture of a virus that has traveled far beyond the lungs and upper respiratory tract. Likewise, the long COVID can be seen to affect an even wider range of organs as research progresses.
Cardiovascular problems have already appeared on the two expanded lists. Several months into the pandemic, doctors and scientists began to recognize that the coronavirus caused blood clots, leading to strokes, heart attacks and emboli.
The study by Al-Aly and colleagues showed that in the period of one to 12 months following patients recovered from COVID-19, they were at increased risk of developing a wide range of cardiovascular problems.
Compared to a similar group of patients who had not had COVID-19, those who had had it were 52% more likely to experience a stroke and 66% more likely to suffer from some form of flow blockage. blood to the heart, including one that results in a heart attack. Additionally, former COVID patients were 69% more likely than their unaffected peers to develop some form of cardiac arrhythmia.
Not surprisingly, people hospitalized with COVID were more likely to suffer from cardiovascular complications. But even patients with light contact with the coronavirus faced high risk. And while people over 65 were most likely to develop these complications, younger and healthier patients also saw their risks increase.