Oct. 14, 2021 — More than half of patients with COVID-19 still had symptoms 6 months after recovery, according to a major review of 57 studies and more than a quarter-million patients.
The results show that long-haul COVID-19 is common and lasting and will require changes in how the health care system operates, experts say.
According to the researchers, half of the survivors (nearly 80% in this study had been hospitalized for COVID-19) developed an swath of symptoms, including nervous sytem disorders, lung, heart and gut problems as well issues related to mental health problems, skin issues and “signs and symptoms related to poor general well-being, including malaise, fatigue, musculoskeletal pain, and reduced quality of life.”
The findings were published online Wednesday in JAMA Network Open.
“We need attention to this issue ASAP,” David Putrino, PhD, director of rehabilitation innovation for Mount Sinai Health System in New York, said.. “We need to understand that a large portion of individuals are experiencing persistent symptoms from their acute COVID-19 infection, and many of the persistent symptoms are extraordinarily debilitating and can lead to inability to participate in daily activities.”
Early in the pandemic, there was “a lot of expectation that this novel virus would be similar to the flu ― that individuals might get very sick, but when they recovered, they would be fully recovered,” Putrino, who was not part of the study, said. “The misunderstanding has been what happens when a novel type of virus ravages through the human body and leaves a toll behind.”
The fact that persistent symptoms are showing up whether or not patients were hospitalized and whether they were symptomatic or asymptomatic “has been a bit of a wake-up call.”
Putrino said his team primarily sees patients who have “invisible” but debilitating symptoms after COVID-19 despite most of their tests coming back normal.
Patients often report extreme fatigue if they physically, mentally or emotionally exert themselves, they experience symptoms for several days. Other commonly reported symptoms include chest pain, brain fog, suddenly feeling hot then cold, or discomfort after eating.
Putrino’s team works closely with Mount Sinai’s Center for Post-COVID Care, which has a much larger group of patients who have complex but medically explainable conditions.
With long-haul COVID-19,, better testing is needed, such as blood tests that can point to some of the complications this study describes, Putrino said.
He added that continuous remote monitoring will be important because symptoms “hit patients hard and then recede.
“This is when we’ll start to see a lot of the physiological dysfunction we might miss in the course of a routine physical examination in a doctor’s office,” Putrino said.
The biggest surprise in the article may be how many survivors of COVID-19 have symptoms for so long, study co-author Paddy Ssentongo, MD, assistant professor at the Center for Neural Engineering, at Pennsylvania State University, said.
Another key point is the vast array of symptoms patients experience: “Every organ is hit ― even the brain,” Ssentongo said
That presents challenges. Because of the fractured health care system In the United States, these patients will need to seek care on different days with different doctors unless they receive care in a long-haul COVID-19or other one-stop center, Ssentongo said.
Mental health effects after long COVID are vastly underestimated, he said.
If those problems are not addressed, the result could be an increase in depression, Ssentongo said. Mental health treatment was not widely prioritized even before the pandemic, he said. .
The COVID-19 pandemic may lead to the integration of mental health care and and physical healthcare.
“This is our best opportunity, since everyone is focused on COVID-19,” Ssentongo said.