The worldwide efforts to flatten the curve of coronavirus infection is literally about life and death. Slowing the spread of COVID-19 as much as possible gives our health care systems the best chance of being able to support and treat patients through COVID infection, keeping death rates as low as possible. Thus, the stats we are now very used to seeing revolve around the hard facts: case numbers, hospitalizations, ICU admissions, death, and numbers recovered (typically defined by two negative COVID test results, and/or clinical recovery).
What hasn’t been talked about much (yet) is whether there could be a risk of long term health consequences after a person has ‘recovered’ from COVID-19.
One of the hallmarks of severe COVID-19 infection that is repeatedly described is a profound inflammatory response, also known as a cytokine storm. This cytokine storm can lead to acute respiratory distress syndrome (ARDS), inflammation of the heart, and multisystem organ failure.
We know that after acute respiratory distress syndrome (ARDS) of other causes, there can be scarring (pulmonary fibrosis) that results in chronic lung disease. After our previous SARS epidemic, some survivors were found to develop pulmonary fibrosis. So, it seems entirely plausible that people who have had COVID-induced pneumonia or ARDS could be at risk of chronic lung disease as well.
As the coronavirus epidemic is still so new and acute, we don’t have data on chronic complications yet. This study evaluated radiological findings of people discharged from hospital after having had COVID pneumonia. Despite all patients being confirmed to be clear of infection (with two negative COVID tests), 94% still had residual lung disease on their final CT scans (pulmonary function testing was not done to see if these findings correlated with impaired function). In this article about the effects of COVID on the heart, the authors discuss that longer term cardiac complications may arise long after the virus is cleared.
I suspect that we will see some survivors of COVID-19 bearing lifelong complications such as pulmonary fibrosis, cardiac fibrosis causing heart failure, and other post inflammatory complications as well. Only time will tell what we see in terms of long term complications that may arise from COVID-19.
While we don’t yet know what the risk or nature of long term complications post COVID infection will look like, I feel this is important to talk about NOW, as another reason to emphasize the importance of preventing the spread of this virus. The unknown of possible long term complications of coronavirus infection is another reason why ALL of us must take care to continue to self isolate, practice hand hygiene, and do everything necessary to prevent the spread of this virus.
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