What is deeply concerning to me is that Long COVID can affect anyone who has tested positive for COVID—from those who experienced mild symptoms to those who were severely ill. Furthermore, although you may not have Long COVID after your first COVID infection, each reinfection can substantially increase the risk of developing it.
This nationwide population-based cohort study initially identified higher risk of incident HL and SSNHL among young adults in the COVID-19 group. After IPTW, the COVID-19 groups showed 3.44-fold and 3.52-fold higher risks of HL and SSNHL, respectively, compared to the non-COVID-19 group. These associations remained significant after adjusting for metabolic profiles and lifestyle behaviors.
Hye Jun Kim, Seogsong Jeong, Kyuwoong Kim, Joon Don Lee, Yun Hwan Oh, Michelle J. Suh
And that, she says, is what most people fail to understand about long COVID: how serious it is, how much is at stake — how fast a healthy girl with boundless energy and big dreams can lose it all. "They think it's incredibly rare, or they don't understand that just because you had one 'nice' bout of COVID doesn't mean the next one isn't going to do permanent damage," Katie says. "People just underestimate it; they assume it won't happen to them and if it does, that someone will be there to help them."
The danger is clear and present: COVID isn’t merely a respiratory illness; it’s a multi-dimensional threat impacting brain function, attacking almost all of the body’s organs, producing elevated risks of all kinds, and weakening our ability to fight off other diseases. Reinfections are thought to produce cumulative risks, and Long COVID is on the rise. Unfortunately, Long COVID is now being considered a long-term chronic illness — something many people will never fully recover from.
Experts say the findings should spark a paradigm shift in the way hospitals approach COVID infection prevention — that's if the latest indicators of illness and death don't.
Independently, advocates, researchers, and clinicians also reported seeing an increase in the number of people who have developed long COVID after a second or third infection. John Baratta, MD, who runs the COVID Recovery Clinic at the University of North Carolina, said the increase is related to a higher rate of acute cases in the fall and winter of 2023.
He stressed that people underestimate the risk of COVID infections in general and, more specifically, the risk of repeated reinfection. Even mild cases can lead to long COVID, especially if it isn’t the first time a person has become sick. One study from Statistics Canada found that around 15 percent of people reported having persistent symptoms after their first infection. That number approaches 40 percent after the third and subsequent infections.
She knew about Long COVID, the name for chronic symptoms following an infection, because her 11-year-old son has it. But “he didn’t have anything like this,” she says. “His set of symptoms are totally different,” involving spiking fevers and vocal and motor tics. Her own experience was so different from her son's, it was hard to believe the same condition could be to blame. “I just thought, ‘It’s really coincidental that I never got well, and now I’m getting worse,’” she says.
For Andrew Miller, a Perth-based anaesthetist and chair of OzSAGE, an independent advisory group of experts in epidemiology, health and economics, a major problem is that COVID is too often being treated by hospitals as a "common cold" when it should be treated as seriously as tuberculosis or golden staph.
Until 2020, Dr Putrino worked mostly with people who had suffered stroke and traumatic brain injury — typically sudden events that result in disability and big shifts in the dynamics of patients' relationships. Now, he sees those same changes rippling through the families who visit his long COVID clinic.
COVID-19 was associated with a significantly increased risk for RSV infections among children aged 0–5 years in 2022. Similar findings were replicated for a study population of children aged 0–5 years in 2021. Our findings suggest that COVID-19 contributed to the 2022 surge of RSV cases in young children through the large buildup of COVID-19-infected children and the potential long-term adverse effects of COVID-19 on the immune and respiratory system.
Lindsey Wang, Pamela B Davis, Nathan Berger, David C Kaelber, Nora Volkow, Rong Xu
Public facing industries, including teaching and education, social care, healthcare, civil service, retail and transport industries and occupations, had the highest likelihood of long-COVID.
Theocharis Kromydas, Evangelia Demou, Rhiannon Edge, Matthew Gittins, Srinivasa Vittal Katikireddi, Neil Pearce, Martie van Tongeren, Jack Wilkinson, Sarah Rhodes
Acute SARS-CoV-2 infection and PCC have been documented to have the following effects: cardiovascular, pulmonary, renal, psychologic, neurologic / cognitive, gastrointestinal, immunologic, endocrine, reproductive, genitourinary, dermatologic
But a massive new study confirms that COVID-19 — specifically, “long COVID,” which can kick in well after an initial infection — remains a significant risk even for those who had the mildest of cases.
People who endured even mild cases of covid-19 are at heightened risk two years later for lung problems, fatigue, diabetes and certain other health problems typical of long covid, according to a new study that casts fresh light on the virus’s true toll.
21% of people hospitalized with COVID-19 and 11% of those who were not hospitalized for COVID-19 developed high blood pressure, compared to 16% of people hospitalized with influenza and 4% of those not hospitalized for influenza.
“I think that we need to understand that infections lead to chronic disease and we need to take infection seriously,” even when it seems to be mild, Al-Aly said.
A rough estimate pegs the size of the population affected by long Covid symptoms at between 7.7 million to 23 million people in the country, according to the U.S. Department of Health and Human Services.
Long COVID can affect many aspects of a person’s life, including their ability to work and afford to meet their basic needs, which can affect their recovery and long-term health and well-being.
Michael Karpman, Olivia Fiol, Susan J. Popkin, Lisa McCorkell, Elaine Waxman, Sarah Morriss
(1) People can be reinfected with SARS-CoV-2, the virus that causes COVID-19, multiple times. Each time a person is infected or reinfected with SARS-CoV-2, they have a risk of developing Long COVID. (2) Living with Long COVID can be hard, especially when there are no immediate answers or solutions.
Long COVID symptoms adversely affected the day-to-day activities of 1.5 million people (79% of those with self-reported long COVID), with 381,000 (20%) reporting that their ability to undertake their day-to-day activities had been “limited a lot”.
What we do know, definitively and without question, is that COVID-19 is not “just a cold,” as some right-wingers have maintained. As the Nature Reviews article notes, “SARS-CoV-2 has the capacity to damage many organ systems.”
Although the majority of patients infected with SARS-CoV-2 recover within a few weeks, long COVID is estimated to occur in 10–20% of cases and affects people of all ages, including children, with most cases occurring in patients with mild acute illness.
Some patients, Pittman says, “have the expectation that they're going to come in, and within a month they're going to be back to normal. And resetting those expectations can be really challenging. You have to be really empathetic because people's lives have completely changed.”
The incidence of new seizures or epilepsy diagnoses in the 6 months after COVID-19 was low overall, but higher than in matched patients with influenza. This difference was more marked in people who were not hospitalized, highlighting the risk of epilepsy and seizures even in those with less severe infection. Children appear at particular risk of seizures and epilepsy after COVID-19 providing another motivation to prevent COVID-19 infection in pediatric populations.
Maxime Taquet, MD, PhD; Orrin Devinsky, MD, PhD; J. Helen Cross, MD, PhD; Paul J. Harrison, DM, FRCPsych; and Arjune Sen, MD, PhD
About 18% of people with long Covid hadn’t returned to work for more than a year, according to a report by the New York State Insurance Fund, state’s largest workers’ compensation insurer.
Children – even healthy teens and the very young – can have long Covid, several studies have found, and it can follow an infection that’s severe or mild.
Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identified with impacts on multiple organ systems.
Hannah E. Davis, Lisa McCorkell, Julia Moore Vogel & Eric J. Topol
“It’s not like, ‘Oh, I’ve had one, so it’s OK. Now I can take off my mask, do what I like.’ It has health consequences for reinfections – higher mortality rate, higher hospitalization rates, higher risk of long term, lingering symptoms,” she says.
The overall labor impact of long Covid is tough to quantify. Estimates suggest hundreds of thousands to millions may be out of work, at a time when there are historic levels of job openings.
Long Covid has affected as many as 23 million Americans to date — and it’s poised to have a financial impact rivaling or exceeding that of the Great Recession. By one estimate, the chronic illness will cost the U.S. economy $3.7 trillion, with extra medical costs accounting for $528 billion.
For people with COVID who were hospitalised, the point at which a diagnosis of seizures or epilepsy was most common was at nine days after infection. For those who were not hospitalised, the peak was at 41 days. In children with COVID, the peak point for seizures or epilepsy was at 50 days after infection and at that time children who had COVID were three times more likely to have epilepsy or seizures than children who had flu.
Arjune Sen
Head of the Oxford Epilepsy Research Group, University of Oxford
The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.
For now, though, even vaccinated, boosted, and previously infected people aren’t immune to Long COVID. Any infection could lead to lingering complications, which underscores the importance of limiting exposure to the virus as much as possible.
Long COVID costs at least $60 billion up to as much as $100 billion a year in just lost wages. The annual cost of medical care for these patients may be another $100 billion. And those numbers don’t factor in decreased productivity from people working with severe fatigue and brain fog, or family members of long COVID patients who must reduce their work hours to take on caretaker roles. Acute COVID is a pandemic; long COVID could be a mass disabling event.
Katie Bach and David Cutler
Date published: Oct. 31, 2022
Date archived: Sept. 5, 2023
Article on statistics
Journalist
European Centre for Disease Prevention and Control
What puzzles me is why it is so difficult to understand that long Covid can be disabling and that not working isn’t really much of a choice. It is that getting well is the job. When most people do recovery, they do want to and need to work.
Denise Brodey
Senior Contributor - Award-winning advocate for disabled jobseekers and employees.
After SARS-CoV-2 infection, one study found evidence many of these cells had been activated and “exhausted”. This suggests the cells are dysfunctional, and might not be able to adequately fight a subsequent infection. In other words, sustained activation of these immune cells after a SARS-CoV-2 infection may have an impact on other inflammatory diseases.
Dr. Lara Herrero
Research Leader in Virology and Infectious Disease, Griffith University
We show that Covid-19 illnesses persistently reduce labor supply. Using an event study, we estimate that workers with week-long Covid-19 work absences are 7 percentage points less likely to be in the labor force one year later compared to otherwise-similar workers who do not miss a week of work for health reasons.
Opinion: Can having Covid trigger shingles? Yes, probably, according to Associate Professor Helen Petousis-Harris, and you might want to think about a shingles vaccine.
On top of the toll it takes on their health, long Covid patients report a devastating impact on finances, including massive medical expenses and job losses.
Policymakers, public-health officials, and the media “have often portrayed covid as a short, flu-like disease, especially in the young,” Perego wrote in an email. As a result, people might not make the connection between a case of COVID-19 and health issues months later, especially if they had a mild initial illness or are fully vaccinated; other people may have been asymptomatically infected or got a false-negative test result, so they don’t know they had COVID-19 at all.
[...] and (3) a greater reduction in global brain size in the SARS-CoV-2 cases. The participants who were infected with SARS-CoV-2 also showed on average a greater cognitive decline between the two time points.
Gwenaëlle Douaud, Soojin Lee, Fidel Alfaro-Almagro, Christoph Arthofer, Chaoyue Wang, Paul McCarthy, Frederik Lange, Jesper L. R. Andersson, Ludovica
COVID-19 doesn’t have to be medically severe to take a toll. Lekshmi Santhosh, a critical-care physician at UCSF, has seen Omicron exacerbate chronic health issues to the point where they turn fatal. “You could say they didn’t die of COVID,” she told me. “But if they didn’t have COVID, they wouldn’t have had this issue.” Iwasaki, of Yale, also worries about the storm of long-COVID cases, which can sprout out of infections that are initially almost symptom-free, that may soon be on the way. “Some of these people are bedridden, unable to return to work for months,” she told me. “There is nothing
Having been fit and active, I now find that on bad days I still struggle with everyday chores, and my usually quick-firing brain remains in slo-mo (“brain fog”), a far cry from the way it used to function when I was still working as a consultant in infectious diseases.
Vaccines reduce the risk of long COVID by lowering the chances of contracting COVID- 19 in the first place. But for those who do experience a breakthrough infection, studies suggest that vaccination might only halve the risk of long COVID — or have no effect on it at all.
Potential contributors to PASC symptoms include consequences from acute SARS-CoV-2 injury to one or multiple organs, persistent reservoirs of SARS-CoV-2 in certain tissues, re-activation of neurotrophic pathogens such as herpesviruses under conditions of COVID-19 immune dysregulation, SARS-CoV-2 interactions with host microbiome/virome communities, clotting/coagulation issues, dysfunctional brainstem/vagus nerve signaling, ongoing activity of primed immune cells, and autoimmunity due to ...
Another consistent finding is that it does not appear to matter whether non-hospitalized patients had more severe cases of COVID-19, mild cases or even cases that caused no symptoms at all.
In this cohort of individuals with COVID-19 who were followed up for as long as 9 months after illness, approximately 30% reported persistent symptoms. A unique aspect of our cohort is the high proportion of outpatients with mild disease.
Jennifer K. Logue, BS; Nicholas M. Franko, BS; Denise J. McCulloch, MD, MPH; Dylan McDonald, BA; Ariana Magedson, BS; Caitlin R. Wolf, BS; Helen Y. Chu, MD, MPH
