Study shows that “long Covid” disables more than heart disease or cancer

People who survived Covid-19 early in the pandemic, before vaccines were available, remained at increased risk of a range of health problems for up to two years after they had overcome their initial infections, according to a new study, and that was longer. common worse if they were hospitalized.

These health issues, which have come to be known collectively as long-term Covid, include heart problems, blood clots, diabetes, neurological complications, fatigue, and mental health issues.

When the researchers accounted for the risks of more than 80 different complications associated with long-term Covid, they translated the collective burden of harm into a metric called the “disability-adjusted life year,” or DALY , in the acronym in English. Each DALY represents one year of healthy life lost due to disease.

They found that long-term Covid generated more than 80 disability-adjusted life years, or DALYs, for every 1,000 people who were not hospitalized for an initial infection.

That means long-term Covid creates a greater burden of disability than heart disease or cancer, which cause about 52 and 50 DALYs per 1,000 Americans, respectively, according to the study. Global Burden of Diseasefrom the Institute for Health Metrics and Evaluation.

“When I first looked at this, I was really shocked,” said study author Dr. Ziyad Al-Aly, who is director of the center for clinical epidemiology at the Veterans Affairs St. Louis Health Care System. “Actually, it’s a huge number. We did the analysis several times and it was always the same.”

After considering his findings, though, Al-Aly said it really shouldn’t come as a huge surprise that long-term Covid is so disabling, because it affects so many different parts of the body.

Al-Aly said his study should be a wake-up call. “I think we need to understand that infections lead to chronic disease and we need to take infections seriously,” even when they seem mild, Al-Aly said.

The study, published on Monday (21) in the journal Nature Medicineanalyzed the medical records of nearly 140,000 veterans who survived for 30 days after contracting a Covid-19 infection in 2020 and compared their results with nearly 6 million other patients in the Veterans Affairs St. Louis Health Care System who showed no evidence of infection.

The research has some important caveats. On average, the people in the study were older, in their 60s, and nearly 90% were male, so the findings may not be reflected for younger people or for women.

None of the people in the study were vaccinated at the time they became infected because vaccines had not yet been developed and there were no antiviral treatments yet to target Covid-19. Since then, studies have shown that vaccination and early treatment can help reduce the long-term risk of Covid.

The researchers only included people in the Covid-19 infection group if they had a positive test, but tests were slow to roll out early in the pandemic, and researchers say many people may have had the infection without any test results recorded in your medical records.

This may have resulted in some people being included in the control group when they should have been in the infection group. If it were a large number of people, say the study’s authors, their results could be an underestimate of the true risks people faced after infection.

Al-Aly said he used this group because he wanted to learn more about the long-term outcomes for people who contract Covid-19 and needed to find patients who already had more than two years after infections, so those risks may have decreased over time. over time as vaccines and better treatments were developed.

Still, the study paints a worrying picture of how long people faced the physical consequences of infections before vaccines. The study found that people who were not hospitalized with Covid-19 were still at an elevated risk of death for about six months after becoming ill.

Over the two years, the risk of having many long-term Covid symptoms declined but remained elevated in about a third of the 77 illnesses studied.

Some of these persistent problems included blood clots, a slower-than-normal heartbeat, fatigue, diabetes, gastrointestinal problems, sleep problems, muscle and joint pain, headache, loss of hearing and smell, and autonomic nervous system dysfunction.

People in the group who had to be treated in hospital for an initial Covid-19 infection fared even worse. They remained at increased risk of death and hospitalization for at least two years after recovery from their acute symptoms.

Of the 77 long and different Covid conditions that were studied, hospitalized people remained at high risk in about two-thirds of them, even two years later. These included heart problems, stomach problems, memory and thinking difficulties, blood clots, diabetes and lung problems.

They were also more likely to have a substance use disorder, including alcohol and opioids, and were more likely to report the possibility of suicide.

“Our findings highlight the substantial cumulative burden of health loss due to long-term Covid and emphasize the continued need for health care for those facing long-term Covid,” said Al-Aly.

“It appears that the long-term Covid effects for many will not only affect these patients and their quality of life, but potentially contribute to a decline in life expectancy and could also affect work participation, economic productivity and social well-being.” .