Long-term COVID-19 effects on the lungs, heart and brain: What experts say they know, and don’t know

Highlights

Damage to the lungs, heart and brain reported in patients tracked in an observational cohort study published October 5, 2020.

Older people and people with many serious medical conditions are most likely to face lingering COVID-19 symptoms.

Studies show long-term health challenges to COVID-19 patients long after recovery.

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Dubai: Most people who had been infected with COVID-19 recover within 14 days. But there are those who report brain fog, palpitations, constant tiredness, mood swings — up to 95 days after the onset of symptoms.

This was reported in the The Lancet quoting Paul Garner, a professor of epidemiology at Liverpool School of Tropical Medicine, UK. “I am unable to be out of bed for more than three hours at a stretch, my arms and legs are permanently fizzing as if injected with Szechuan peppercorns, I have ringing in the ears, intermittent brain fog, palpitations, and dramatic mood swings,” Garner wrote about his own experience with COVID.

Many others had similar complaints: the medical journal reported that 78 of 100 patients in an "observational cohort" study who had recovered from COVID-19 had abnormal findings on cardiovascular MRI (median of 71 days after diagnosis) and 36 of those reported dyspnoea and unusual fatigue. Neurological symptoms

Neurological symptoms are "extremely common" among coronavirus patients who had been hospitalised, said clinical researchers. The study, published on October 5, 2020 in the Annals of Clinical and Translational Neurology journal was led by Eric Liotta of the Department of Neurology of the Northwestern University Freinburg School of Medicine.

Citing patient data, they found that symptoms (from mild to severe) can include headaches, dizziness and "altered brain function". The findings highlight the coronavirus’ wide-ranging effects on the human body. Many of their patients continued to experience these symptoms long after they recovered from the disease, researchers reported.

In the study, Dr Liotta’s team reviewed medical records of the first 509 patients hospitalised within their network of 10 hospitals and medical centers in Chicago, Illinnois, in March and April 2020. About 1 out of 4 had been put on ventilators. Out of the 509 COVID-19 patients whose data were reviewed by a team led by Northwestern University researchers, it emerged that 1 out of 3 patients developed a more serious type of neurological problem: encephalopathy — altered brain function. One startling result: A majority of 509 patients — 82% — developed problems stemming from the nervous system. "That means 4 out of 5 hospitalised patients in our hospital system at the beginning of the pandemic had those neurologic problems," said Dr. Igor Koralnik, a co-author of the study and chief of neuro-infectious diseases and global neurology at Northwestern University (NU). Muscle pain was reported by nearly 44.8% of patients, and 37.7 percent complained of headaches.

One out of three patients developed a more serious type of neurological problem: encephalopathy — altered brain function. Problems ranged from mild symptoms, such as difficulty with attention, short-term memory, concentration and multitasking abilities, "all the way to confusion, stupor and coma," Koralnik said.

Many patients in the hospital with COVID complained of muscle aches, and loss of smell and taste. Those are reversible, and benign. But more than these, the NU data show that neurological manifestations are also common, even if often mild. However, more severe brain-function issues were more likely to occur in older patients over 65, the researchers reported.

The WHO clarified that these rather concerning effect happens in fewer than 5% of total infections. The world body reports that more than 80% do recover from the disease without needing special treatment. For the vast majority – especially children and young adults – illness due to COVID-19 is generally minor. The outcome vastly differs for some “immuno-compromised” persons (those who are over 60 years, and with underlying medical conditions such as diabetes, heart disease, respiratory disease or hypertension), who can face serious illness. Among those who face severe COVID-19 cases, it mainly affects the lungs. But recent research also show the heart and brain bear the disease’s brunt.

One effect of COVID-19 now known to clinicians is the disease’s ability to make blood cells more likely to clump up and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle. Blood clots are also known to damage the lungs, legs, liver and kidneys. Coronavirus can also weaken blood vessels — against contributing to potentially long-lasting problems with the liver and kidneys.

This raises the risk of long-term health problems, say experts. And it’s only now that clinicians are starting to get data on the pandemic’s long-term effects. As the contagion unfolds, one health effect that the US Centres for Disease Control and Prevention (CDC) is closely watching and working to understand relates to COVID-19’s knock-on effect on heart. One effect of COVID-19 now known to clinicians is the disease’s ability to make blood cells more likely to clump up and form clots. Large clots can cause heart attacks and strokes. However, much of the heart damage caused is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle. Blood clots are also known to damage the lungs, legs, liver and kidneys. Coronavirus can also weaken blood vessels — against contributing to potentially long-lasting problems with the liver and kidneys. One effect of COVID-19 now known to clinicians is the disease’s ability to make blood cells more likely to clump up and form clots. Large clots can cause heart attacks and strokes. However, much of the heart damage caused is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle. Blood clots are also known to damage the lungs, legs, liver and kidneys. Coronavirus can also weaken blood vessels — against contributing to potentially long-lasting problems with the liver and kidneys.

Myocarditis is an inflammation of the heart muscle (myocardium). Myocarditis can affect your heart […]

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