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Long-Haul COVID Symptoms Common, Rise With Severity of Illness

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THURSDAY, April 22, 2021 (HealthDay News) -- For people who've suffered through a bout of COVID-19, their misery is too often not over. New research shows that a wide variety of "long-haul" symptoms are common, and the risk rises along with the severity of their case of COVID-19.

In what may be the largest such study to date, "the findings show that beyond the first 30 days of illness, substantial burden of health loss — spanning pulmonary and several extrapulmonary [non-respiratory] organ systems — is experienced by survivors of the acute phase of COVID-19," according to a team led by Dr. Ziyad Al-Aly, of the VA St. Louis Health Care System, in St. Louis, Mo.

As reported April 22 in the journal Nature, the new study tracked outcomes for over 73,000 non-hospitalized COVID-19 patients and almost 5 million without the illness. It also compared outcomes for nearly 14,000 Veterans Affairs (VA) patients hospitalized with COVID-19 against those of a similarly sized group of VA patients who'd been hospitalized with the seasonal flu.

The bottom line, said the researchers, is that in the six months after onset of their illness, COVID-19 survivors had a 59% increased risk for death compared to people who hadn't had the illness, and a 20% higher odds of needing to go back for some form of outpatient care.

The COVID-19 patients also had raised risks for "several conditions in almost every organ system," ranging from respiratory illnesses to nervous system symptoms, to mental health issues, heart troubles, gastrointestinal issues and simply "poor general well-being," the St. Louis team reported.

What's more, the odds that COVID-19 survivors would encounter long-haul symptoms rose along a "risk gradient that increased across [the] severity" of their initial symptoms as they encountered the illness, Al-Aly's team said.

Two experts not connected to the report weren't surprised.

The VA finding "falls well in line with previous reports from other U.S. and foreign reports" on long-haul COVID-19, said Dr. Thomas Gut, associate chair of medicine and director of ambulatory care services at Staten Island University Hospital, in New York City.

"At our Post-COVID Recovery Center, most people affected experience neurocognitive and respiratory complaints, which correlates well with the VA data," Gut said. "Although the article does not discuss specific complaints related to each organ system, it does demonstrate that post-COVID syndrome contains multiple organ involvement."

Dr. John Raimo is chair of medicine at Long Island Jewish Forest Hills, also in New York City. He applauded the study, saying it gave doctors and the public a deeper understanding of the issue.

"The fact that patients with more severe disease had an increased risk for future symptoms can allow physicians to better plan for and counsel patients regarding the need for regular follow-up," Raimo said.

And Gut said the findings don't bode well for health care systems going forward.

"It's worrying how many people are currently being affected, and how many more would potentially develop this syndrome as the pandemic continues globally," he added.

More information

Find out more about long-haul COVID-19 symptoms at the U.S. Centers for Disease Control and Prevention.

SOURCES: John Raimo, MD, chair, medicine, Long Island Jewish Forest Hills, New York City; Thomas Gut, DO, associate chair, medicine, and director, ambulatory care services–medicine, Staten Island University Hospital, New York City; Nature, April 22, 2021, online

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