Findings from a large comprehensive study of COVID-19 show that COVID-19 survivors - even those with mild symptoms - have to deal with a variety of health problems long after the infection has resolved. Study findings show that COVID-19 survivors, including those not hospitalised, had an increased risk of death six months after a COVID-19 diagnosis. 


These findings highlight the long-term burden of this disease and how it is likely to continue to affect people in the coming years. The study involved over 87,000 COVID-19 patients and 5 million control patients in a federal database. Results of the study demonstrate that up to six months after diagnosis, the risk of death after even a mild case of COVID-19 cannot be ignored. This risk increases with disease severity. Millions of people worldwide have been infected with coronavirus. If one considers these findings, it becomes evident that the lingering effects of COVID-19 are likely to stay for decades. 


In this study, researchers did not focus on neurologic or cardiovascular complications. They took a broad view of the disease. Their findings show that after surviving the initial infection, survivors of COVID-19 had a 60% increased risk of death over the following six months compared with the general population. At six months, excess deaths among survivors of COVID-19 were estimated at eight people per 1000 patients. In patients who had severe symptoms which required hospitalisation and who survived beyond 30 days, mortality was higher (29 excess deaths per 1000 patients over the following six months). 


The researchers also point out that deaths that occur later due to long-term complications are not recorded as deaths due to COVID-19. Hence, as far as the death toll from the pandemic is concerned, those might only be the tip of the iceberg, since only those deaths are being counted as COVID-19 deaths that occur immediately due to the viral infection. 


COVID-19 may be a respiratory virus, but it can affect nearly every organ system in the body. According to the researchers, several major health issues can persist in COVID-19 survivors over at least six months and affect every organ and regulatory system. These health issues include cough, shortness of breath, low oxygen levels in the blood, stroke,  headaches, memory problems, problems with senses of taste and smell, anxiety, depression, sleep problems, substance abuse, new onset of diabetes, obesity, high cholesterol, acute coronary disease, heart failure, heart palpitations, irregular heart rhythms, constipation, diarrhoea, acid reflux, acute kidney injury and chronic kidney disease, blood clots, skin rash, hair loss, joint pain, muscle weakness, malaise, fatigue and anaemia.


Patients hospitalised because of COVID-19 fared worse than those who had influenza. COVID-19 survivors had a 50% increased risk of death than flu survivors, and COVID-19 survivors had a substantially higher risk of long-term medical problems.


While some of these problems may improve with time, others could get worse. Thus, it is important for healthcare providers to follow up on these patients to identify and monitor any ongoing impacts of the virus. 


Source: Nature

Image Credit: iStock



Al-Aly Z., Xie Y. Bowe B (2021) High-dimensional characterization of post-acute sequalae of COVID-19. Nature.

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COVID-19, post-COVID-19, pulmonary system Post-acute Sequalae of COVID-19