'Long Covid' can affect anyone who has had Covid-19 and should be considered a 'major health crisis,' VA research expert says

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Title : 'Long Covid' can affect anyone who has had Covid-19 and should be considered a 'major health crisis,' VA research expert says
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'Long Covid' can affect anyone who has had Covid-19 and should be considered a 'major health crisis,' VA research expert says

By Melissa Patrick
Kentucky Health News

Long-Covid impacts between 4% and 7% of the general population and will have a major impact on our economy and health systems, according to research presented at the annual HealthWatch USA conference, held online Sept. 14. 

Dr. Ziyad Al-Aly
"We think it's really a major health crisis,"  Dr. Ziyad Al-Aly, chief of research and development service at Veterans Affairs St. Louis Health Care System, said, later adding, "So we think it's very, very important that governments and health systems prepare for the people in need of post- Covid care." 

Al-Aly is a clinical epidemiologist who also serves as the co-chair of the U.S. government-wide committee tasked to develop a national research action plan on long-Covid. 

Al-Aly noted that the phrase long-Covid came from an early analysis of prolonged Covid-19 symptoms by a group of long-Covid patients.  Their early surveys found that some people were still experiencing weakness, fatigue, brain fog, muscle pain and other manifestations months after their initial Covid-19 infection, 

He said these early surveys is what prompted further scientific research and that this group is now called the Patient-Led Research Collaborative 

"I really think this is a historic moment in the history of medicine, in the annals of medicine, that patients came to the fore and looked at all the of us scientists [and said] something here is wrong and needs to be investigated, needs to be researched and really gave the disease, they gave the entity its name," he said.  

Graphic: Al-Aly et al. Nature 2021
Al-Aly said his team's research found that Covid-19 patients, who were 30 days post infection, went on to have a variety of problems, including cardiovascular conditions, respiratory problems, persistent cough, shortness of breath, kidney problems, mental health problems, musculoskeletal disorders, malaise, fatigue and anemia, and more. 

"So this is really not a respiratory virus," he said. "It's really a systemic virus, it's a systemic illness that can affect nearly every organ system." 

Further he said that while his research found that  people who were hospitalized for Covid-19  have a much higher risk of long-Covid, and that that risk was highest among those who were in intensive care or in need of mechanical ventilation -- anyone who has ever had Covid is at risk.

"The risk was evident, even among those people who nursed it at home and did not need to be hospitalized," he said. "So this is really very important because the lion's share, the majority of people with Covid-19 don't ever get hospitalized." 

His research also looked at how long-Covid played out in different racial groups, sex groups age groups and health status. And while long-Covid is lumped under a broad umbrella term, he said his research found that long-Covid is "multifaceted"  and "non-monolithic," meaning that some long-Covid conditions were more pronounced in younger individuals, and some were more pronounced in older ones and the same was true across race, sex and and baseline health status. 

Al-Aly said his team is really concerned about some of the chronic conditions that are resulting from long-Covid, including cardiovascular disorders, new onset diabetes, kidney disease, and neurologic and mental health disorders. 

"Some of these conditions could really impact life expectancy and could really stick with people for a lifetime," he said. 

For example, he said their research found that people who had had Covid-19 have a significantly increased risk of kidney disease and that even in patients that did not require hospitalization, a trajectory of their kidney disease over time is the equivalent to aging two to four years, instead of just one. 

As for the increase in mental health and substance use disorders among people who have had Covid-19, Al-Aly cautioned that this could cascade down to becoming a suicide epidemic in the next few years if these issues are not urgently addressed. 

He added that his research has found that Covid-19 vaccinations reduce, but do not eliminate the risk of long-Covid. 

"Overall, the risk reduction that we see in our in our population is about literally 15% . . .  and that's not very high," he said. "It  is definitely doing something,  it is definitely contributing to risk reduction. But it's certainly not . . .  the panacea, or sort of the  tool that can really totally . . . eliminate the risk of long- Covid." 

Al-Aly recognized that some other studies have found Covid-19 vaccines to offer higher risk reduction to long-Covid and said this is likely due to how each of the studies define the condition. 

He also touched on some of the major hypotheses around what is causing people to develop long-Covid and said the leading one is that the virus is persisting or not clearing in some people and that is what provokes further inflammation and the aforementioned conditions. 

Al-Aly wrapped up by saying that our current focus on Covid-19 only addresses the "tip of the iceberg" and does not focus on the long-term manifestations of Covid-19 and its effect on life expectancy. 

All of the slides and videos from the speakers at the HealthWatch USA conference, titled "Frontline Worker Safety in the Age of Covid-19: A Global Perspective" will soon be made available on its website.  HealthWatch USA is a non-profit organization that promotes health care transparency and patient advocacy based in Somerset. 




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