Some young, healthy patients who catch the coronavirus are reporting long-term, debilitating illness. Chelsea Alionar, a 37-year-old in Keizer, Ore., is going on more than 100 days of being sick, with a racing heart beat, chest pains and numbness. Emily Jensen, a 34-year-old surfer and runner in Minneapolis, says she now needs an inhaler just to walk up the stairs. Annie Harris, a 22-year-old recent college graduate, struggles with extreme fatigue and headaches in Greenwich, Conn. And a French opera singer has been told that her lungs are permanently scarred and she will not be able to sing professionally again. The women all tested positive for COVID-19 roughly three months ago, yet they are still experiencing symptoms or aftereffects of the disease. They’re part of a group of long-term patients that doctors are increasingly studying in an effort to better understand the lasting impact of COVID and why some patients suffer long term consequences while others do not.
The science behind what’s happening is still nascent, but some theories are emerging. Some doctors believe the culprit is a neurological condition that may affect up to 15% of all Covid-19 patients. Others blame chronic fatigue syndrome. Some believe it is due to an immune responses gone haywire. Long-term patients’ symptoms vary widely, from elevated heart rates and trouble breathing to gastrointestinal problems and cognitive difficulties. Many of these patients are younger and had previously been healthy and came down with COVID cases only considered mild to moderate. But months later they are still sick, and some are getting worse.
In May, Mount Sinai Health System in New York City opened a Center for Post-COVID Care illustrating the seriousness and reality of this problem. The center is monitoring roughly 1,000 COVID-19 patients with initially mild to moderate cases, whose symptoms have lasted on average 50 to 70 days. David Putrino, Mount Sinai’s director of rehabilitation innovation, believes most of these patients are developing a neurological condition called dysautonomia, which occurs when the autonomic nervous system is out of balance. The autonomic nervous system controls functions such as temperature, blood pressure and heart rate. Symptoms can include racing heart rate, extreme fatigue and shortness of breath. This blog earlier reported on psychological symptoms in COVID patients and, given the fact that the ACE-2 receptor that the virus binds to is found in vascular endothelium (cells lining veins, arteries and capillaries), systemic effects of the infection in different organs makes sense. But, the widely disseminated effects could also be due to an overactive immune response.
More and more this looks like a completely new disease and medical care for COVID-19 patients with quite different symptoms is being learned on the fly.
We will see.