Long Covid symptoms result in more impairment than heart disease or cancer, according to recent research

In contrast to those who did not test positive, those who survived Covid-19 early in the pandemic, before there were vaccines, continued to have a higher risk for a variety of health issues for up to two years after recovering from their initial infections. This was particularly true if they were hospitalized.

These health issues, which have come to be referred to as long Covid, include cardiac issues, blood clots, diabetes, neurologic consequences, exhaustion, and issues with mental health.

A disability-adjusted life year, or DALY, is a measure created by researchers after adding up the risks for more than 80 distinct problems linked to prolonged COVID. One year of healthy life lost to sickness is represented by one DALY. They discovered that for every 1,000 patients who weren't hospitalized for their first illness, extended Covid caused more than 80 disability-adjusted life years or DALYs.

According to the Global Burden of Disease research by the Institute for Health Metrics and Evaluation, long-term COVID-19 results in a larger burden of disability than either heart disease or cancer, which cause around 52 and 50 DALYs for every 1,000 Americans, respectively.

"When I looked at that initially, I was shocked," said Dr. Ziyad Al-Aly, the study's author and the head of the clinical epidemiology center at the Veterans Affairs St. Louis Health Care System. "That's a big amount.

We performed the analysis several times, but the results were consistently the same.

But after reflecting on their findings, Al-Aly asserted that given the extent to which Covid impacts the body, it shouldn't come as much of a surprise.

Al-Aly stated, "I think that we need to understand that infections lead to chronic disease and we need to take infections seriously," even if they appear to be minor.

The study compared the health outcomes of nearly 140,000 veterans who endured a Covid-19 infection for 30 days in 2020 to nearly 6 million other patients in the VA health system who showed no signs of infection. It was published on Monday in the journal Nature Medicine.

The study contains several crucial limitations. The findings might not apply to individuals who are younger or women since those who use the VA health system on average are older—in their 60s—and almost 90% of them are men.

Since vaccines and antiviral medications specifically formulated to treat Covid-19 were not yet available, none of the research participants had received vaccinations at the time they contracted the disease. Since then, research has demonstrated how long-term risk may be reduced by immunization and prompt treatment.

Since tests took a little to become widely available early in the pandemic, the researchers suggest many patients may have had the illness without test results being noted in their medical records. However, participants were only included in the Covid-19 infection group if they received a positive test. As a result, some individuals who ought to have been in the infection group could have been included in the control group. According to the study's authors, if that number was significant, their findings could represent an underestimate of the actual dangers that individuals experienced after infection.

Al-Aly said that he chose this group to learn more about the long-term effects of Covid-19 exposure and because he needed to locate patients who had recovered from their illnesses more than two years prior. As more effective vaccinations and treatments were created, these risks may have decreased over time.

The study still provides a grim picture of how long early illnesses hurt people's physical health.

According to the study, patients with Covid-19 who were not hospitalized continued to have a higher-than-average chance of dying for nearly six months after becoming unwell.

Additionally, over the following two years, patients' odds of experiencing several long-lasting Covid symptoms decreased, but they remained high for nearly one-third of the 77 investigated conditions. Blood clots, a slower-than-normal heartbeat, lethargy, diabetes, gastrointestinal issues, sleep issues, muscle and joint pain, headaches, hearing and smell loss, and autonomic nervous system dysfunction were a few of those persistent issues.

The study's scope and depth were complimented by specialists who were not affiliated with the researcher.

I find it quite intriguing that even after two years, those with COVID infection continue to have much worse health than people who did not. That's important, according to Dr. Linda Geng, co-director of the Stanford Clinic for Post-Acute Covid-19 Syndrome.

Even poorer outcomes were seen in those in the group who required hospitalization for a primary Covid-19 infection. For at least two years following the resolution of their acute symptoms, they continued to be at elevated risk of passing away and being admitted to the hospital.

People who were hospitalized continued to be at greater risk for around two-thirds of the 77 various long Covid problems that were assessed, even two years later. These included heart issues, stomach issues, cognitive and memory issues, blood clots, diabetes, and lung issues. They were also more likely to suffer from alcohol and opioid use disorders as well as other drug use disorders. Additionally, they were more likely to report having suicidal thoughts.

In her clinic, Geng says the study's findings are consistent with what she observes in her lengthy Covid-19 patients.

Long Covid, according to her, is such a wide range of issues that people must be aware that the study's findings could not apply to their particular circumstances.

Many people do improve, according to Geng. Some people may have experienced symptoms for a few weeks before improving over three months. There are also other individuals throughout the three to six-month time frame. Yes, a spectrum exists.

According to Geng, a person's position on that spectrum will vary depending on their age, pre-Covid-19 health, vaccination status, and use of antivirals during the early stages of illness.

The Johns Hopkins Bloomberg School of Public Health epidemiologist Bryan Lau, who is involved in the University's Covid Long study, praised the study for handling enormous amounts of data, but he points out that because the researchers were relying on electronic medical records for their data, they weren't able to talk to patients to delve into any of the trends they were seeing.

"They did examine DALYs, which, as you may know, is a gauge of the degree of impairment in this population. However, it also differs significantly from asking a familiar person, "Can you climb a flight of stairs?" The data can also be obtained by walking a quarter of a mile, according to Lau, who wasn't part of the study.

Finally, Lau said that despite the study's merits, it is wise to keep in mind that, in medical research, the truth is typically found in the body of data gathered through time, not in any one study.

Till more research is available, he added, "I take everything with a little bit of salt, if you will."