A new study has linked mild COVID-19 to gut, brain and lung problems that develop up to 3 years after the viral infection has passed.
This is based on millions of Veteran Affairs records from the first year of the pandemic before the rollout of vaccines and antivirals.
Researchers compared more than 114,000 veterans who got mild COVID-19 with a control group of more than 5 million veterans who didn’t have COVID.
People with mild COVID-19 were:
- 8% more likely to have a GI problem than the control group three years later
- 10% more likely to have a neurological problem
- 22% more likely to have a pulmonary issue.
Dr. Ishwara Sankara, a neurointensivist with Texas Health Fort Worth, told KERA’s Sam Baker this may stem from inflammation.
COVID-19 showed us the inflammatory process that happens, especially after a post viral infection, can be much longer than what we anticipated before.
We know from previous data, especially with Epstein-Barr virus, that you can have long-term consequences.
COVID also seems to be mimicking the same process, where the inflammatory cascade that triggers in our body lasts longer. And this study reflects the same process that can last up to three years.
So you can develop inflammation from COVID-19 that can lie dormant for a while before a problem occurs?
What this study particularly talks about is that even two years or three years after the infection has occurred, these can last, like with patients who are predisposed to having strokes. They have an increased risk of having strokes even up to three years after this infection. And this process is more seen in patients who have been hospitalized for COVID-19.
Are we talking about a possible link or a proven direct causation here?
It is hard to say. My understanding of this article is that patients who COVID-19 has affected, people who had underlying medical problems like obesity and diabetes, predominantly even in the younger patients who got hospitalized acutely, and mortality in these subgroups have been high, I think COVID-19 keeps those patients at risk, have a higher risk of developing their symptoms even after three years, after getting COVID.
So, I think it's kind of a chicken and egg thing. We do not know if COVID directly causes this, but I think what it does is that it exposes the underlying co-morbidities to the extent that patients can have equally from it.
But this is not the same as long COVID?
It is not, because with long COVID, you have continued symptoms. For example, you get a COVID-19 infection and after you recover from that infection, you continue to have those problems for weeks and months to a few years after. Some of the things described by patients are fatigue, brain fog, loss of sensation, which has been associated with COVID-19, exercise, malaise and very non specific symptoms.
This is a little different. What this study is talking about is that even after 2 or 3 years, after you have had a COVID-19 infection, your risk of developing complications, either neurological or G I-related or cardiovascular disease, remains high even three years after having the infection. After three years, we see some decrease in the incidence of this infection in COVID-19-infected patients.
All that said, would the new illness linked to old COVID-19, be harder to treat or cure?
I don't think we have an answer to that question yet. What I understand is one of the things that I actually would ask when I see a patient with a new stroke or mini-strokes is their history of COVID. I think the treatment would still be the same. I think the recovery would still be the same.
But having that understanding that you could be at a higher risk of having strokes, even in young patients, who have had COVID-19 and especially if they have been hospitalized. I think their risk of having mini-strokes, is higher, even up to 3 years.
So that would be something I would change in my practice – asking patients about their COVID exposure and whether they've been hospitalized because of COVID-19 in the last few years.
Well, now that we've possibly scared some former COVID patients, what's the takeaway from this?
One of the things I would encourage patients to do is to be aware of their health. Regular exercise, diet.
Common things that we do to decrease the risk of strokes are eating right, no smoking, regular exercise, and keeping up with their doctor's visit would be what I would do. I wouldn't change much.
So, take care of yourself.
Take care of yourself and be aware that if you were hospitalized with COVID-19, you could be at higher risk of having cardiac issues, heart disease, mini-strokes, and G I issues. And if you were to develop those, talk sooner to your provider about seeking help. Don't ignore your symptoms.
RESOURCES:
Three-year outcomes of post-acute sequelae of COVID-19
Mini-Strokes, Gut Problems: Scientists See Links to an Old Bout of Covid
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