The long-term effects of COVID-19 are still under review considering how relatively recent the coronavirus pandemic is. Although COVID has significantly impacted the world for over a year making it seem as if COVID has had long-term influence, in the science world, a year is basically a blip. It gives some information, however, long-term effects are hard to gauge since physical effects from the virus may be only about a year and a half old. Nonetheless, there is already a small mass of data looking at the long-term effects to this point. These numbers may change over the years as scientists are able to expand their research to 5, 10, 20 years and beyond, but for the moment, there are quite a few effects that have already been identified. If you have had COVID-19, and still don’t feel 100% yet, it may be due to some of these already identified consequences listed below.

Fatigue

Fatigue is an overwhelming feeling of being tired or exhausted. Fatigue was cited by many studies as an overwhelmingly common lingering effect of COVID-19. During the acute illness phase of the virus, many experienced extreme fatigue. This may have been due to the energy required by their bodies to thwart off the attack presented by this very contagious and aggressive virus. In addition to just being energetically low due to the work of the immune system, most of these patients were having a hard time getting good breath. COVID-19 affected the lungs making it very difficult for most individuals to receive the necessary amount of oxygen. Anorexia (loss of appetite) and inability to consume required fluids and nutrients also contributed to the fatigue felt during the acute phase of the illness.

Fatigue is a common post-viral symptom of many diseases and illnesses, including mononucleosis, tick-borne encephalitis, SARS, and the flu. It is still under investigation, but what has been supported is that chronic fatigue proportional to the severity of illness is quite common. The cause, however, is what is still being debated. One hypothesis looks at the cytokine storm and how that may impact energy levels. Cytokines are components of the immune system that recruit necessary components to fight off the invader. However, this response can be overbearing and lose control, leading to the cytokine storm. The cytokine storm recruits way too many inflammatory cells and can lead to the destruction of healthy tissues. It is unclear how the cytokine storm may lead to chronic fatigue, and they are investigating this in addition to other potential factors.

Headache

Headache was the second most common long-term effect of COVID-19. Headache is also a symptom that many COVID-19 patients suffered from during the disease. This symptoms has resolved for most, but for some, there is a lingering headache. Headaches can be quite debilitating and severely impact that quality of one’s life. Headache is still under review for why there are post-viral cases, however there have been a couple of hypotheses for why. One thought is the increased circulation of inflammatory molecules. After a virus, or as a potential result of a cytokine storm, there may be increased presence of inflammatory cytokines in the blood. This can lead to increased vasodilation which can lead to headaches and discomfort.

Another thought about headaches is damage to the trigeminal nerve by the virus which leads to misfiring or excessive activation. The trigeminal nerve is responsible for all sensation and feeling to the face. Therefore, if the trigeminal nerve is overactive, then one can experience pain and uncomfortable sensation. COVID-19 has been shown to have such an effect on this nerve, possibly due to vasodilation or activation by inflammatory cytokines.

Attention Disorder

Attention disorder is the third most common post-COVID-19 symptom. It is unclear if this is a physiological or psychological long-term consequence. However, due to the isolative nature of COVID-19 pandemic lockdown, attention disorders may stem from the lack of socialization and overuse of technology. Distance learning and work from home measures have been in place for more than a year for most people. Computers and environment confusion may have made it harder for most individuals to focus. The lack of return to normal may have continued this inability to focus as well.

Mixing work, school, and home has been quite the struggle for most. Also, giving children more screen time than they would have had normally is also problematic. Too much screen time for children can lead to attention disorders, especially when they are exposed at younger ages. With preschools and kindergarten classes being excessively held on iPads and other devices, this may lead to difficulty concentrating longitudinally. Children aren’t alone either. With parents mixing their home and work life, it may be harder to simply focus on one domain. This feeling of mental chaos may take a while to diminish as life shifts to it’s new normal.

Hair Loss

Hair loss, or anagen effluvium, has been loosely related to COVID-19 and is the fourth leading post-COVID symptom. However, physicians have come across patients who had no hair loss prior to COVID-19, and then experienced immense shedding in the months following their acute infection. These patients have made a full recovery, but it still is an emotional and psychological toll on them. Although there is no confirmation, researchers think that COVID-19 related hair loss is due to the inflammatory reactions. Inflammatory reactions attack hair follicles, causing them to break at the root and shed much faster than they should. Once again, the cytokine storm associated with COVID-19 could be to blame for the excess of inflammatory molecules. Low-dose steroids were used as treatment options to help patients recover their hair loss.

Dyspnea

Dyspnea is shortness of breath, or difficult/labored breathing and is the fifth most common post-COVID-19 symptom. This is a difficult long-term effect because it can contribute to feelings of fatigue and even attention disorders. Breathing is a very passive and automatic process that we do not think about. So, if this becomes difficult for some patients, that can be a major detriment to simply living life. Dyspnea is a consequence of impaired breathing function. In the context of COVID-19 it has to due with long-term effects of the lung tissue damage that took place during acute infection.

During the infection, the coronavirus impacts lung cells, not only destroying them, but also causing a cascade of inflammatory reactions. These inflammatory reactions destroy lung tissue and also cause edema which is filling of the lungs with fluid. Lungs are supposed to be moist tissues with hair filled sacs, like a sponge that’s lubricated on the outside but dry sacs on the inside. However, when inflammation happens, they fill up with too much fluid, which doesn’t allow for oxygen to be delivered to the rest of the body after inhalation. This can lead to difficulty breathing and is the cause for ventilator use. After COVID, some of this lung tissue may still not be repaired. Even though patients don’t have edema, scarred lung tissue is still very hard to breathe through and makes oxygen delivery very tough. It’s unclear how long these difficulties may last.

If you have had COVID-19 and are still experiencing these symptoms, please reach out to see if we can connect you with services to help guide you towards recovery.

 

Sources:

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