If you’ve been unlucky enough to contract COVID but lucky enough to get through it relatively unscathed, you’re no doubt counting your blessings. But it might pay to hold that count, because the latest research suggests up to one-third of older adults develop new conditions after recovering from the disease.
The concept of ‘long COVID’ has itself been around for a rather long time now, the term first coined, oddly enough, by an archaeologist in May 2020, according to New Scientist.
As for understanding long COVID and its causes, doctors and scientists are still working on unravelling that tangled web. The good news is, we appear to be getting closer to that understanding. The bad news is that the long-term effects of COVID appear to be more widespread than previously thought.
Throughout its existence, COVID has been seen as very much a respiratory problem and, indeed, in its earliest phase, it is just that for most sufferers. The cold and flu-like symptoms of sore throat, blocked nose and headaches are exceedingly common in those who have had a COVID diagnosis.
But with the benefit of more than two years of hindsight – and data – it has become clear that many who have recovered from COVID are developing other medical problems further down the track. And these symptoms revolve not around the respiratory system but the body’s other major organs, such as the heart and kidneys, as well as the neurological system.
In a new report published by the British Medical Journal, research showed that 32 of every 100 individuals aged 65 or older who were infected with SARS-CoV-2 had a diagnosis of one or more new clinical sequelae (conditions which are the consequence of a previous disease or injury) that required medical attention. That figure was a full 11 percentage points higher than a comparator group (those who had not been diagnosed with COVID).
Dr Ken Cohen, executive director of translational research at Optum Labs and corresponding author of the study, said although the research could not demonstrate causation, the findings may be the result of two different syndromes.
“Broadly, I think about post-acute sequelae of COVID-19 as two syndromes, although there is overlap. The first is seen in seriously ill patients typically in the intensive care unit and often on respiratory support. These patients have a systemic inflammatory response that is quite severe, and many of the post-acute sequelae are a consequence of the organ damage that occurs from this process.”
The other category, Dr Cohen explains, comprises those with “milder infection not requiring hospitalisation”.
“Here,” he says, “we have fewer answers. We do know, for example, that SARS-CoV-2 can affect the olfactory nerve, causing anosmia [the loss of smell] and that the clotting system can be activated, increasing the risk of thrombosis. But in other areas, such as sleep and mood alterations, cognitive difficulties and ongoing fatigue and myalgias, to date, we don’t have the answers.”
The notion that blood-clotting is the primary cause of long COVID has become popular within the medical community. Tiny blood clots can restrict the flow of blood to the organs and damage the walls of blood vessels.
As well as affecting vital organs in older adults, evidence is mounting of post-COVID effects on the male reproductive system. Research conducted at Northwestern’s Feinberg School of Medicine pointed to an association between SARS-CoV-2 and testicular pain, erectile dysfunction, hypogonadism (diminished functional activity of the gonads), reduced sperm count and quality, and decreased fertility in males.
Despite a seemingly endless increase in the range of long COVID side-effects, there is confidence that treatments will evolve to manage these. Professor Danny Altmann, of Imperial College London, is optimistic: “I’d be surprised if we didn’t have some pretty good answers and a shelf of therapeutics a year from now.”
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