New findings on long COVID reveal that COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year post-infection compared with people who have not had the virus. However, the three-year death risk marks a significant decline compared with such risk at previous time points post-infection. The study also shows that even people with mild COVID-19 still experienced new health problems related to the infection three years later.
New findings on long COVID — long-term effects on health experienced by many who have had COVID-19 – present a g rnrnGood news and bad news are presented in a study from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system. The bad news is that COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year compared with people who have not had the virus. However, the three-year death risk is still significantly lower compared with the risk at the one- and two-year marks post-infection. The findings also reveal that even people with mild COVID-19 were still experiencing new health problems related to the infection.
The study found that the risk of death decreases significantly one year after a SARS-CoV-2 infection for those who were not hospitalized for the virus. This group represents the majority of COVID-19 cases.
Published in Nature Medicine on May 30, the new research followed the long-term health effects of the virus on individuals who were infected with the original strain of COVID-19 in 2020. That year, approximately 20 million people in the U.S. tested positive for the virus. The study examined the risk of death and 80 other negative health conditions in individuals three years after being diagnosed with the virus.COVID-19.
Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University and a prominent figure in long COVID research, stated, “We are uncertain why the effects of the virus last for such a long time. It could be due to the virus persisting in the body, chronic inflammation, immune system dysfunction, or a combination of these factors. We typically think of infections as short-term illnesses with health impacts that occur around the time of infection. Our data challenges this belief. COVID-19 continues to provide us with new insights, and one important lesson is that a brief, seemingly harmless encounter with the virus can still result in long-term health issues.”
According to federal data, up to 10% of individuals who contract the virus suffer from long COVID.
Prior research by Al-Aly has shown that COVID-19 can cause damage to various human organs, leading to conditions affecting the lungs, heart, brain, and the body’s blood, musculoskeletal, and gastrointestinal (GI) systems.
Al-Aly, a nephrologist who treats patients at the Washington University-affiliated John J. Cochran Veterans Hospital in midtown St. Louis, stated that there is a lack of studies with longer follow-up. Addressing this knowledge gap is crucial for improving our understanding of the long-term effects of COVID-19.our understanding of long COVID and will help inform care for people suffering from long COVID.”
Researchers examined millions of medical records from the U.S. Department of Veterans Affairs, which is the largest integrated health-care system in the country. The analysis looked at over 114,000 veterans with mild COVID-19 who were not hospitalized, more than 20,000 hospitalized COVID-19 patients, and 5.2 million veterans without a COVID-19 diagnosis. The study spanned from March 1, 2020, to Dec. 31, 2020, and followed patients for at least three years, until Dec. 31, 2023. This included a variety of patients.
Researchers studied a diverse group of people, including those of different ages, races, and sexes, to ensure representation.
After three years of infection, hospitalized COVID-19 patients had a 34% higher health risk across all organ systems compared to those without COVID. This is a decrease from the 182% increased risk one year after infection, and a 57% risk two years after.
For nonhospitalized patients, there was a 5% increased risk of experiencing long COVID in the third year after infection. This means 41 more health problems per 1,000 individuals, which is a small but significant burden.The long-term effects of COVID-19 in the third year mainly impacted the gastrointestinal, respiratory, and nervous systems. In comparison, the risk increased by 23% one year after contracting the virus and by 16% two years later.
Researchers also assessed the number of years of healthy life lost due to COVID-19. They discovered that among those not hospitalized, three years after infection, COVID-19 had led to 10 lost years of healthy life per 1,000 individuals. In contrast, three years after infection, those who were hospitalized for COVID-19 had experienced 90 lost years of healthy life per 1,000 individuals.
For reference, in the UThe data shows that in the U.S., heart disease and cancer result in approximately 50 years of healthy life lost per 1,000 people, while stroke contributes to 10 lost years of healthy life per 1,000 individuals.
“It’s concerning to find that even a mild SARS-CoV-2 infection could lead to long-term health issues,” said Al-Aly, who is the director of the Clinical Epidemiology Center at the VA St. Louis Health Care System and leads the research and development service. “The impact is even more severe for those with severe SARS-CoV-2 infection. The disease burden among hospitalized individuals is very worrisome.”
“COVID-19 poses a significant threat to the long-term health and well-being of individuals and should not be downplayed,” he stated.
The long-term impact of long COVID may evolve as researchers gather data from years beyond 2020, when vaccines and antivirals were not yet available. Additionally, Al-Aly’s analysis does not take into account subsequent variants such as omicron or delta.
“Even after three years, you may have moved on from COVID-19, but COVID hasn’t moved on from you,” Al-Aly explained. “Some individuals may feel that they are in the clear because they contracted the virus and did not experience health issues, but that may not be the case.””Three years post-infection, the virus may continue to cause damage and lead to illness in the gastrointestinal tract, respiratory system, or nervous system.”
