Strokes, heart attacks, sudden death: Does America understand the long-term risks of catching COVID?

A 35-year-old friend dies of a hemorrhagic stroke. A friend in her 40’s and another in her 70’s suffer from recurring bouts of extreme dizziness when they stand up with their heart pounding in their chests. A 21-year-old student with no medical conditions is admitted to intensive care with heart failure, while a 48-year-old avid tennis player who was previously healthy suddenly suffers a heart attack. A relative is diagnosed with pericarditis, an inflammation of the protective sac around the heart.

I cannot confirm the exact etiology of all these cases. But each of the people I mentioned had a history of COVID either days or months prior – and all had only mild cases of infection at the time.

Despite what we know, is it possible that we are still underestimating the reach and danger of COVID? It’s not normal that I know so many people with serious illnesses. Not normal at all.

tedious Social media threads to have started compiling lists of people similar to those mentioned above, and while there are many possible causes for their unfortunate health, the sheer volume of cases suggests something more concerning than just a Twitter phenomenon.

A large international study involving 136 research institutions in 32 countries has documented an increased incidence of ischemic stroke in young patients compared to before the pandemic. More than a third were under 55 years old, many lacked typical risk factors such as smoking, diabetes and high blood pressure.

Is COVID the reason?

In a study involving patients from the first wave of the pandemic, University of Florida scientists found that survivors of severe COVID-19 illness were two and a half times more likely to die in the year after the illness than people who did were never infected. Notably, nearly 80% of downstream deaths were not due to typical Covid complications such as acute respiratory distress or cardiac causes.

“The results suggest that a serious impact from COVID-19 extends beyond the cost and suffering of the initial hospitalization,” says Arch Mainous, one of the study’s authors.

How vaccinated patients fared

In a comprehensive analysis of more than 30,000 vaccinated patients who suffered breakthrough COVID infections (before Omicron), scientists found that even those vaccinated six months later faced a higher risk of death and debilitating long COVID symptoms affecting multiple organs ( lung, heart, kidney, brain and others) compared to controls with no evidence of SARS-CoV-2 infection.

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Even the strongest are not immune. Researchers have identified a disturbing pattern of sudden cardiac death in athletes in the wake of the pandemic, possibly due to COVID-related heart complications – myocarditis and pericarditis. Arizona Cardinals football lineman JJ Watt recently announced that he had an episode of atrial fibrillation, and while there are many possible causes of atrial fibrillation, it is worth noting that Watt was only diagnosed with COVID-19 about six weeks earlier. Atrial fibrillation has long been associated with COVID.

COVID reinfections

In a non-peer-reviewed study, Washington University School of Medicine’s Ziyad Al-Aly and his team analyzed the medical records of 38,000 people with COVID reinfections. Compared to people with a single infection, the researchers found that these re-infected people had a higher risk of mortality, hospitalizations and impaired health in multiple organs.

These risks were present regardless of vaccination status. Any infection increases the risk of acute and long-term complications.

We’re still learning how ubiquitous it all is. An analysis of more than 150,000 COVID-19 survivors published in naturopathy found that people with coronavirus are at increased risk of developing neurological sequelae — including stroke, cognitive and memory problems, seizures, movement disorders, and many other problems — in the first year after infection. The risk of developing these long-term complications was also evident in people who did not require hospitalization during their initial infection.

“The results show the profound long-term consequences of COVID-19,” Al-Aly told me. “Some of these will disfigure people for a lifetime.”

The researcher estimates that COVID is responsible for more than 40 million new neurological cases. One important caveat: the study period predated vaccines for the most part. However, Al-Aly says, “We know that vaccines minimally reduce Covid risk, not long-term elimination.” In fact, a large study found that vaccines were only about 15% effective in preventing long-term COVID.

No age group is reliably safe

Significantly, the risk of some of these complications is higher in younger adults. At the other end of the spectrum, a large study found that COVID-19 increased the risk of developing Alzheimer’s by 50% to 80% in people aged 65 and older — and that was in people without a prior diagnosis.

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Researchers believe that COVID-19 infection induces a prothrombotic and proinflammatory state that may increase the risk of blood clots. In a just-released cohort study of 48 million adults in England and Wales, COVID-19 has been linked to a dramatic increase in both arterial clots (which cause strokes and heart attacks) and venous thromboembolism (which includes blood clots in the lungs and legs). brought other places).

We are clearly still in the clutches of the virus, and some of the consequences are terrifying. A study that included data from over a million pediatric patients found that adolescents ages 18 and younger had a 72% increased risk of developing type 1 diabetes in the six months following their COVID infection. This risk is not limited to children; It is also seen in adults.

A horror scenario? A mild case of COVID leading to lifelong diabetes. But rather than continue beating the drum of caution, most cities, governments, and even the CDC are relaxing restrictions when it comes to COVID precautions.

America needs to wake up – now. A recent survey by the Kaiser Family Foundation shows that two-thirds of US adults have no intention of getting updated booster shots anytime soon, but widespread breakthrough infections and other immune-evading variants are on the horizon.

“The level of immune flight and evasion right now is amazing, crazy,” Yunlong Richard Cao, an immunologist at Peking University in Beijing, told Nature a few days ago. In an unpeered preprint, Cao et al. found that new subvariants such as BQ.1.1, CA.1 and in particular XBB are the most antibody-avoidable strains to date. “These results suggest that current herd immunity and BA.5 vaccine boosters may not provide broad enough protection against infection,” they wrote.

In our country 300 to 400 COVID deaths are already taking place every day. Cases are increasing in some European countries such as France, Germany, Italy and Belgium. “We are clearly at the beginning of winter [COVID-19] Wave,” said Federal Minister of Health Karl Lauterbach in a press conference. Germany has just introduced new rules mandating the wearing of masks on trains, local buses, and in hospitals, nursing homes and doctor’s offices.

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The road ahead will be bumpy before we can develop a variant-safe vaccine, allow nasal vaccines to block infection at the port of entry and reduce transmission, and develop better treatments. As the virus becomes more immune-preventable, our arsenal is shrinking rather than expanding, despite what the CDC and political leaders may claim. The monoclonal antibody strategy, for example, proved ineffective as the virus outwitted us and continued to evolve, rendering many monoclonal therapies obsolete soon after approval.

We still have a lot to understand about long COVID, especially in the vaccinated population, but Al-Aly appreciates that 8% to 12% of vaccinated people with breakthrough infections may die due to a long COVID. An estimated 145 million people worldwide suffer from the disease, with cases increasing by more than 300% in 2021.

We need to do much better work to prevent mass infections and reinfections, advance research, fund new treatments for victims, and develop a coordinated response both nationally and internationally. Manufacturing universal coronavirus and nasal vaccines and medicines to minimize long-term Covid risk is a top priority. As Al-Aly puts it, “We need ambitious policies to stay ahead of this virus and the pandemic.”

As a country we are obviously fed up with masking, amplifying and generally speaking to COVIDn. But no matter how strenuous this march was, we are still a long way from reaching our goal. We need to stop pretending otherwise.

Carolyn Barber, MD, has been an emergency department physician for 25 years. author of the book Runaway Medicine: What You Don’t Know Can Kill YouShe has written extensively on COVID-19 for national publications including wealth. Barber is a co-founder of the California-based homeless outreach program Wheels of Change.

The opinions expressed in Comments are solely the views of their authors and do not necessarily reflect the opinions and beliefs of wealth.

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