Shedding light on the hidden aftermath of surviving COVID-19

The experiences of COVID-19 victims have become a reminder of loss and struggle as the pandemic nears its third year. Through them, one can try to understand the great toll that the virus can exact on those it infects. Nonetheless, the stories of COVID-19 survivors do not simply end with survival or death. With the existence of “long COVID” entering public consciousness, we are learning that for some, their battle with COVID-19 has not yet ended.

The next grueling chapter

In conversations about COVID-19, mortality rates are often brought up as a metric to determine the severity of the virus. This is the mistaken belief that high survivability makes it less dangerous. However, recovering from COVID-19 does not always mean that one will return to their original health. In fact, it may just mark the beginning of an even longer and more painful journey.

Dr. Paddy Ssentongo, a physician and professor at Penn State University, gathered a team of researchers in March of 2020 to study the health complications that people experience after recovering from COVID-19. All of these complications are collectively regarded as long COVID.

According to Ssentongo, over 50 percent of COVID-19 survivors experience long COVID. Although this number decreased to 19 percent after the mass distribution of vaccines, people should still be wary of it. “It’s not the [number of deaths] per se that is going to be found a burden but actually the long COVID symptoms,” he articulates.

Ssentongo and his team were able to identify around 38 symptoms of long COVID in different organs and organ systems. Starting with the nervous system, he explained that long COVID patients may experience headaches along with the loss of taste and smell as a result of damage to the cranial nerves in the brain.

In the respiratory system, patients may experience dyspnoea—difficulty breathing—and lung opacification, or the increased density of the lungs. They may also experience constitutional or non-disease-specific symptoms that are not associated with a specific organ. These include persistent fevers and joint and muscle pains. Furthermore, arrhythmias—disordered heart rates—are symptoms experienced in the cardiovascular system.

Long COVID symptoms were initially thought to subside within two to five months after patients leave hospital care. However, Ssentongo’s research found that these symptoms sometimes persisted beyond six months.

He says that patients who ended up using ventilators are more vulnerable to long COVID because of high viral load levels. However, someone experiencing severe COVID-19 symptoms does not always equate to them acquiring long COVID, since those with mild symptoms may also experience long COVID in due time.

Hoping that the symptoms will eventually reduce, Ssentongo and his team have decided to extend their study on long COVID by following up on patients years after their recovery.

To understand how long COVID affects people on a more personal level, The LaSallian reached out to the Lasallian community. Jose Rosario (II, AB-OSDM) shares that it took a month and a half for him to fully regain his sense of taste and smell. He discloses that he also experienced an increased heart rate and shortness of breath, which was especially severe due to his asthma. Because of this, Rosario was reliant on an oxygen tank for around five days even post-recovery. Due to severe bloody coughs, he reveals he also had trouble sleeping and had to take 10 milligrams of melatonin every night to put himself to sleep.

Silent struggles

Of all the symptoms that Ssentongo and his team studied, mental health disorders such as post-traumatic stress disorder, depression, and anxiety are some of the most difficult to treat. This is primarily because patients often fear to disclose their mental health, hindering them from receiving proper treatment or even a diagnosis.

These mental health disorders are caused by the neurotrophic effects of COVID-19 on the brain. To elaborate, the virus is capable of attacking the central nervous system and damaging nerve tissue, which could result in neuropsychiatric symptoms such as depression and anxiety. Additionally, drastic changes in lifestyle brought about by the COVID-19 pandemic such as isolation and unemployment may also increase one’s susceptibility to developing mental health disorders.

On top of the physical manifestations of long COVID, Rosario also says he struggled mentally. According to him, quarantining allowed for negative thoughts to flood his mind. “I was drained because I was only in my room. I did not go out for 14 days,” he expresses.

To make matters worse, he shares he also had to cope with academic stress. “It was actually more of mental torture. I took the [physical] symptoms well…it was staying in the room for 14 days that was intolerable,” voices out Rosario.

Despite making headway in understanding SARS-CoV-2—the virus that causes COVID-19—Ssentongo divulges that “there’s still a lot we don’t know about the virus.” In fact, the margin separating symptoms of COVID-19 from long COVID alone remains unclear because they are technically “on the same scale,” he informs.

Gray areas

Though there are many uncertainties surrounding long COVID, one thing that Ssentongo is certain of is that the frequency of long COVID among survivors is correlated to certain factors—number one being vaccination.

He emphasizes that “if [one ends] up with COVID-19 after vaccination, the symptoms of long-COVID may cut down.” Furthermore, he prompts people to get vaccinated as soon as they can as it is the best chance communities have to mitigate the spread of the virus.

Ssentongo advises other scientists, however, to “think beyond the vaccine.” This is where precision medicine comes into play—alternatives to the vaccine that may prevent COVID-19 from spreading. Since one person’s recovery and response to a treatment may be different from others, precision medicine looks into a patient’s genetic makeup to “see if there is anything we can modulate” for immunity.

Currently, efforts are being made to leverage artificial intelligence to predict and identify if a patient is susceptible to severe symptoms of COVID-19, or high risk cases that require hospitalization. Essentially, precision medicine’s end goal is to recognize biological differences to improve a patient’s health.

Wishful thinking

In light of the surging Omicron variant cases, many downplay the severity of COVID-19 since a number of patients have reported that their symptoms are like that of a cold that subsides after a few days. In hindsight, however, the virus is still capable of damaging your body when—and long after—you are ill.

With long COVID, symptoms may reappear, some may even never go away, and since the virus can damage every other organ aside from the lungs, the possibility of developing health complications like chronic kidney impairment and stroke is not to be scoffed at.

Much remains to be done for healthcare professionals and epidemiologists in unraveling the mysteries of long COVID as the number of its cases skyrocket every day across the globe. Given this, Ssentongo says that the most we can do for now is to curb the COVID-19 pandemic into an epidemic. However, even if we manage to do this, the perils of long COVID call into question whether or not we will see the world as we once knew it.