Becker's Hospital Review

126 CMO / CARE DELIVERY 6 potential long-term side effects of COVID-19 By Gabrielle Masson R esearchers "don't yet fully appreciate" what happens aer a patient recovers from a serious case of COVID-19, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, as reported by CNN. "We don't know the extent of full recovery or partial recovery, so there's a lot we need to learn," Dr. Fauci said at the BIO International Convention in June. Around 10 percent of the 3.9 million people in the United Kingdom contributing to the COVID Symptom Study app have reported effects lasting more than four weeks. While experts are uncertain what all the long- term effects of COVID-19 are, Becker's has compiled a list of what we know so far. Note: is is not an exhaustive list. 1. Psychological problems COVID-19 patients may experience psychi- atric issues such as post-traumatic stress dis- order, depression, cognitive impairment and anxiety due to the trauma of the illness and treatment, said Christian Bime, MD, medical director of the intensive care unit at Banner University Medical Center Tucson (Ariz.). Dr. Piero Clavario, director of a post-COVID rehabilitation center in Italy, said his team contacted 55 COVID-19 survivors treated by hospitals in May, CNN reported. Fiy percent of the individuals reported psychological problems, according to Dr. Clavario. Only eight individuals didn't require follow-up support or report any complications. 2. Muscle weakness "What surprises me the most is that even the patients that have not spent any time in the ICU are extremely feeble: there is no evidence of a cardiological or pulmonary problem, but they are not even able to walk up a flight of stairs," Dr. Clavario told CNN. "Most show a serious muscle weakness." Dr. Clavario said most individuals were able to recover aer exercising regularly. 3. Long-term fatigue Overwhelming fatigue, classified as fatigue lasting more than six weeks, has been re- ported by many individuals recovering from COVID-19, according to data from the COVID Symptom Study app. 4. Acute respiratory distress syndrome e virus can cause acute respiratory distress syndrome, which can lead to limited lung capacity, kidney complications, and poor conditioning due to limited lung and/or or- gan function, Dr. Bime explained. Damage to lung tissue can result in scarring, which can decrease lung function even aer the initial damage has passed, though Dr. Bime did note that scarring can partially heal. 5. Pneumonia-induced lung injury e pneumonia that COVID-19 causes tends to affect both lungs, said Panagis Gal- iatsatos, MD, expert on lung disease at Bal- timore-based Johns Hopkins Bayview Medi- cal Center. While most people recover from pneumonia without lasting lung damage, the pneumonia associated with COVID-19 may be severe and lung injury may result in breathing difficulties, Dr. Galiatsatos said. 6. Loss of smell, taste It's not uncommon for patients with viral upper respiratory infections to experience temporary, or sometimes permanent, loss of taste or smell, said Justin Turner, MD, PhD, associate professor of Otolaryngology-Head and Neck Surgery and medical director of Nashville, Tenn.-based Vanderbilt University Medical Center's Smell and Taste Center. n Physicians puzzled by prolonged comas after COVID-19 patients taken off ventilators By Anuja Vaidya P hysicians across the country are reporting a new medical mystery related to COVID-19 care — patients who recover enough to be taken off ventilators of- ten do not regain consciousness until days or weeks after, NPR reported. Typically, patients removed from ventilators regain con- sciousness within a day, but among COVID-19 patients, the coma appears to persist. Though physicians do not know why this prolonged uncon- sciousness occurs among COVID-19 patients, there are sev- eral theories. COVID-19 patients require larger doses of sed- atives than other patients and are usually on the ventilator for longer periods. Additionally, many COVID-19 patients have low oxygen levels, which may cause brain damage. "So there are many potential contributing factors," Brian Edlow, MD, associate director of Massachusetts General Hospital's Center for Neurotechnology and Neurorecovery in Boston, told NPR. "The degree to which each of those factors is playing a role in any given patient is still some- thing we're trying to understand." Physicians are joining together to try and learn more about this condition. Researchers from Massachusetts General Hospital, Columbia University Medical Center and Weill Medical College in New York City formed a research con- sortium. The group is sharing data on COVID-19 patients in prolonged comas. An international research group based at the University of Pittsburgh Medical Center is also examining these per- sistent comas. They are aiming to release early research into the effects of COVID-19 on the brain, including pro- longed comas, in September, NPR reported. n

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