Becker's Clinical Quality & Infection Control

15 INFECTION CONTROL 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 An- thony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, according to a June 9 CNN report. "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. Editor's note: is is not an exhaustive list. 1. Psychological problems. COVID-19 patients may experience psychiatric issues such as post-traumatic stress disorder, 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 fee- ble: 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 reported 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 ca- pacity, kidney complications, and poor conditioning due to limited lung and/or organ 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 Galiatsa- tos, MD, expert on lung disease at Baltimore-based Johns Hopkins Bayview Medical Center. While most people recover from pneu- monia 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 New York City's COVID-19 death rate comparable to 1918 flu pandemic, study finds By Mackenzie Bean N ew York City's spike in deaths amid the COVID-19 pandemic this spring was comparable to the death toll at the peak of the 1918 flu pan- demic, a study published in JAMA Network Open found. Researchers compared data on all-cause mortality in New York City for the two-month period ending May 11 and the peak two months of the 1918 flu pandemic. They used data from the CDC, New York City Depart- ment of Health and Mental Hygiene, and the U.S. Census Bureau for the analysis. During the peak two months of the 1918 pandemic, 31,589 deaths occurred in New York City among 5.5 mil- lion residents. These figures translate into an incident rate of 287.2 deaths per 100,000 person-months — a common metric used to denote deaths over time, according to The New York Times. This spring, 33,465 all-cause deaths occurred in New York City among 8.3 million residents. This translates to an incident rate of 202.08 deaths per 100,000 per- son-months — just 29.6 percent lower than during the 1918 pandemic. "For anyone who doesn't understand the magnitude of what we're living through, this pandemic is comparable in its effect on mortality to what everyone agrees is the previous worst pandemic," study author Jeremy Faust, MD, an emergency physician at Brigham and Women's Hospital in Boston, told The Washington Post. n

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