May 13, 2020 — The symptoms came suddenly but took a long time to leave.
Akhink Omer, 31, still remembers the exact date: March 9. One day she felt perfectly fine, and the next she was hit with fever, diarrhea, fatigue, coughing fits, severe body aches and “the worst headache of my life for the first few days.”
At that time, there were only two confirmed cases of COVID-19 in her home state of Tennessee.
By March 16, her condition had worsened. “The fatigue was intense, and the coughing was so bad, I felt like I was choking, like someone was grabbing me by the throat,” Omer says. By the time she went to the emergency room, her blood pressure was dangerously low, her heart rate was racing, and a chest X-ray showed pneumonia in both lungs. Omer was admitted to the hospital and tested for SARS-CoV-2, the virus that causes COVID-19. Her test came back positive 2 days later.
She spent 8 days in the hospital not only fighting to breathe, but also struggling with isolation, as masked hospital staff scurried in and out, some visibly afraid to be in the same room with her. Although her symptoms improved enough for her to go home on March 24, she left the hospital with abnormal liver tests likely caused by a medicine she received, low iron levels, a persistent cough with lots of phlegm, and continued weakness. Though she had survived her ordeal, she coughed for weeks after and struggled to get back to her previous level of activity.
Like Omer, more than 1.5 million people are somewhere along the road to recovery among the estimated 4.3 million people worldwide who have had confirmed infections.
Doctors are just starting to learn what recovery from COVID-19 looks like and whether it will cause long-term damage to its survivors — both physically and mentally. Doctors are still trying to understand what long-term health effects may look like after recovery, what impacts may resolve, and what may linger.
Wide Range of Health Impacts, Wide Range of Illness
Doctors stress that most people who have COVID-19 are likely to recover without any long-term effects. “In most cases, over 80% of people don’t have severe disease, so most people are going to recover fully,” says Carlos del Rio, MD, an infectious disease specialist and professor of epidemiology at Emory University.
“It’s going to be more of the small percentage of people with severe and critical symptoms where the concern arises about long-term impact on the lungs and other organs, but we don’t fully understand what that will look like,” he says.
Still, doctors are seeing a growing list of related health impacts beyond just respiratory problems, including the digestive system, heart, kidneys, liver, brain, nerves, skin, and blood vessels. For people with severe and critical disease, dangerous immune system and blood clotting responses can also cause a lot of damage throughout the body and may result in long-term health effects. For some, kidney damage may require long-term dialysis, strokes and blood clots may lead to disability, and scarred lungs may lead to permanently decreased lung function. Treatment itself — whether it is time on a ventilator, in the intensive care unit, or certain drug therapies — may also cause lasting harm. Whether these effects resolve or leave damage remains to be seen.
A study of hospitalized patients in Wuhan, China, found that survivors recovered after a host of complications: 42% had sepsis, 36% had respiratory failure, 12% had heart failure, and 7% had blood clotting problems. Though these patients survived, it’s not clear what recovery will look like for them.
Gregg Garfield of California was in the hospital for 64 days with a severe case of COVID-19. He had kidney damage,