LOS ANGELES - During the onset of the pandemic, many doctors were baffled by the variety of harmful effects caused by COVID-19 — originally thought to be just a respiratory illness.
But certain cases, which have now evolved into what researchers know today as "long COVID," illustrate the elusiveness of the disease and that there is still much more to learn from it.
One such alarming case comes from research led by Dr. Ziyad Al-Aly, chief of research and development at VA St. Louis Health Care System and clinical epidemiologist at Washington University in St. Louis.
Analyzing data from millions of Americans, his team found that kidneys from patients with long COVID accelerated in age by an average of four years in the span of just one.
"You can start thinking about getting COVID as almost as an accelerant to aging," said Dr. Al-Aly. "When we studied specifically, let’s say, kidney disease, we’ve seen that people who’ve gotten COVID-19 on average had a decline in their kidney function in the span of one year that is commensurate with what people experience in the span of four years."
These accelerations in aging were also found in other organs like the heart and brain. As to why this happens in certain age groups or men or women, Dr. Al-Aly said more data is needed.
He explained that we need to rethink how we view COVID-19: It’s not a respiratory illness.
In fact, this is a common debate that sits at the heart of many conspiracy theories and basic questions surrounding the virus. Why do some people experience it in the form of a common cold and some experience it in the form of a life-changing virus that can kill?
Dr. Al-Aly says we’re seeing COVID-19 evolve similarly to how we originally first saw cancer evolve in its early forms. Back then, we didn’t have the understanding of the different forms of cancer that we do now. Later down the line, we may be able to classify the different forms of long COVID.
"The short answer is we don’t completely understand," Dr. Al-Aly continued. "One of the leading theories is that some people are able to clear out the virus and get rid of it and some individuals experience what we call ‘persistence of the virus.’"
Dr. Al-Aly explains the persistence of the virus instigates inflammation in the body which triggers other problems that we know can be found in symptoms of long COVID.
Another hypothesis Dr. Al-Aly speculates is that some people’s immune system goes haywire and attacks itself, which can cause another manifestation of long COVID.
"When we deeply understand this we’re going to have different types of long COVID and not just lump them all together," Dr. Al-Aly said.
Currently, several symptoms of COVID-19 identified in the study are not recognized by the U.S. Centers for Disease Control and Prevention. Symptoms like "COVID toes" and "rheumatoid arthritis" aren’t listed on the CDC’s website detailing the long-term effects of the coronavirus.
According to the CDC, the most commonly reported long-term symptoms include:
- Shortness of breath
- Joint pain
- Chest pain
Other reported long-term symptoms include:
- Difficulty with thinking and concentration (sometimes referred to as "brain fog")
- Muscle pain
- Intermittent fever
- Fast-beating or pounding heart (also known as heart palpitations)
More serious long-term complications appear to be less common but have been reported. These have been noted to affect different organ systems in the body. These include:
- Cardiovascular: inflammation of the heart muscle
- Respiratory: lung function abnormalities
- Renal: acute kidney injury
- Dermatologic: rash, hair loss
- Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems
- Psychiatric: depression, anxiety, changes in mood
The CDC said, "While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness."
According to a separate study from the NIH published in 2020, researchers found evidence to suggest that brain damage may also be a product of COVID-19. Researchers uncovered blood vessel damage and inflammation in the brains of 19 deceased COVID-19 patients.
"We found that the brains of patients who contract infection from SARS-CoV-2 may be susceptible to microvascular blood vessel damage. Our results suggest that this may be caused by the body’s inflammatory response to the virus" said Dr. Avindra Nath, clinical director at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS).
Nath, the senior author of the study, added that while COVID-19 is most commonly known to be a respiratory illness, he hopes this study will help the medical community recognize the scope of complications that can arise out of contracting the deadly coronavirus.