IN MY OPINION, the only thing that matters is the number of deaths.
Here's why YOUR OPINION is uninformed and wrong. It is also why your continued claims that those who don't die "fully recover" are false. Yes, this is as reported in media, but these are doctors/scientists that are talking. They have no political agenda. To ignore their scientific findings and opinions because they are inconsistent with your narrative serves no one.
Three Months In, These Patients Are Still Ravaged By Covid’s Fallout
Doctors are studying coronavirus patients who are still experiencing symptoms or aftereffects of the disease, months after infection
Chelsea Alionar, who began experiencing symptoms of Covid-19 in March, at her home in Keizer, Ore. She helps run a Facebook group for long-term patients.
Leah Nash for The Wall Street Journal
By Sumathi Reddy
July 1, 2020 10:00 am ET
Chelsea Alionar, a 37-year-old in Keizer, Ore., is going on more than 100 days of being sick, with a racing heart beat, chest pains and numbness.
Emily Jensen, a 34-year-old surfer and runner in Minneapolis, says she now needs an inhaler just to walk up the stairs.
And Annie Harris, a 22-year-old recent college graduate, is struggling with extreme fatigue and headaches in Greenwich, Conn.
Emily Jensen initially fell sick in mid-March. ‘No one knows: Is this going to be my life for the next two years?’
Photo: Emily Jensen
All three women tested positive for Covid-19 roughly three months ago, yet they are still experiencing symptoms or aftereffects of the disease. They’re part of a group of long-term patients that doctors are increasingly studying in an effort to better understand the lasting impact of Covid.
“Only now people are beginning to realize that there are long-haul fighters like me struggling out there,” says Ms. Harris.
The science behind what’s happening is still nascent. But some theories are emerging, many of which are being tested in new studies. Some doctors believe the culprit is a neurological condition that may affect up to 15% of all Covid-19 patients. Others blame chronic fatigue syndrome. Many see a common root in immune responses gone haywire. Some doctors believe some long-term symptoms may stem at least in part from anxiety, though many patients adamantly reject that suggestion.
Long-term patients’ symptoms vary widely, from elevated heart rates and trouble breathing to gastrointestinal problems and cognitive difficulties. Many patients are younger and had previously been healthy, with Covid cases initially considered mild to moderate. But months later they are still sick, and some are getting worse.
Doctors don’t believe these people are contagious months after infection. In a few cases, patients do still test positive for the disease, but doctors think those tests are likely picking up dead traces of virus.
One place at the forefront of longer-term care is Mount Sinai Health System in New York City, which in May opened a Center for Post-Covid Care. The center follows patients who were hospitalized, as well as people with long-term symptoms who were never hospitalized.
The center is monitoring roughly 1,000 Covid-19 patients with initially mild to moderate cases, whose symptoms have lasted on average 50 to 70 days.
David Putrino, Mount Sinai’s director of rehabilitation innovation, believes most of these patients are developing a neurological condition called dysautonomia, which occurs when the autonomic nervous system is out of balance. The autonomic nervous system controls functions such as temperature, blood pressure and heart rate. Symptoms can include racing heart rate, extreme fatigue and shortness of breath.
Dr. Putrino estimates dysautonomia may affect as many as 5% to 15% of all Covid-19 patients. “That is our lead theory as to what is going on,” says Dr. Putrino. It’s unclear if the condition is triggered by an overactive immune system, if the virus itself is getting into the nervous system, or if it’s a post-viral syndrome, says Dr. Putrino.
David Putrino, Mount Sinai’s director of rehabilitation innovation, believes some Covid patients are developing a neurological condition called dysautonomia.
Mount Sinai’s Center for Post-Covid Care recently launched a program dedicated to these patients, treating them for dysautonomia with therapies such as guided exercise programs and dietary changes, says Dr. Putrino. The center is conducting several studies following long-term patients to better understand why some people recover and others don’t.
Dr. Putrino has surveyed about 600 people in social-media support groups who self-identified as “long-haul” patients. The median age was 42 years old and 80% were women, he said. But researchers say age and gender data could be skewed by the people who choose to join groups. While there is no definition of what a long-hauler is, Dr. Putrino says they are following patients who have symptoms lingering for more than four weeks.
Other possible explanations for long-haul cases include a condition called myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS. The condition is the subject of research and debate, but some scientists theorize it can be triggered by stressful events, including viruses and trauma. Symptoms may include mental fog, exercise intolerance and fatigue for at least six months.
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Avindra Nath, clinical director of the National Institute of Neurological Disorders and Stroke, is developing a study to evaluate 40 Covid-19 patients experiencing ME/CFS symptoms for a week through brain scans, metabolic studies and blood tests.
Ron Davis, a professor of biochemistry and genetics at Stanford Medical Center, is also conducting a study with the nonprofit Open Medicine Foundation. He says studies have found that up to 10% of people with some viruses can develop ME/CFS. “So the concern with this coronavirus is that we will get a large number of cases,” says Dr. Davis.
Serena S. Spudich, chief of neuroinfectious diseases and global neurology at Yale, says a number of long-term patients are reporting sensory changes on their body. She believes this is likely caused by damage to the nerves that go to the skin, the result of an immune response gone haywire, which she speculates may be more likely in people with healthy immune systems.
Nerve damage can be treated with medication and peripheral nerves regenerate, but some patients experiencing cognitive issues may have a more serious brain injury. Dr. Spudich and colleagues are launching a long-term study following Covid -19 patients experiencing neurological problems.
Akiko Iwasaki, professor of immunobiology at Yale, believes there are three potential explanations for long-term symptoms: Patients have a dormant reservoir of virus in the body that periodically gets reactivated; traces of the virus in tissues are triggering inflammatory symptoms; or the immune response goes into overdrive and mistakenly starts attacking the body’s own cells.
The lack of certainty around causes and even symptoms has created challenges for people suffering from longer-term effects. In interviews with more than 20 long-haul patients ranging in age from 22 to 62 years old, a portrait emerged of patients struggling with wide-ranging symptoms. For some, it comes in waves; for others it’s constant. Some say they are slowly getting better while others add new symptoms every week.
Ms. Alionar, the 37-year-old in Keizer, Ore., helps run a Facebook group for long-haul patients, which split into two groups after membership grew to over 3,500. She says she has faced resistance from medical professionals she’s met with in dozens of appointments since she fell ill. “They tell me that there’s really no way that I could be sick with Covid this long and that I absolutely have to be depressed and anxious and it’s got to be mental health,” says Ms. Alionar, who recently resumed her job as an auditor after a 2.5-month medical leave.
Before Covid-19, Ms. Alionar enjoyed yard work, biking and walking her two pugs and Australian shepherd. Her symptoms started in March; she tested positive for Covid in April. Now her symptoms come in waves, running the gamut from a dry cough and hearing loss to heart palpitations, chest pain, fever and numbness in all extremities. At one point her cough disappeared and then came back. Then there is the headache, joint and muscle pain and extreme fatigue.
Ms. Alionar wears a monitor to track her heart beat. Her symptoms come in waves, from a dry cough and hearing loss, to heart palpitations and chest pain.
Photo: Leah Nash for The Wall Street Journal
“If I go outside and walk for 30 minutes it will put me down for two days,” she says. “If I go to Safeway, I’m down for several days. Leaving the house is not an option.”
Experts say some long-term Covid patients are experiencing severe respiratory effects and reduced lung capacity.
Those are among the many symptoms Ms. Jensen is experiencing. She fell sick in mid-March. Initially she had gastrointestinal issues and then developed a fever, cough and chest pressure.
“The next day the fatigue hit. It was like being hit by a bus,” says Ms. Jensen, an education manager for a kids’ television show.
By late March she had severe breathing issues and an intermittent fever. “I couldn’t get out of bed. I was eating canned soup from the can,” she recalls.
Understanding how the body clears the new coronavirus is becoming more important as the U.S. begins to reopen. WSJ’s Daniela Hernandez explains how the body fights infection and why feeling better doesn’t equal being virus-free. Photo illustration: Laura Kammermann
She started feeling better, but in early April she suffered a relapse. The fever and cough came back for two weeks. In mid-May she went to the emergency room with severe pain under her ribs. She had a kidney infection that had spread.
She has been feeling a little better lately but still has fatigue, brain fog, dizziness, tingling sensations and breathing issues. “If I overexert myself it’s like I take several steps back and basically can’t do anything for several days,” she says. “I’ve never had breathing issues before and now I have to use my inhaler sometimes when I’m having a conversation,” she says.
“It’s scary,” she adds. “No one knows: Is this going to be my life for the next two years?”
Some long-haulers report having previous autoimmune disorders or prior bad reactions to viruses like Epstein-Barr, which causes mononucleosis.
Annie Harris in her bedroom at her family's house in Greenwich, Conn. Since becoming ill in March, ‘it has impacted every single inch of my body,’ she says.
Photo: Susan Harris
Ms. Harris is a 22-year-old who just graduated from Colgate University in Hamilton, N.Y. She had two strong reactions to previous viruses: She was hospitalized in 2016 when she got mono and had to get iron infusions when she had a bad stomach virus in 2018.
Her symptoms started March 20 with a low-grade fever, headache and fatigue. She first tested positive for Covid on March 24. In May, she abruptly started getting severe gastrointestinal symptoms. She cut out dairy, gluten and sugar, but says she still gets nauseous and has stomach cramping.
She had a telemedicine appointment with Mount Sinai’s Post-Covid clinic and has another virtual appointment with a neurologist there in July. “It’s a really unpredictable virus,” says Ms. Harris. “It has impacted every single inch of my body.”