We Still Don’t Know All the Long-Term Consequences of ‘Mild’ COVID-19

Surviving COVID-19 is one thing. Becoming healthy again is another. Recent studies have found that even people who didn’t seem to have life-threatening cases show signs of damage to their heart. We don’t know what the future has in store for them.

While I’m thinking specifically about this study from Germany showing heart damage in 80 per cent of the patients examined, there are other clues that there’s a large, murky grey area on the spectrum of illness in between dying and surviving unscathed.

For example, we’ve known for a while that even patients who have cleared the infection and tested negative twice may have lingering symptoms, leaving them officially “recovered” but hardly feeling that way.

A recent U.S. CDC report found that 19 per cent of young people surveyed were not back to their normal health within 14 to 21 days after developing symptoms. In older age groups, the proportion was even higher.

The German study surveyed people who had recovered from COVID-19, 33 per cent of whom had been in the hospital as part of their care. The rest recovered at home. In this group, 78 per cent showed signs that their heart had been affected by the disease, and 60 per cent had ongoing inflammation in their heart muscle. What’s most concerning is that having these markers of heart damage did not correlate with how severe the patients’ symptoms had been. In other words, it seemed to be common even in milder cases.

I wouldn’t put too much stock in the specific numbers, since it’s possible the population they studied isn’t representative of everybody who gets COVID. But the experts I’ve seen discussing the paper still see it as a bad sign.

Worrisome results out today in JAMA Cardiology. Of 100 relatively young (median age 49) patients who recovered from COVID, nearly 80% showed myocardial inflammation or other cardiac symptoms. If I read right, minimal selection bias; 2/3 never hospitalized.https://t.co/flT9WOiIjb

— Carl T. Bergstrom (@CT_Bergstrom) July 28, 2020

The truth is, we don’t know what the long-term consequences of COVID-19 infection are. It’s clearly not something that everyone bounces back from. And since the disease was first identified in December of 2019, that means nobody on this earth has been recovered for more than seven months. We have no idea what COVID-19 recovery means after a year, or five years, or ten years. Are some people’s hearts just slow to recover, or will there be lifelong damage?

This is why I can’t dismiss concerns about the death rate from people who are infected “only” being 1 per cent. (We don’t know the exact number; it’s hard to pin down.) Let’s say 99 per cent of us who get infected will live. Great! But some of us may be severely ill, and it’s entirely possible some of us will never fully recover.

In the middle of a global discussion about how to safely reopen schools, I think about this a lot. Since much of the pandemic has transpired while schools were closed, we don’t have a good sense of how often kids get sick, how often they get infected asymptomatically, and how often they are able to spread it to family members. We know some of them do get severely ill. But what about the kids who have a mild case or none at all? Could some of them end up with heart damage for life? We truly don’t know.

This pandemic has been humbling in many ways, and one of those is the fact that we can no longer rely on our gut feelings, nor even on being well informed, to fully understand the risks in our lives. Maybe everybody who survives the coronavirus will eventually be fine. Maybe they will not. We have to make our decisions with the understanding that we do not have all the answers.