August 28, 2023
3 min read
Source/Disclosures
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Disclosures:
Al-Aly reports that he has been an uncompensated consultant for Pfizer.
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Key takeaways:
- COVID-19-associated hospitalization significantly increases risk for long COVID.
- The risk for long COVID decreased for nonhospitalized patients 6 to 19 months after recovery.
A large study found that long COVID-related conditions may persist among patients for as long as 2 years after recovery from acute disease, with COVID-19-related hospitalization increasing the risk sharply.
People who had COVID-19 — regardless of hospitalization — were at elevated risk for diabetes, lung problems, fatigue, blood clots and disorders of the gastrointestinal and musculoskeletal systems, according to the study, which enrolled more than six million patients, including more than 138,000 with a documented SARS-CoV-2 infection.
Most people who have had COVID-19 have not been hospitalized, and their risk for some long COVID-linked conditions declined over time after recovery from the acute disease, researchers reported.
We spoke with Ziyad Al-Aly, MD, MASN, chief of research and development at the VA St. Louis Health Care System and senior clinical epidemiologist at Washington University in St. Louis, about the new study and its findings.
Healio: The study shows significant impacts to health from long COVID 2 years after acute illness. Is it clear yet what is causing these long-term effects?
Al-Aly: We think this is the lasting effect of the infection. We are used to thinking that the infection can result in acute problems and one recovers when one gets over these acute problems. But it is very clear that SARS-CoV-2 can lead to long-term health problems and that the risk horizon from an infection is long — meaning that an infection can lead to problems 1 or 2 years after the acute phase. This is a sobering reality and illustrates the long-lasting risks of SARS-CoV-2 infection.
Healio: Does this study help clarify which patients are at greater risk for long COVID?
Al-Aly: It is very clear that severity of the acute infection — and whether the infection necessitated hospitalization — is a very important predictor of illness trajectory over the 2 years following the infection. Although people who had mild acute COVID-19 still had elevated risks of several health problems at 2 years, both the magnitude of risks and the range of health conditions for which risk remained elevated were much more pronounced at 2 years among people who were hospitalized during the acute phase of COVID-19.
Healio: In the study, you describe an impact from long COVID that is greater than the long-term impact of cancer and heart disease, two medical conditions with a lot of established mechanisms for research and support. Are we investing enough money in long COVID research and care?
Al-Aly: No. Long COVID remains an invisible health crisis, and our response to it does not match its scale. I have called and continue to call for a long COVID moonshot — a coordinated national strategy to understand long COVID and to best prevent and treat it.
Healio: Did the 2-year results surprise you, or were they what you expected? Why?
Al-Aly: I was hoping for better news, and hoping that SARS-CoV-2 infection would not be associated with lasting risks in people who had mild disease — this is the majority of people in the U.S. and the world who had COVID-19. It is very sobering to see the numbers, the scale and the breadth of organ damage that one virus can produce a year or 2 after infection.
Healio: Is the potential for developing long COVID being underplayed?
Al-Aly: Yes. Big time. I think long COVID is the inconvenient truth that some of us are choosing to sweep under the carpet. This is unfortunate, and it makes the crisis even more invisible, less talked about and reduces our prospects of addressing the challenges of long COVID as expeditiously as possible.
References:
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