As Patients Recover From Coronavirus, Doctors Wonder About Long-Term Health Impacts

The Centers for Disease Control and Prevention is reporting nearly 1 million known cases of COVID-19 in the United States. Of those, about 139,000 are listed as recovered.

But experts are warning of possible long-term effects for patients after they’ve survived the coronavirus. Doctors know now that the disease attacks many systems within the body — from the lungs and heart to the liver and kidneys, says Yale cardiologist Dr. Harlan Krumholz.

“The virus can attack almost any organ system within the body,” he says, “and … can do so with a ferocity that's rarely seen and can place people in positions where almost every body system is affected.”

The immune system’s response to the coronavirus alone could cause long-term damage because this “violent battle taking place” puts stress on the entire body, Krumholz explains.

“The body's defense system is preparing to do battle and in doing so, releases a lot of substances that both help us to fight the virus, but can also have what we call sort of systemic effects that can make us feel lousy,” he says. “And it's almost as if it's friendly fire from our own body.”

Doctors are also learning about the coronavirus’s direct harm to various organ systems, but Krumholz cautions that more studies are needed to understand this virus.

“We do not really deeply understand what we call the path of physiology of this, what's really causing the underlying problems,” he says.

Early on in the outbreak, doctors realized that people with heart conditions were at greater risk of developing a severe case of COVID-19, Krumholz says. But doctors are now discovering that the virus can actually cause direct damage to the heart.

“Many more people are showing mild damage to the heart than a smaller group that's showing more damage to the heart, and that's a consequence that we fear,” he says. “That's really major. In many cases, we think [it’s] damage that will persist after people get better.”

Long-term damage to the lungs is also a major concern with this virus, and Krumholz says some doctors have suggested that putting people on life-saving ventilators too early could be contributing to it.

Doctors are “trying different things to prevent them from going on ventilators, in part because once on ventilators, it has often been difficult to get people off of ventilators and to help them recover,” he says. “And some people have suggested that the ventilators may even be playing a role in that.”

Some doctors have surmised that small blood clots in the lungs could be causing severe respiratory distress in some COVID-19 patients, Krumholz says. Some are proposing testing certain medications to break up the blood clots to see if that helps patients improve.

Hospitals are also now confronting an increased need for dialysis machines because many coronavirus patients are suffering from kidney damage. Krumholz says a combination of factors is putting stress on the kidneys, including the virus directly entering the kidneys and the immune system inadvertently causing some damage.

“The direct action of the virus, the reaction of the body, the fluctuations in people's conditions and blood pressure and the medications we use,” he says, “all of these things can come together to affect the kidneys in ways that makes it more difficult for people to recover and can put them in a difficult position when they do.”

On top of the physical concerns, Krumholz says health care officials also need to be prepared to support the mental challenges that Americans might face in the years after they recover. Many people who suffered severe cases of COVID-19 and were hospitalized without their families will likely experience post-traumatic stress disorder, he says.

“We want to say, 'Hey, you're better. You're home,' ” he says. “But sometimes that's only the beginning of an extended recovery period where people are getting their strength back, getting their bearings and also their mental health is suffering in that period because they've just been through something so challenging and difficult.”

Karyn Miller-Medzon produced and edited this interview for broadcast with Tinku Ray. Samantha Raphelson adapted it for the web.