Will some victims of Covid-19 be ill for YEARS?
Boris’s doctor called it ‘the new polio’ – after the 1950s epidemics that left a generation blighted for life. Now experts are asking...
CRUSHING fatigue. Lung and heart damage. St r okes. Even brain damage. These are just a few of the frightening complications of coronavirus that indicate infection could, in some cases, lead to long-lasting, debilitating illness in those who survive it, a growing number of doctors are claiming.
Data gathered by UK researchers suggests primary symptoms themselves can come and go, or endure for ‘30 days or more’, far beyond the official two-week period suggested by the World Health Organisation.
And for certain patients, t he disease itself may be just the beginning of a long, hard battle – with one recent report warning of the looming threat of ‘post-Covid disability’.
One 48-year-old mother-of-three from East London has revealed how the virus left her with a deadly heart condition – quite possibly for life. Almost nine weeks after her ‘cold symptoms’ struck, doctors diagnosed dilated cardiomyopathy – Covid-19 had caused severe inflammation of the heart muscles, making it harder for it to pump blood around the body.
Doctors also found severe scarring
to both of her lungs. The woman, who did not want to be named, says: ‘I’ve been told that most cases improve gradually, but some require a pacemaker in future – and occasionally, a heart transplant. I still fight for breath and I get nausea and dizziness so severe that if I sit up, I have to lie back down again. I can only sleep on my right side, to relieve pressure on the heart.’
Other lingering repercussions include chronic memory loss, a swollen left eye and a strange, stabbing pain in her left leg.
The lung doctor who treated Boris Johnson, Professor Nicholas Hart, has claimed coronavirus could end up becoming ‘this generation’s polio’ and lead to a wave of further debilitating problems for patients many months, or years, after their symptoms begin.
This will scare anyone who can recall the polio epidemics of the 1950s, which killed thousands, and left a generation with life-long mobility problems. The virus, spread via bodily fluids, infected up to 8,000 a year in the UK between 1947 and 1956 – when a vaccine was finally found.
As has been seen in the current pandemic, large numbers of those with polio suffered few, if any symptoms. Yet one in ten of those who contracted the disease died. And in many more, the virus, which attacks the brain, led to permanent paralysis of one or more limbs, muscle-wasting and joint problems. Worse still, symptoms could return with a vengeance, years, or even decades later.
Posting on his Twitter page during the first week of lockdown, Prof Hart, critical care specialist at Guy’s and St Thomas’ NHS Foundation Trust wrote: ‘Covid-19 is this generation’s polio. Patients have mild, moderate and severe illness. Large numbers of patients will have physical, cognitive and psychological disability post-critical illness that will require long-term management.’
This newspaper has now spoken to a number of coronavirus victims who have been suffering from symptoms for months, in some cases.
One of them is Prof Paul Garner, an expert in tropical medicine at the renowned Liverpool School of Tropical Medicine. He spoke of ‘a rollercoaster of ill health, extreme emotions and utter exhaustion’ which has lasted seven weeks.
Prof Garner, 64, has travelled the world investigating viruses. After developing coronavirus seven weeks ago, Prof Garner says he suffered a ‘heaviness and malaise, tightness in the chest – [at times I have] been so unwell I felt I was dying’.
He says that he does not believe this to be ‘ some post- viral syndrome, it is the disease.’
Everyday there has been ‘ extreme fatigue’ although the other symptoms have varied. ‘There was something new each day. A muggy head; acutely painful calf; upset stomach; tinnitus; pins and needles; aching all over; breathlessness; dizziness; arthritis in my hands.’ He admits, despite his age, that he believed years of running and military fitness would protect him from the worst of Covid-19.
But at times the illness left him struggling to even walk.
While there is no evidence that coronavirus will cause the same cruel and devastating aftereffects as polio, doctors are concerned it has the potential to lead to long- term damage in large numbers.
Carmine Pariante, professor of biological psychiatry at King’s College London, says: ‘We don’t have the data yet, but we are concerned that some people will be affected long-term. There is, particularly for patients in intensive care, a perfect storm of potential damage to the body and the brain.
‘But we also need to see whether even those with milder forms who weren’t treated in hospital have some consequences such as long term physical or mental fatigue. We don’t know – but it might well be possible.’ Azeem Majeed, professor of primary care at Imperial College London, adds: ‘ Because this is a new disease, no one is sure of the long-term complications. Many will have a lot of lung disease in particular, and also some strain on the heart. These patients need to be followed to see what effect there is.’ The emerging problem is two-fold. The most seriously affected patients, of whom there are many thousands, have spent weeks in intensive care. It is already known from extensive research that being on life support can cause long-term complications including muscle weakness, lung problems and fatigue even five years later. Rehabilitation services are already gearing up to face ever- greater numbers coming through the system needing physiotherapy, psychological support and cardio-pulmonary rehab, according to Professor Lynne Turner-Stokes, chair of rehabilitation at King’s College London. But there is another unexpected element: a growing number of reports that even people with mild illness, who didn’t go to hospital, are experiencing long-lasting symptoms. Some people infected in February or March are still being ambushed by extreme fatigue, headaches, sudden breathlessness and problems concentrating or doing even light exercise.
Despite not being unwell enough for hospitalisation, 49- year-oldKirs tin Courtney, from Bath, is still batt ling crippling fatigue, dizziness, breathlessness and panic attacks – even six weeks after coming down with the virus.
‘Over 40 days later I’m still being hit by this virus in waves of hideousness,’ says the HR adviser, who believes her husband James and daughters, Tilly, 11, and Olive, 14, also had the virus, but with milder effects.
Kirstin says: ‘It can take me two hours to get ready and downstairs in the morning.’
The issue is that we don’t know how many of these patients there are, as we are not routinely testing suspected Covid-19 cases in the community. That also means their symptoms cannot be tracked.
A report co- authored by Prof Turner-Stokes for the British Society of Rehabilitation Medicine recognised the ‘significant challenges’ ahead because of ‘an as-yet unquantifiable additional caseload of patients with post-Covid disability’.
These problems are being seen even in those who did not require hospital admission, it added. One way of attempting to gather information is via the Covid-19 Symptom Study app, run by a team of researchers at King’s College London, in a bid to identify virus hotspots. It is already suggesting that there are longer-than-expected recovery times.
Tim Spector, professor of genetic epidemiology at King’s, who leads the team, says that while the average time for recovery was 12 days, ‘we are also seeing a significant number of people reporting symptoms that can go on much longer than this, for 30 days or more’.
Prof Majeed, who is also a GP in Clapham, South London, says he is seeing ‘ongoing problems’ among those who had either had or were suspected of having Covid19. ‘ Some people might recover for a few days and then develop a temperature and cough, and this might go on for weeks. This relapsing and remitting illness appears to be common.’
The virus itself attacks the lungs. But it also causes viral pneumonia – inflammation and a build- up of fluid in the lungs, which is the result of the immune system’s response to the infection.
There are likely to be lingering lung problems and many of those coming into Prof Majeed’s practice are suffering ongoing breathlessness. ‘ The changes on lung X-rays are quite unique,’ he explains, ‘and much more severe than we’d see with flu. So there are concerns about whether people will still have reduced lung function after several years.’