Milwaukee Journal Sentinel

COVID-19 wreaks financial havoc

Study of similar illness finds significant impact

- Mark Johnson

For those infected with the new coronaviru­s, simply surviving is the top priority. But a study suggests that some survivors will face long-term financial burdens that could run into hundreds of thousands of dollars.

The study by researcher­s at University of Michigan and several other institutio­ns examined the costs borne by people who suffer acute respirator­y distress syndrome, one of the severest complicati­ons of COVID-19.

Published in the journal Critical Care Medicine, the study examined ARDS survivors in 2017 and 2018, well before the new coronaviru­s was discovered late last year. However, one of the study authors, Katrina E. Hauschildt, a doctoral candidate in sociology at University of Michigan, called the findings “incredibly relevant to people who get ARDS from COVID-19.”

ARDS is the most common cause for COVID-19 patients being transferre­d into the intensive care unit, said Lynn Schnapp, chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health.

“It’s a serious, I want to say, ‘dreaded,’ complicati­on,” Schnapp added.

ARDS is an extreme shortness of breath that leaves vital organs deprived of oxygen and often forces patients to be hooked up to ventilator­s. It’s a complicati­on that can be brought, not only by COVID-19, but by a wide variety of conditions, including pneumonia, flu and severe trauma.

The study’s authors interviewe­d 46 ARDS survivors and found that 31 — roughly two-thirds — experience­d at least some serious financial repercussi­ons.

“I am dead broke. That’s a fact,” said a 61-year-old man in the study. He reported that at the time of his illness he’d had insurance, but it lapsed because he was unable to work.

“I had to dip into my 401(k),” a 62year-old man in the study reported. “Actually to this day, we’re still paying off the medical bills.”

A 61-year-old woman reported that her medical bills reached $2 million, though she said her husband had excellent insurance. “So that is not a problem in the least, but we would have lost every single thing we owned if we didn’t have insurance.”

The study reported that after surviving ARDS many patients were unable to work, either temporaril­y or permanentl­y.

A 55-year-old man in the study said he had to sell his fire prevention company and go on disability after suffering ARDS.

“About 40% of the people who get ARDS aren’t able to work for the next year,” said Jonathon Truwit, enterprise chief medical officer at Froedtert Hospital and a professor at the Medical College of Wisconsin.

Truwit said that ARDS survivors find that their lungs recover and are able to breathe almost normally. However, the survivors suffer other problems, especially muscle weakness.

“You have problems with your ability to walk distances or lift things, your ability to concentrat­e. You have nightmares,” Truwit said, adding that about one in three ARDS survivors suffers from depression, and about 40% have to return to the hospital at least once over the next year.

After reading the new study, Schnapp said that patients who get the syndrome as a result of COVID-19 are unlikely to do any better than those in the study. “They will experience similar financial distress,” she said, “maybe even worse because of the economy, the loss of jobs and loss of insurance coverage.”

A Chinese study published in the journal Critical Care said the version of ARDS brought on by COVID-19 seems to differ from the version brought on by other causes. For example, it tends to appear days later in COVID-19 patients than in patients with other conditions.

Schapp said the question of whether there are key differences between ARDS brought on by COVID-19 and the version caused by other conditions “has been the subject of much debate around the country. We still are waiting for sufficient data.”

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