#17,911
The CDC is reportedly contemplating the relaxation of their home isolation recommendations for COVID cases. But how many people are currently aware of - or are abiding by - the current 5-day isolation and home testing recommendations is unknown.
My guess, based on limited personal observation, anecdotal reports, and the abysmal uptake of the updated COVID vaccine is: `not many'.
The power of social media and wishful thinking has - at least in the minds of much of the public - defanged the SARS-CoV-2 virus. It is now regarded as `no worse' than seasonal flu, despite the litany of scientific reports showing long-term harm, particularly from repeated infections.
AHA: COVID-19 May Trigger New-Onset High Blood Pressure
JAMA: Additional Evidence Of A Post-COVID/Diabetes Link
The Lancet: Neurological and Psychiatric Risk Trajectories After SARS-CoV-2 Infection
MMWR: Post–COVID-19 Symptoms and Conditions Among Children and Adolescents
Nature: Long-term Effects of SARS-CoV-2 Infection on Human Brain and Memory
While `fatigue' is often listed at the top of symptoms reported by those suffering from post-COVID syndrome (aka `Long COVID'), it isn't quite as benign as it sounds. It is often debilitating and can be life altering.
And according to a new report in the EID Journal, those experiencing extended fatigue are also at a significantly higher risk of hospitalization and death.
Due to its length I've only posted the link and some excerpts. Follow the link to read it in its entirety. I'll have a postscript after the break.
Research
Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection
Quan M. Vu, Annette L. Fitzpatrick, Jennifer R. Cope, Jeanne Bertolli, Nona Sotoodehnia, T. Eoin West, Nikki Gentile, and Elizabeth R. Unger
Abstract
This study aimed to estimate the incidence rates of post–COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020–February 2021 who were followed for a median of 11.4 (interquartile range 7.8–15.5) months and compared them to data from 9,022 propensity score–matched non–COVID-19 controls.Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non–COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48–1.92) for fatigue and 4.32 (95% CI 2.90–6.43) for chronic fatigue.The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.
(SNIP)
In our unadjusted analyses, patients with COVID-19 who had incident fatigue were at higher risk for hospitalization and death than were persons without incident fatigue. The severe outcome is likely driven, at least in part, by some of the comorbidities and predictors identified in this study. Elevated death rate was previously reported among fatigued patients without COVID-19 (HR 1.45) (26). Increased awareness of fatigue and other PCC is warranted to enable patients to seek early care when needed. Further research is also warranted to investigate the causes and preventive measures for the severe outcomes associated with post-COVID fatigue.
In conclusion, our data indicate that COVID-19 is associated with a significant increase in new fatigue diagnoses, and physicians should be aware that fatigue might occur or be newly recognized >1 year after acute COVID-19. Future study is needed to better understand the possible association between fatigue and clinical outcomes. The high incidence rates of fatigue reinforce the need for public health actions to prevent infections, to provide clinical care to those in need, and to find effective treatments for post–acute COVID-19 fatigue.
Dr. Vu is an epidemiologist in the Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention. His primary research interests are infectious diseases and postinfectious sequelae.
There can be little doubt that Post-COVID syndrome is real, and for a small-but-significant percentage of the population, it can prove severe enough to cause permanent disability and even premature death.
Some experts have even suggested we may see huge increases in COVID-19 related heart failure and neurological diseases in the years ahead.
Clyde W. Yancy, MD, MSc1,2; Gregg C. Fonarow, MD3,4JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3575
Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms
Emily A. Troyer, Jordan N. Kohn, and Suzi Hong
We saw heart attack rates jump very early in the pandemic, and they remain elevated, even in young adults. Research has shown that the SARS-CoV-2 virus can infect the heart (see Cardiovascular Tropism and Sequelae of SARS-CoV-2 Infection), and infection has been linked to myocarditis, pericarditis, blood clots, and arrhythmia.
It may take years to fully understand the long-term impact of SARS-CoV-2 infection on public health, just as we are now getting a better understanding the long-term risks of influenza infection (see Risk of Cardiovascular Events After Influenza).
But with COVID once again on the rise, and a new round of variants in the mix, it still makes sense to limit your exposure, and try to avoid spreading the infection if you can.
And that means staying home if you are sick.
Regardless of whether you think it is from COVID, influenza, RSV, or any other respiratory illness.
