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Large-Scale St. Louis VA Study Measures Severity, Scope of 'Long COVID'

A federally-funded grant is helping judges in 13 states, including Missouri, learn more about the science of the coronavirus.
David Kovaluk
St. Louis Public Radio
Doctors at the St. Louis Veterans Affairs Health System say long-term effects of COVID-19 can be serious and can affect every organ system in the body.

Many people who get sick with COVID-19 continue to have wide-ranging health problems months after they recover from their initial infection, researchers at the Veterans Affairs St. Louis Health Care System have found.

In a study published this month in the journal Nature, the researchers wrote that even after COVID-19 patients no longer tested positive for the coronavirus, they continued to have serious or chronic health issues. The study of more than 73,000 COVID-19 patients found that they sought care and medications more frequently than people who did not get sick.

“What we’re seeing in acute COVID, we’re seeing literally the tip of the iceberg,” said Dr. Ziyad Al-Aly, a doctor at the St. Louis VA hospital and one of the study’s authors. “If you start looking at long COVID, that’s what’s beneath that tip. … Some people call this our next big health crisis. I don’t think that that is an exaggeration.”

The patients saw higher incidences of issues — such as heart and kidney problems and mental health disorders. The most prevalent were respiratory symptoms. The group of so-called COVID-19 long-haulers developed problems in practically every organ, Al-Aly said.

“Our approach was designed to leave literally no stone unturned,” Al-Aly said. “We looked at every single disease we know exists. Our report shows the burden of COVID is substantial, it’s not really small, and it can take different shapes and different forms in different people.”

Patients who recovered from COVID-19 also had higher incidences of depression, diabetes and other chronic diseases.

The study’s findings confirm what Dr. Maureen Lyons, director of Washington University’s new Care and Recovery After COVID clinic, is seeing in her patients.

“Common symptoms include profound fatigue, inability to concentrate, inability to focus, headache, chest pain, chest pressure, high heart rates, and really symptoms that span every organ system,” she said. “The impact of COVID, even potentially what seems like a mild case initially, can be quite impactful and can last a long period of time and truthfully an unknown period of time.”

Most of the patients with long COVID who come to the clinic did not go to the hospital when they first got sick, and many are younger, healthy people, she said. The average clinic patient is in their mid-40s.

The VA study found that while people with more severe cases of COVID-19 who required hospitalization were more likely to have continuing health problems, even those who had relatively mild cases of the disease developed long-term health problems.

The study's authors say it is not clear if or how the coronavirus is related to such long-term health issues. The ongoing health disorders could be caused by the virus continuing to live inside patients’ bodies, they wrote.

They also say it’s possible that the virus could cause a patient’s immune system to go into overdrive and make them sick.

Most of the VA patients in the study are men, which reflects the organization’s overall patient mix. It’s possible long COVID could be more widespread in women, the study’s authors said.

Follow Sarah on Twitter: @petit_smudge

Sarah is the health reporter at St. Louis Public Radio.

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