A review of the research published on Monday in the journal Nature Medicine describes the potential long-term effects of coronavirus on the entire body, highlighting the challenges that long-haulers face in their recovery.
The review describes in detail all the organs affected by Covid-19 in the long term, including lungs, heart, kidneys and skin, as well as the gastrointestinal, neurological and endocrine systems.
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The publication comes at a time when dozens of post-Covid clinics have been established across the country, serving Covid-19 patients whose symptoms persisted for months on end.
“With the recognition of more multi-organ effects of this virus, the need for multidisciplinary care is becoming more evident,” said Dr. Kartik Sehgal, one of the authors of the article.
Sehgal, a medical oncologist at the Dana-Farber Cancer Institute in Boston, diverted his attention from cancer when the pandemic started last spring. “We all kind of come together as a whole field of doctors to take care of the growing needs in hospitals to take care of patients with Covid-19,” he said.
Although most long-haulers never became ill enough to be hospitalized, the review found that up to a third of patients hospitalized with Covid-19 experienced long-term symptoms.
“It is clear that care for patients with Covid-19 does not end at the time of hospital discharge,” wrote the study’s authors.
The most common long-term symptoms of Covid-19 included fatigue, shortness of breath, brain fog, loss of smell or taste, anxiety, depression and post-traumatic stress disorder.
There is no specific treatment for Covid-19 long-haulers. Many clinics are focused on physical therapy to treat symptoms.
The review suggests that nutrition should also be a treatment target.
“We certainly saw very malnourished people,” said Dr. Greg Vanichkachorn, an occupational medicine specialist who treats long-distance travelers at the Mayo Clinic in Rochester, Minnesota.
Vanichkachorn, who was not involved in the report, said the tiredness of many long-distance travelers may be the reason they have no desire to cook or eat. It may also be, he said, because many report a continued loss of taste and smell.
Although long-term symptoms have been reported by up to a third of patients confirmed with Covid-19, Sehgal pointed out that many people infected with the coronavirus may not know this. It is possible, therefore, that many long-haulers are suffering without understanding the cause of their continuous symptoms with brain fog or fatigue.
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Symptoms can be subtle, said Sehgal, “so if someone is showing symptoms that cannot be explained in any other way,” it may be important to consider Covid-19.
Dr. Elaine Wan, senior author of the review and professor of medicine at Columbia University’s Faculty of Vaginal Physicians and Surgeons, said the report will change her practice.
“No matter what the patient comes for, I now ask if they have already had Covid-19. It changes the possible range of diagnoses,” she said in a statement.
Vanichkachorn said that future research will need to focus on what is happening inside the body – at a cellular level – that leads to long-term Covid-19 symptoms.
Last month, the National Institutes of Health announced a billion-dollar research initiative on Covid-19 long-haulers.
“As soon as we do more research on this,” said Vanichkachorn, “I think we will have more opportunities for treatment and drugs.”
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