May 31, 2022
Several notable studies have been released in recent weeks that describe a series of health conditions experienced by individuals who have recovered from COVID-19. Known as “long COVID,” the impact of these pervasive conditions on health and quality of life may have significant implications for surgeons and patients as they make treatment decisions related to readiness for and recovery from surgery.
Key findings conclusions include:
Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention)
“Post–COVID Conditions among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years”
Researchers looked at electronic health record data over more than 18 months in adults in two groups—those aged 18−64 and those aged 65 and older—to examine the occurrence of 26 conditions that may have stemmed from previous COVID-19, weeks or months after recovery. These data indicated that 38% of all COVID patients experienced a condition versus 16% of controls, with pulmonary embolism and respiratory issues occurring most frequently.
These findings may be relevant for surgeons because the researchers noted that “care requirements might place a strain on health services after acute illness in communities that experience heavy COVID-19 case surges.”
Lancet Respiratory Medicine
“Health Outcomes in People 2 Years after Surviving Hospitalisation with COVID-19: A Longitudinal Cohort Study”
This study measured six health outcomes at 6 months, 12 months, and 2 years after COVID-19 hospitalization and recovery in Wuhan, China. In the nearly 2,500 studied patients, half of the survivors had longitudinal improvements in mental and physical health from the acute phase of their infection; however, even 2 years later, they had a notably lower health status than the control group, with high prevalence of pain and discomfort, as well as reduced lung function in patients who had more serious disease.
According to the study, “long COVID symptoms at 2 years were related to decreased quality of life, lower exercise capacity, abnormal mental health, and increased use of healthcare after discharge. Physical health and health-related quality of life of COVID-19 participants were still poorer than those of the control population 2 years after acute infection.”
Nature
“Long COVID after Breakthrough SARS-CoV-2 Infection”
This study had a more specific focus on whether vaccination against COVID-19 conferred any protection from long COVID in the event of a breakthrough infection (BTI). Using US Department of Veterans Affairs health databases, the authors looked at more than 33,000 individuals with BTI 6 months after infection against several control groups of individuals who did not have COVID-19 infection.
The findings showed that although vaccinated individuals with BTI had a lower risk of death and incidence of post-acute sequelae, including cardiovascular, coagulation and hematologic, gastrointestinal, kidney, mental health, metabolic, musculoskeletal and neurologic disorders than patients who were never vaccinated, individuals with BTI still were significantly more likely than control groups to experience death and ongoing symptoms.
The authors concluded, “Measures for the prevention of breakthrough infections are needed to most optimally reduce the risk of the long-term health consequences of SARS-CoV-2 infection.”