Researchers have said people who have survived the coronavirus disease (Covid-19), including those who were not hospitalised, have an increased risk of death in the six months after their diagnosis. The research by experts at the Washington University School of Medicine in the US, published in the Nature journal on Thursday, also reveals the massive burden the coronavirus disease may place on the world’s population in the coming years, they said.
“Our study demonstrates that up to six months after diagnosis, the risk of death following even a mild case of Covid-19 is not trivial and increases with disease severity. Physicians must be vigilant in evaluating people who have had Covid-19. These patients will need integrated, multidisciplinary care,” senior author Ziyad Al-Aly, an assistant professor of medicine at Washington University School of Medicine, said.
The researchers, after their study which involved more than 87,000 patients and nearly five million control patients, have also catalogued the numerous diseases associated with Covid-19, providing an overview of the long-term complications of the deadly disease. They confirmed that despite being initially a respiratory virus, long Covid-19 can affect nearly every organ system in the body.
The researchers were able to calculate the potential scale of the problems first seen from anecdotal accounts and smaller studies that hinted at the wide-ranging side effects of surviving Covid-19 patients. These side effects include breathing problems, irregular heart rhythms, mental health issues and hair loss, they said. “This study differs from others that have looked at long Covid-19 because, rather than focusing on just the neurologic or cardiovascular complications, for example, we took a broad view and used the vast databases of the Veterans Health Administration (VHA) to comprehensively catalogue all diseases that may be attributable to Covid-19,” said Al-Aly.
The researchers showed that Covid-19 survivors—after surviving the initial infection—beyond the first 30 days of illness had an almost 60 per cent increased risk of death over the following six months compared to the general population. The researchers noted that at the six-month mark, excess deaths among all Covid-19 survivors were estimated at eight people per 1000 patients. They said that among patients who were ill enough to be hospitalised with Covid-19 and who survived beyond the first 30 days of illness, there were 29 excess deaths per 1000 patients over the following six months.
“These later deaths due to long-term complications of the infection are not necessarily recorded as deaths due to Covid-19. As far as total pandemic death toll, these numbers suggest that the deaths we are counting due to the immediate viral infection are only the tip of the iceberg,” Al-Aly said.
The researchers analysed data from the national health-care databases of the US department of veterans affairs—including 73,435 Veterans Health Administration (VHA) patients with confirmed Covid-19 but who were not hospitalised. Almost 5 million VHA patients, who did not have a Covid-19 diagnosis and were not hospitalised during this period, were included for comparison. The veterans were primarily or almost 88 per cent men but the large sample size meant that the study still included 8880 women with confirmed cases of the coronavirus disease.
The researchers said they analysed VHA data to conduct a separate analysis of 13,654 patients hospitalised with Covid-19 compared with 13,997 patients hospitalised with seasonal flu to help understand the long-term effects of more severe bout of the coronavirus disease. All patients survived at least 30 days after hospital admission and the analysis included six months of follow-up data.
(With agency inputs)