It’s much more than lung injury and male infertility, the after-effects of the new coronavirus.

On May 4, the Ministry of Foreign Affairs and the Health and Care Commission jointly invited Zhong Nanshan academician synods the “epidemic” for international students, saying: “As long as there are no underlying diseases, recovery will be quick.” New coronary pneumonia patients than SARS patients lung fibrosis is not too heavy, the former lung damage does not appear too large, will slowly recover, so the after-effects are not large. “Although most patients will slowly recover, some of the potential sequelae cannot be ignored.

In early March, Lauren Nichols of the United States began to develop symptoms, and the 32-year-old woman felt a strong burning sensation as she breathed, like acid reflux. But she didn’t see a doctor until the situation got worse, and eventually she tested positive for Covid-19. But to her, it was just the beginning. Over the next eight weeks, she developed a variety of symptoms, including chronic fatigue, diarrhea, nausea, tremors, headaches, lack of concentration and short-term memory loss.

“The guidelines provided by the U.S. Centers for Disease Control and Prevention (CDC) are completely inconsistent with my symptoms, which means that the medical community cannot ‘confirm’ my symptoms,” she said. It also plunges me into a vicious circle of suspicion, confusion and loneliness. “

Potential long-term health effects of the new coronavirus

About 5 to 80 percent of those who tested positive for Covid-19 may have no symptoms or develop symptoms for days or even weeks after testing, many of whom develop short and mild symptoms. The World Health Organization says it is expected to take more than two weeks for patients with mild illness to recover, and critically ill or critically ill patients are expected to recover in three to six weeks.

Since Covid-19 is a new type of disease, and even the earliest recovered patients in China have only passed for a few months, the long-term health trajectory of seriously ill patients has not been studied. But doctors say the new coronavirus can attach to cells in many parts of the body and penetrate many major organs, such as the heart, kidneys, brain and even blood vessels.

“The difficulty we face is finding out the long-term effects,” said Joseph Brennan, a cardiologist at Yale University School of Medicine. While some patients may make a full recovery, he and other experts worry that patients with new coronary pneumonia may suffer long-term damage, including lung scars, heart damage, neurological and mental health effects.

The NHS estimates that 45 per cent of Covid-19 patients requiring hospital treatment require ongoing medical care, 4 per cent in hospital and 1 per cent in permanent emergency care. Studies of other coronaviruses, such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), as well as preliminary evidence obtained by researchers, suggest that it will take years for some patients to fully recover. Unfortunately, for other patients, the damage may never recover.

Of course, we don’t know much about the sequelae, but there are some potential long-term effects that are already visible in some Covid-19 patients.

Symptoms of scarins in the lungs

In March, 32-year-old Melanie Montano tested positive for Covid-19. More than seven weeks after her first illness, she still develops intermittent symptoms, including burning of her lungs and dry cough.

Brennan said the symptoms occur because “the virus produces an incredibly aggressive immune response, so the lungs are filled with debris and pus that makes the lungs less flexible.” “In CT scans, the normal lungs are black, while the lungs of Covid-19 patients usually have lighter gray patches, or “matted glass shadows,” which may not heal.

Our researchers have made a long-time discovery about this. A national study found that 77 percent of Covid-19 patients had this lesions. In another study published in the journal Radiology, researchers suggested that 66 of the 70 hospitalized patients found some degree of lung damage in CT scans, and that more than half had lesions that could develop into scars. A third study showed that the lesions were not confined to critically ill patients. Of the 58 asymptomatic patients, 95% also had frosted glass shadows in their lungs. More than a quarter of people develop the condition within a few days.

It's much more than lung injury and male infertility, the after-effects of the new coronavirus.

Covid-19 patients usually have shallower gray patches in their lungs

“This change in tissue can lead to permanent damage,” said Ali Gholamrezezhadehad, a radiologist at the University of Southern California’s Keck School of Medicine. “Although it is not yet known whether patients with persistent lung symptoms will develop permanent lung damage, doctors can learn more from patients recovering from SARS and MERS.”

A small longitudinal study, published in the journal Nature, followed 71 SARS patients from 2003 to 2018 and found that more than one-third had scars in their lungs, which could mean impaired lung capacity. The after-effects of MERS are somewhat hard to infer, as fewer than 2,500 people are infected, 30 to 40 percent of whom die. But one study found that about a third of the 36 MERS survivors also had long-term lung damage.

“For this group of people, lung function will never recover, which means that their ability to perform normal activities will never return to normal levels,” said Gholamrezanezhad, who recently gave a literature review of SARS and MERS. “Furthermore, Covid-19 may end up with higher scarring rates than SARS and MERS patients, as these diseases usually affect only one lung, and Covid-19 appears to often affect both lungs, which also increases the risk of lung scarring.”

He has seen residual scars in Patients with Covid-19, so a study is being designed to determine which factors may put some people at higher risk of permanent damage. He suspects that any type of lung disease or other health condition may increase the risk of long-term lung damage. In addition, he claims, “the older you get, the more likely you are to have scars in your lungs.” “

For people with this lung bruise, normal activity can become more challenging. “Everyday activities like climbing stairs make these people breathless,” Brennan said. “

Stroke, embolism and blood clots

Many patients hospitalized for Covid-19 have an unexpected high incidence of thrombosis, which may be due to an inflammatory response in the body. But these blood clots can lead to pulmonary obstruction, stroke, heart attack and other serious and long-lasting complications.

The formation of blood clots in the brain can lead to stroke. Although stroke is more common in older people, stroke is now reported even in young Covid-19 patients. In Wuhan, about 5% of Covid-19 patients admitted to hospital had a stroke, and SARS had a similar condition.

Among young stroke patients, the mortality rate is relatively low, and many people recover. But research shows that only 42 to 53 percent of people are able to return to work.

Blood clots also cut off blood circulation to parts of the lung tissue, a condition known as pulmonary embolism, which can be fatal. Two studies in France showed that 23 to 30 percent of covid-19 patients had lung embolism problems at the same time. An analysis found that after the appearance of pulmonary embolism symptoms, the recovery of a variety of symptoms, including fatigue, palpitations, shortness of breath, obvious physical movement restrictions.

Blood clots in other major organs can also cause serious problems. Renal failure is a common problem in many patients with Severe Covid-19, and dialysis machines are blocked by blood clots. Some of these acute kidney injuries may be permanent and require continuous dialysis.

Blood clots in non-organs are also severe. For example, deep vein thrombosis occurs when blood clots form in veins, usually in the legs. Nick Cordero, a Tony Award-nominated Broadway actor, recently had his right leg amputated because of a blood clot caused by new coronary pneumonia.

Blood clots can also cause abnormalities even after the patient recovers. For example, a 32-year-old woman in Chicago died a week after being discharged from the hospital from severe swelling in her leg, caused by deep vein thrombosis. Then there’s Troy Randall, a 49-year-old cardiologist in New Jersey who was announced to be able to return to work after his recovery, but suffered a severe headache because of a stroke.

Despite the lack of data, one study found that as many as 31 percent of covid-19 patients had the problem. At the same time, the International Society for Thrombosis has issued guidelines requiring recovering Covid-19 patients to continue taking anticoagulant drugs after discharge from the hospital.

Heart damage

Critical conditions, especially lack of oxygen, can put extra pressure on the heart. But doctors now believe that in Covid-19 patients, the virus may also cause inflammation of the heart muscle.

“In China, doctors notice that some people come to the doctor with chest pain,” said Mitchell Elkinde, president of the American Heart Association and a professor of neurology and epidemiology at Columbia University. They first had a heart attack, then developed symptoms of new coronary pneumonia, and then tested positive. “

A study in Wuhan in January found that 12 percent of Covid-19 patients showed signs of cardiovascular damage. These patients had high levels of troponin, a protein released by myocardial injury. There have also been other reports that the new coronavirus may directly cause acute myocarditis and heart failure.

In March, another study looked at 416 hospitalized Covid-19 patients and found that 19 percent of them showed signs of heart damage. Among survivors, Covid-19 could cause sustained heart damage and worsen existing cardiovascular diseases, further increasing the risk of heart disease and stroke, researchers at the University of Texas Health Science Center warned.

This happened to a doctor at Mount Sinai Hospital in New York when she recovered from Covid-19 and found out she had cardiomyopathy. The disease causes the heart to be unable to deliver blood throughout the body. Although she was healthy before, when she returned to work, she couldn’t run around as she used to.

What happens to the patient depends on the effecton of the heart. For example, Covid-19 is thought to be associated with myocarditis. In myocarditis, inflammation weakens the heart’s function, creating scar tissue, making the body’s oxygen circulation more difficult. The Myocarditis Foundation also advises these patients to avoid smoking and drinking alcohol and not to exercise vigorously until they have the approval of their doctor.

The effects on neurocognitive and mental health

New coronary pneumonia also appears to affect the central nervous system and have long-term consequences. A national study found that more than a third of the 214 confirmed Covid-19 patients developed neurological symptoms during the illness, including dizziness, headache, impaired consciousness, vision, impaired taste/smell and nerve pain. These symptoms are more common in patients with severe illness, with a incidence rate of up to 46.5%. Another French study found that 58 of the 64 patients with severe Covid-19 had neurological problems.

The neurological effects of Covid-19 patients may be slightly delayed compared to SARS and MERS. “Although there are about 8,000 SARS patients worldwide, there are fairly limited reports of neurological complications, and these complications occur two to three weeks after onset,” Dr. Andrew Josephson of the University of California, San Francisco wrote in the Journal of the American Medical Association. “These symptoms include muscle weakness, burning or tingling, numbness, and muscle tissue breakdown. Neurological damage, including impaired balance, confusion and coma, is also associated with MERS.

Long-term complications of Covid-19, whether caused by the virus itself or by inflammation caused by it, can cause problems including attention and memory loss, as well as end-of-the-nerve dysfunction. “These nerves affect the normal function of your arms, legs, fingers and toes,” Elgind said. “

People who receive intensive treatment at the hospital also have other cognitive problems. For example, one-third or more of ICU patients experience insanity. Studies have shown that mental disorders in patients with severe illness may indicate a long-term cognitive decline in the future.

Extensive previous studies of acute respiratory distress syndrome (ARDS) have shown that patients with covid-19 severe illness may have neurological problems after discharge from hospital. Research shows that one in five ARDS survivors still have cognitive impairment five years after discharge from hospital. Persistent impairment sq. may also include short-term memory problems, learning and performing dysfunction. This can lead to difficulties in working or difficulty in performing normal tasks on a daily basis.

ARDS survivors also have an increased risk of depression and anxiety, and many also experience post-traumatic stress. Although data on Covid-19 are severely lacking, patients have been struggling with psychological stress for at least a year after recovering from the SARS outbreak.

“I feel like I’m in my own body, in my home, and the public and even the people closest to me will ignore me and have a great misunderstanding of me,” Nichols said of her struggle with Covid-19. I feel very lonely. “

A nurse who cared for AIDS patients tested positive for Covid-19 more than a month ago. She’s still struggling with fever, heart problems and neurological problems, but she says the hardest part is that she’s tired of being treated as “a bomb that no one knows how to dismantle, and that’s what aids patients experience.” “It also adds to her mental burden. “People need to know that the disease will persist and damage your life and health,” she said. No one knows what to do. “

Inflammation in children, male infertility and other possible long-term effects

Mysterious symptoms of the new coronavirus have plagued scientists and patients. One of the most recent cases in children in the UK, Italy and Spain has strange symptoms including a rash, high fever and heart inflammation.

On 4 May, the New York City Department of Health noted that at least 15 children had these symptoms. These cases showed a severe immune response similar to Kawasaki disease. Although only some of the children tested positive for Covid-19, Russell Weiner, president of the Royal College of Paediatrics and Child Health, told the New York Times: “These symptoms are most likely related to Covid-19. “Children recovering from these symptoms may experience heart muscle and vascular complications as adults.

It's much more than lung injury and male infertility, the after-effects of the new coronavirus.

Children develop a severe immune response similar to Kawasaki disease

Other researchers believe that the special effects of Covid-19 on men may exceed their disproportionate mortality rates. “The testicles contain a large number of ACE2 receptors, so in theory, Covid-19 can lead to male infertility,” Ali Raba explained in a recent letter to the World Journal of Urology. “Another study looked at 38 severe patients with Covid-19 in China and found that 15 patients had viral RNA in semen samples during the illness, and two of the 23 recovering patients had viral RNA in their semen.

Another recent study also showed a decline in the proportion of male hormones in 81 male patients, which may affect their future fertility problems. The researchers called for more attention to be paid to the effects of fertility, especially in men of childbearing age. A paper published in the April 20 issue of the journal Nature even suggests that “young men planning to have children should be tested for fertility after recovering from new coronary pneumonia.” “

Researchers are only just beginning to figure out the effects of viral infections on other organ systems. For example, domestic researchers recently tested the blood of 34 Covid-19 rehabilitation patients. The researchers found that, regardless of the severity of the disease, many biological indicators “failed to return to normal” after the patient recovered and was discharged from the hospital. Most worryingly, tests show that their liver function will continue to suffer.

What this means for survivors and researchers?

All of these preliminary studies show that we still know very little about the effects of the virus on patients with neo-coronary pneumonia, such as what symptoms they may have, how long it will take to get back to normal, and what other measures we need to take against them.

Many people don’t even tell them when it’s safe to stop self-isolation. Nichols and other survivors claim they may have felt better the day before, but the next day the situation will get worse.

The new coronavirus has caused confusion in the health system, and survivors say their own battle with the virus is hard to draw attention to. “Both the support of the health system and the awareness of the impact of the disease are severely lacking,” Nichols said. Every day the symptoms change like a roller coaster, full of a lot of unknowns. I may feel healthier today, but the next day I may feel very weak and miserable. “