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Fatigue, shortness of breath, anxiety: What we now know about the longer-term effects of Covid-19

Some patients who recovered at home have reported fatigue and other symptoms weeks after their diagnosis.

Image: Shutterstock

AS HEALTH OFFICIALS here learn more about Covid-19, they are warning people of potential prolonged health impacts for some – even those who did not need to be hospitalised. 

Health authorities have said they are seeing an increase in the number of people taking a long time to fully recover their energy levels and still having difficulties with exercise tolerance, even if they weren’t hospitalised for the illness.

Increasingly they have also been pointing to numbers of new cases among younger people.

This week 27-year-old Dublin footballer Siobhán Killeen, who works as a radiographer at the Mater Hospital, shared her experience with Covid-19 at a Department of Health briefing.

In March she experienced symptoms including fever, body aches and headaches and tested positive for the coronavirus.

“While I was fortunate not to need hospitalisation the unknown of the disease was frightening. I didn’t know how my symptoms would escalate, I was isolated from my friends and family. The guilt was overwhelming. You ask that question of yourself: ‘Have I put my family at risk? Have I put others at risk?’,” she said.

Killeen said three months after her diagnosis she is still “on the long road to full recovery”.

“I thought it would take a two-week period of feeling the worst of Covid,” she said. “In reality the weeks and months following my isolation were the toughest. I was fatigued, my fitness levels had deteriorated, I had shortness of breath while exercising and I had feelings of worry.

As A Dublin footballer, I was not expecting that my recovery would be so tough and take so long. I know I had a good baseline fitness, I was in great health and it was a very tough battle.

She said she was naive in thinking her age and health would protect her from a very infectious disease and urged people of all ages to follow the public health advice.

Similar experiences have been reported in other countries.

study published at the end of April of 25 recovered patients in the Chinese city of Wuhan, where the virus first emerged, found they had not fully recovered normal functioning regardless of the severity of their symptoms. 

Alessandro Venturi , director of the San Matteo hospital in the Italian town of Pavia told the New York Times the hospital has seen “many cases in which people have taken a long, long time to recover”.

He said the discomfort often seems to last longer for people who had lightest symptoms.

“It’s not the sickness that lasts for 60 days, it is the convalescence, it’s a very long convalescence.”

 While studies on Covid-19 are generally small in scale so far, there is evidence from past epidemics caused by similar viruses such as SARS.

One study found survivors of SARS suffered lung infections, higher cholesterol levels and generally became ill more frequently than others for up to 12 years after the epidemic.

Fatigue

A number of people who spoke to TheJournal.ie recently about their experience with Covid-19 said they can still feel some after-effects of their illness, weeks on from their diagnosis. 

Suzanne* (50) from Drogheda, was forced to take four weeks off work after developing symptoms on 25 March. 

Although she said she has no issue with her breathing and his been able to get back to walking, she is still not fully back to herself.

“I would say I’m 99% over it, but I would still have this fatigue,” she said. “I wonder is it just my age, or pre-menopause? I have heard people say it’s something they’ve had as well.”

For patients with more severe illness, after effects can be more severe. In one study in Wuhan, CT scans taken over a month for 90 patients found that of the 70 discharged from hospital, 88 had mild to substantial residual lung abnormalities on their last scans. 

28-year-old Michael Prendergast this week also told RTÉ’s News At One that it has taken him 14 weeks to get “any semblance of normality back”.

He was hospitalised in March after contracting Covid-19 and said he has since had to return to hospital twice due to symptoms of the coronavirus, including fever, shaking and vomiting.

Prendergast said his doctor has said he does not need to be worried about permanent side-effects as he is young and relatively fit, but the last number of months have been “horrible”.

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He said he now starting to feel stronger and has been able to start exercising again.

Recovery for hospitalised patients

Dr Vida Hamilton HSE National Clinical Advisor and Group Lead, Acute Hospitals said some patients have lost as much as 18 kilos during their hospitalisation. This is due to a  “hyper metabolic response”  in patients with prolonged illness whereby the body begins to consume the muscle as fuel to fight off the infection.

“This requires a considerable amount of effort in rebuilding strength and musculature to be able to mobilise independently again afterwards. There are significant rehabilitation needs, particularly in people who have survived intensive care with Covid-19,” she said.

She said there are also impacts on the emotional wellbeing of patients, with some experiencing anxiety, depressive disorders and flashbacks associated with the trauma, particularly those who have been through a life-threatening event in the intensive care unit.

“And of course, in some people with the most severe end of the disease, they could have problems with short-term memory loss and difficulties of concentration that do improve with time, but that take time and care in order to give the person the ability to perform at their best possible level.”

Acting Chief Medical Officer Dr Ronan Glynn also this week warned that this disease is “unpredictable” and people should not assume they will recover in a couple of days like they would with a common cold.

“In general terms, anyone who has a flu or anyone who has a significant viral illness, whether they’re hospitalised or not, it’ll take them a number of weeks to recover,” he said.

“Anecdotally we’ve heard from GPs and we’ve heard from primary care that there are a proportion of people – young people, fit people like we heard from Siobhan the other day. It’s not the same as a common cold.

“It’s not a given that you’ll bounced back after a couple of days. Granted, there are people who suffer no symptoms or very mild symptoms. But the problem with this virus and the problem with this disease is that for any one individual who got it, it’s unpredictable.

“You could have a very benign disease course, or you could end up in intensive care. And unfortunately, we simply don’t know enough about the disease at this point to say with any certainty for any one individual what that outcome will be and that’s why we still go on about all the precautions that people need to take.”

- With reporting by Dominic McGrath.

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