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Pandemic health consequences: Grasping the long COVID tail

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Emerging evidence suggests that approximately 10% of people who survive Coronavirus Disease 2019 (COVIDAU : PleasenotethatCOVID 19hasbeendefinedasCoronavirusDisease2019atitsfirstmentioninthesentenceEmergingevidencesuggeststhatapproximately10%ofpeoplewhosurvive:::Pleasecorrectifnecessary: -19) wi l have lingering symptoms that negatively affect their quality of life,… Click to show full abstract

Emerging evidence suggests that approximately 10% of people who survive Coronavirus Disease 2019 (COVIDAU : PleasenotethatCOVID 19hasbeendefinedasCoronavirusDisease2019atitsfirstmentioninthesentenceEmergingevidencesuggeststhatapproximately10%ofpeoplewhosurvive:::Pleasecorrectifnecessary: -19) wi l have lingering symptoms that negatively affect their quality of life, ability to work, and function [1,2]. This important group of people with the post-COVID-19 condition may seem small in comparison to the overall number of people with COVID-19 infection [3]. However, many patients who survive COVID-19 are likely to have considerable symptom burden, high resource utilization and health service needs, reduced economic productivity, and possibly a shortened life expectancy. The study by Bhaskaran and colleagues published in PLOS Medicine addresses an evolving, poorly studied, and important area of health policy and planning related to the care of patients who survive hospitalization for COVID-19 [4]. At face value, the scope of the COVID-19 pandemic is enormous. Within 2 years, nearly 300 million people have been infected with the Severe Acute Respiratory Syndrome Coronavirus 2 (SARSAU : AU : PleasenotethatSARS CoV 2hasbeendefinedasSevereAcuteRespiratorySyndromeCoronavirus2atitsfirstmentioninthesentenceWithin2years; over250millionpeoplehavebeeninfected:::Pleasecorrectifnecessary: -CoV-2) virus, and more han 5 milli n people have ied from it [5]. But, th re is also a long tail to this statistical distribution of hardship. Studies report that numerous patients will continue to experience fatigue, shortness of breath, pain, sleep disturbances, anxiety, and depression [6]. More serious organ dysfunction such as pulmonary fibrosis, cognitive impairment, myocarditis, and renal failure may also develop [6]. Whether these translate into clinical diagnoses of chronic diseases like interstitial lung disease, dementia, heart failure, and chronic kidney disease remains to be seen. Collectively, the prospect for immense suffering among these individuals will undoubtedly have huge and enduring impacts on healthcare systems globally. As the world continues its largest vaccination effort in history and looks to eliminate the impacts of acute COVID-19, we must not forget that a meaningful minority who survive will transition from an acute to chronic disease state. In turn, management strategies and health resource planning must also appropriately transition. As a multisystem disease, the post-COVID-19 condition will require the involvement of multidisciplinary care teams [7]: Who will help to look after these patients? Bhaskaran and colleagues studied over 164,000 hospitalized adults with COVID-19 matched to an “active control” group of adults hospitalized with influenza and to general population controls. They compared the mediumand long-term risks of hospital admission and death across the 3 study groups. The main findings were that people discharged following hospitalization for COVID-19 had a 2-fold higher associated risk for rehospitalization and death than the general population and similar risks compared to those hospitalized for influenza. These outcomes were most pronounced in the first 30 days following discharge yet remained substantially elevated over time. Further, those hospitalized with COVID-19 were more likely PLOS MEDICINE

Keywords: plos medicine; health; disease; pandemic health; health consequences; medicine

Journal Title: PLoS Medicine
Year Published: 2022

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