The epidemic has been in the three years, and the global number of patients with sequelae of COVID-19 is expected to reach 145 million. There are more than 200 symptoms of COVID-19 in the long term. How should humans respond?
The new crown epidemic is about to end its third year. As of today, October 15, 2022, the number of infections worldwide is currently more than 610 million, and the cumulative death toll exceeds 6.55 million. The sequelae of the new crown or the long-term new crown are being discussed and paid more and more attention from all countries.
Long-term COVID-19 has brought great disasters to human society
As the novel coronavirus continues to mutate into a more contagious form, COVID-19COVID-19COVID-19Critical Pneumonia still exists today and has caused the first, second, third, and even more infections among people around the world. But at least tens of millions of people who had been sick a long time ago have not fully recovered.
They live under the symptoms of "long COVID" or "post COVID", a general term for various persistent health conditions and symptoms caused by COVID that doctors do not fully understand now.
A large number of patients in the world are considered to have long-term COVID-19, but little is known about the disease - although studies have recently proposed several theories of etiology.
AFP said it is estimated that 10% to 20% of people infected with the new coronavirus will experience long-term symptoms of the new coronavirus after recovering from the disease for a few months. The most common ones are fatigue, breathing difficulties and unclear thinking, which is called brain fog.
The U.S.-based Institute of Health Indicators and Assessment (IHME) estimates that nearly 145 million people worldwide have at least one of these symptoms in 2020 and 2021.
According to the IHME model released by the World Health Organization (WHO ) earlier this month, in Europe alone, 17 million people have long-term COVID-19 symptoms at least three months after infection.
WHO Europe Director Hans Kruger said that these tens of millions of people "cannot continue to endure silently", and he called on the world to act quickly and learn more about the situation.
researchers have been trying to catch up, but the massive permutation and inconsistency of symptoms complicate things.
According to a study by University College , more than 200 different symptoms have been attributed to the new crown.
On October 10, 2022, "Journal of the American Medical Association " published a large-scale global study led by the WHO, which is regarded as the most comprehensive analysis of the sequelae of the new crown since the epidemic. The study collected data from 1.2 million symptomatic COVID-19 infections in 22 countries. According to the model, 6.2% of COVID-19 infections were estimated in 2020 and 2021, and more than 74,000 people reported that they had at least one sequelae of COVID-19 three months after their first infection.
"The new crown is not just a respiratory disease, but it will also affect multiple tissues and organs of the human body, affecting central nervous system , peripheral nervous system , gastrointestinal tract, heart, musculoskeleton, etc. There are now more than 200 sequelae of new crown." Akiko Iwasaki, professor of immunology at Yale University School of Medicine, said in a video interview in August 2022, "Even if the new crown pandemic stops today, tens of millions of people still suffer from the sequelae of new crown. This is a parallel epidemic that is happening, with acute and severe new Compared with crown infection, it receives much less attention. ”
A U.S. hospital is treating COVID-19 patients (photo)
Long-term COVID-19 is a "mixture of multiple symptoms"
The aforementioned study published online in the Journal of the American Medical Association includes data on 1.2 million COVID-19 infections with symptoms from 2020 to 2021 before the Omickron epidemic. The data comes from 44 published studies and 10 multi-country cooperative studies, as well as two electronic medical records databases in the United States. The researchers began collecting data from March 2020 and continued until January this year.
This study mainly involves three long-term COVID-19 symptoms: continuous fatigue and physical pain, respiratory problems, and cognitive problems. The results show that in 2020 and 2021, three months after infection with the new crown, the proportion of these three symptoms was 3.2%, 3.7% and 2.2% respectively.The proportion of infected people who need hospitalization and intensive care are 27.5% and 43.1% of the sequelae of COVID-19, respectively, which is far higher than the proportion of non-hospitalized patients. Among the patients with sequelae of COVID-19, 15.1% still have symptoms one year after infection.
According to the British weekly website of the New Scientist website on July 25, 2022, a study of 2.4 million electronic health records showed that hair loss, reduced sexual desire and difficulty ejaculation may be undetermined symptoms of "long new crown" (referring to the long-term syndrome of new crown pneumonia).
Anurada Subramanian of the University of Birmingham, UK, said: "We studied the impact of the new coronavirus on 115 symptoms and found that 62 of them were significantly associated with the new coronavirus within 12 weeks (or even longer) after infection with the virus. Some of these new symptoms are very new symptoms, such as decreased libido, sexual dysfunction and hair loss, which have not been attributed to the long-term effects of the new coronavirus."
Analysis by the research team also showed that people with new coronavirus tend to have one of these symptoms. It is very common that people experience various symptoms, including fatigue, rash, and pain. These symptoms affected about 80% of the subjects who had COVID-19.
More than one-tenth of the research subjects (14.2%) had cognitive symptoms, including depression, anxiety, insomnia and brain fog. 5.8% of the study subjects mainly had respiratory problems, such as coughing, shortness of breath and wheezing.
A more comprehensive analysis report using U.S. health data on "" on September 22, 2022, showed that stroke, cognitive impairment, memory problems, depression, anxiety, migraine headaches, movement disorders, hearing and vision problems, balance and coordination problems, and Parkinson-like disease in the first year after infection with the new coronavirus.
researchers analyzed about 14 million hidden personal identity medical records of patients of different ages, races and genders in a database maintained by the U.S. Department of Veterans Affairs . These data were earlier than delta delta, omicron omicron and other coronavirus variants.
According to their findings, it is estimated that approximately 6.6 million people across the United States have suffered brain damage related to the virus. Those infected with the COVID-19 virus have a 77% increased risk of memory problems, a 50% increased risk of ischemic stroke, and an 80% increased risk of epilepsy or seizures .
The possibility of a new coronary pneumonia patient suffering from mental health diseases (such as anxiety or depression) has also increased by 43%, the possibility of a dysfunction of a 42%, the possibility of a mild to severe headache has increased by 35%, the possibility of an eye problem such as blurred vision or retinal inflammation has increased by 30%, and the possibility of a hearing abnormality such as tinnitus and has increased by 22%
The sequelae of the new coronary, that is, a series of medium- and long-term effects that may occur after infection with the new coronary, including fatigue, dyspnea and cognitive dysfunction, and mental health effects that are directly or indirectly accepted. Up to now, many countries around the world have followed up on the sequelae of COVID-19.
A study published in the Lancet in July 2021 showed that through feedback from 3,762 confirmed or suspected COVID-19 infections in 56 countries, researchers collected more than 200 "long-term COVID-19" symptoms in 10 organ systems. Of all the symptoms, these patients developed an average of 55.9 symptoms involving 9.1 organ system.
On September 13, 2022, the WHO issued a statement saying that model data from the Institute of Health Indexes and Evaluation (IHME) of the University of Washington School of Medicine shows that in the first two years of the new crown pandemic, about 10%-20% of infected people in the entire European region will continue to experience the sequelae of the new crown after the infection recovers. IHME research shows that nearly 145 million people around the world have at least one long-term COVID-19 symptoms.
"While most people can fully recover after infection, the findings show that more analysis is still needed to monitor the long-term effects of the disease," said Hans Kruger, WHO Regional Director of Europe.
htmlOn October 5, the U.S. Centers for Disease Control and Prevention (CDC) updated the latest tracking data on the sequelae of the new crown.According to ABC on October 6, as of September 26, among adults who have been infected with the new coronavirus for a long time, 81% of people reported that their long-term symptoms have reduced their ability to do daily activities. The highest daily activity restriction rate comes from the age group of 18-29, while the lowest proportion comes from the age group of 40-49.
On October 6, a report released by the UK's National Office for Statistics showed that as of September 3, more than 2.3 million infected people in the UK had sequelae of COVID-19, accounting for about 3.5% of the UK's total population. Among those who self-reported to have sequelae of COVID-19, about 1.8 million had contracted COVID-19 at least 12 weeks ago, and 1.1 million had contracted them at least a year ago. There are many people infected many times among these people, and the sequelae have adversely affected the daily activities of 1.6 million people.
Chinese scientists are studying the pathological causes and treatment methods of patients with new crown
There are also large-scale studies on the sequelae of the new crown in China. On May 11, 2022, Cao Bin's team from the National Respiratory Medicine Center of the China-Japan Friendship Hospital published a two-year follow-up study on hospitalized patients with COVID-19 in the Lancet. Respiratory Medicine. The study followed up on 1,192 patients hospitalized in Wuhan between January 7 and May 29, 2020. The survey content includes a 6-minute walk test, laboratory test and questionnaire, which involves symptoms, mental health, and health-related quality of life.
Results show that regardless of the severity of the initial disease, their physical and mental health status improved over time. 438 of the 494 patients returned to their original jobs two years later. However, among the more than a thousand follow-up subjects, 55% still had sequelae. Compared with patients who do not have long-term symptoms of COVID-19, these patients have poor quality of life and exercise ability, more mental health problems, and more medical care needs after discharge.
A common feature of these studies is that most of the information on the sequelae of COVID-19 that people can obtain comes from the self-report of infected people. "This makes the results lack objective measurement standards. This leads to the sequelae of COVID-19 like a 'basket' without boundaries," said Kim Dongyan, professor and virus expert at the School of Biomedicine of the University of Hong Kong.
On April 11 this year, Akiko Iwasaki, professor of immunology at Yale University School of Medicine, said on a video link that there are many reports trying to define the prevalence of sequelae among new coronavirus patients, but this needs to be considered in different situations. Among the severely ill patients with COVID-19, the proportion of sequelae of COVID-19 is as high as 50%, while this proportion is 5% to 30% in who are asymptomatic infected with mild symptoms or even . The reason for the difference is that the sequelae of COVID-19 lack a unified definition. At present, the difference between the definition of the sequelae of COVID-19 given by in the United States and the WHO is mainly in terms of time definition. The former refers to the occurrence of new and recurring health problems at least four weeks or longer after the first infection, while the latter refers to the symptoms lasting for at least 2 months within 3 months of infection with the new coronavirus.
"At present, there is no unified theory about the sequelae of new crown in the scientific community." In Jin Dongyan's view, the sequelae of new crown is not a simple disease, but should be regarded as a mixture of multiple symptoms.
The pathogenesis of the long-term new coronavirus is unknown
KAIT TV, affiliated to the Arkansas Department of Health, reported on October 11 that data from the Arkansas Department of Health showed that the number of new infections in the state has steadily decreased in the past three months. In contrast, hospitalizations have increased slightly, which the state's health officials attribute to the effects of the aftermath of the coronavirus.
The sequelae of the new crown still exists inconclusive, such as how many infected people may eventually develop long-term symptoms, and which group of people are most susceptible to being affected? How to treat and can it be cured in the end? "There is no real targeting the symptoms of long-term COVID, but it does have certain fluctuations," said Olivier Robino, a long-term COVID coordinator at the French Emerging Infectious Disease Research Institute. "There is no real targeting the symptoms of long-term COVID, but it does have certain characteristics of fluctuations," he told AFP, and the symptoms "seem to intensify after intellectual or physical effort - they become less frequent over time."
According to IHME research, one thing we know is that people with more serious initial cases, including those who need to be hospitalized, are more likely to get a long-term COVID-19 pandemic.
researchers have been searching for the exact reason behind this situation.
A study published in the journal Clinical Infectious Diseases in September 2022 found that the infamous spike protein of the new coronavirus—the key to allowing the virus to enter human cells—is still in patients a year after infection.
researchers said this suggests that the virus host may persist in some people, which may cause inflammation, leading to long-term COVID-19 symptoms.
If they are correct, a test can be developed to identify spikes, which can lead to a great and difficult goal of long-term COVID-19 research: a clear method of diagnosis.
However, their findings have not been confirmed by other studies and several other reasons are proposed.
A major theory is that tissue damage caused by severe cases of COVID-19 can trigger lasting damage to the immune system. Another theory suggests that the initial infection leads to tiny blood clots, which may be related to long-term COVID-19 symptoms.
However, "for each of these assumptions, the data is not very reliable," said Olivier Robino. Most likely, he added, “we won’t find a single reason to explain the long-term COVID-19”.
"The reason may not be the only reason. They can be connected or inherited in the same body, or they are different in different individuals."
Hong Kong University Jin Dongyan analyzed, "Compared with the Delta variant strain and the original strain, the proportion of the sequelae of the new crown during the pandemic stage of the Omickron has been reduced."
On June 18, 2022, a study published in the Lancet of King's College London, UK compared the sequelae of the new crown during the period of Delta and Omickron. Nearly 60,000 Omickron infected and more than 40,000 Delta infected were included in the analysis at different times. The research results show that the possibility of infection with the Omickron virus strain is 24% to 50% of that of the delta virus strain.
Long-term symptoms are not unique to the new crown. "After the 1918 Influenza A (H1N1) pandemic, the SARS outbreak in 2003, and the 2014 Ebola outbreak in West Africa, patients had sequelae after infection," said Jin Dongyan.
Akiko Iwasaki said on the aforementioned video link that the symptoms of the sequelae of the new crown are very wide at present, but not every patient has obvious symptoms and requires a correct diagnosis from a doctor. However, the reasons for the occurrence of the sequelae of COVID-19 are still in the hypothetical stage.
In Akiko Iwasaki's view, chronic inflammation that persists in the new coronavirus or virus residues in the tissues may cause is one of the most important hypotheses at present. In addition, there are hypotheses such as infections that may cause autoimmune disease and intestinal microbial disorders in some patients.
"At present, scientists from all over the world are very concerned about and worried about the sequelae of infection with the new coronavirus." On October 13, 2022, Liang Wannian, head of the expert group of the National Health Commission's epidemic response and treatment leadership group, said at a press conference that there is no scientific understanding of the pathogenic mechanism and final duration of the sequelae of COVID-19. Unlike the general influenza and known diseases, scientists still have many unknowns about the new coronavirus.
The UK National Institute of Health and Nursing (NICE) updated in November 2021 for the long-term COVID treatment plan includes discussing issues with patients, measuring body temperature, checking the heart and lungs and undergoing an electrocardiogram. If necessary, patients will be referred for pulmonary rehabilitation. The treatment plan also involves optimized control of long-term symptoms, limited to the use of antibiotics for adjuvant treatment in the case of confirmed or secondary bacterial infections, etc.
Children, the elderly and women are more likely to suffer from long-term COVID-19 but are often overlooked.
"As the pandemic continues, more and more people of all ages are infected with the new coronavirus, and the number of children who may be affected by the long-term COVID-19 has increased," said Dr. Amanda Morrow of the Kennedy Krieg Institute's Pediatric COVID-19 Rehabilitation Clinic and lead author of the pediatric statement in a recent media briefing.
The most common long-term COVID symptoms in children are fatigue and attention problems, persistent fever, headaches, sleep problems, and new mental health problems such as anxiety and depression. Moro said older girls may have an increased risk of developing long-term COVID-19.
Experts say that long-term COVID-19 symptoms, management and rehabilitation vary from child to child and adult. In addition, it is not easy to distinguish long-term COVID-19 diagnosis from other potential medical problems, because long-term COVID-19 may involve many body systems.
"Parents, carers, teachers and coaches are the front lines of observing changes and children that may be related to long-term COVID-19 changes," Morrow said.
"Children usually have fewer pre-existing diseases than adults, so as long as the symptoms of COVID-19 are relative to previous acute COVID-19 disease, they should be considered," Morrow said. “Toddlers and children with disabilities may have difficulty describing their symptoms, so it’s important to try to comb through this during medical interviews.
The American Society for Physical Medicine and Rehabilitation is also planning to publish a consensus guide on diagnosing and treating children with long-term COVID-19 as part of their acute sequelae of novel coronavirus (PASC) series.
Dr. Amanda Morrow, of the Baltimore Kennedy Krieg Institute and Johns Hopkins Medical School, is a co-author of the PASC Guidelines, pointing to the many challenges facing children with long-term COVID-19.
“Sometimes these children are ignored, or are not believed,” she says. “We are really working to (educate clinicians and parents) to get the trust and support of the children so that they can really focus on rehabilitation.” "
at Kennedy Krieger Institute), Morrow works with a multidisciplinary team that includes a neurologist, an physical therapist , a behavioral psychologist and an social worker , as well as an neuropsychology team and education experts who can help children who are struggling in school. Currently, the clinic has a one-month waiting list of new patients.
Morrow notes that patients in the clinic All were healthy before, and only a very small number of people had experienced medical problems before contracting the COVID-19 virus, mostly mild infections.
Now, they all suffer from lingering symptoms such as fatigue, cognitive difficulties, dizziness, dizziness, headaches and physical difficulty. Some are dealing with emotions-related symptoms, although she warns that these symptoms may be related to the patient's environment rather than directly to the infection.
On February 7, 2022, a long-term COVID-19 patient underwent a lung function test at the Hufeland clinic in Bad Ames, Germany.
WHO said on September 13, 2022 that in the first two years of the epidemic, at least 17 million people in the EU may have experienced long-term COVID-19 symptoms, and women are more likely to suffer from this disease than men.
The report said that the model also shows that women experience long-term COVID-19 is twice as likely as men, and this risk increases dramatically in severe infections that require hospitalization. According to the report, one in three women and one in five men may develop COVID-19.
“Understanding how many people are affected and how long it will be important for health systems and government agencies to develop rehabilitation and support services,” Christopher Murray, director of the Institute for Health Indicators and Assessment, which conducted the study for the WHO Murray said.
This study represents an estimated rather than actual number of affected people, consistent with some recent studies on long-term symptoms after coronavirus infection with .
A U.S. veteran study published in the journal Nature Medicine in May 2022 provides new evidence that shows that long-term COVID-19 may occur even after a breakthrough infection in people vaccinated, and the elderly face higher risk of long-term impact. The study shows that about one-third of breakthrough infections in patients with breakthrough infections show signs of long-term COVID-19.
Another report from the U.S. Centers for Disease Control and Prevention found that one in every four adults aged 65 and older had at least one potential long-term COVID-19 health problem over the course of up to one year after the first coronavirus infection, compared with only one in five of the younger adults.
Human scientists try to release new guidelines for diagnosing and treating long-term COVID-19 symptoms
In July 2021, the WHO released the rehabilitation guideline for patients with mild and moderate clinical manifestations pointed out that patients with mild and moderate clinical manifestations are recommended to start rehabilitation treatment from the beginning of the onset. After the mildly infected patients recover, it is recommended to walk easily and do breathing exercises. If necessary, they can use mechanical equipment.
The disease has different severity in different patients, but the impact of the disease on quality of life is devastating for some people. Since July 2021, the new crown infection has been regarded as a defect or disorder in the United States by law. Several research programs funded by U.S. authorities have been launched to help find clear answers to the risk factors, symptoms and possible treatments for "long-term COVID-19".
Since the novel coronavirus is a new virus, the diagnosis and treatment of its lingering symptoms and health effects are unknown. Like other chronic diseases, it is difficult for people who have been infected with the new coronavirus to be diagnosed or even believed by their health care providers.
"Long-term COVID-19" medical experts from the American Society of Physical Medicine and Rehabilitation In September 2022, the first "Long-term COVID-19" guide was released to diagnose and treat this mysterious disease. Experts say they hope the guide will help other doctors use their experience with their patients to help resolve and alleviate their symptoms.
The guide shows that medical experts are generally concerned that COVID-19 still causes serious health problems in many Americans even after addressing the initial infection. At least 9 million long-term COVID-19 patients are struggling to cope with a range of symptoms, but experts say that the number may reach 28 million.
"When we recognize the long-term COVID-19, this new problem has evolved due to the pandemic, we really feel obliged to stand up and do our best to solve it," Dr. Steven Flanagan, president-elect of the American Society of Physical Medicine and Rehabilitation, said at a roundtable attended by reporters. "We recognized two years ago that this is a problem.
experts say that the priority in addressing long-term COVID-19 is to “identify, evaluate and treat” symptoms in a variety of medical disciplines, including cardiovascular and lung-to-nerve, cognitive and gastrointestinal care.
Lead author of the Autonomous Nerve Dysfunction Guidance Statement and Johns Hopkins University Post-Acute COVID-19 Panel Alba Alba Dr. Azola said that the medical community needs to tailor personal rehabilitation plans to the unique needs of each patient.
A patient with a long-term COVID-19 was examined at the "Second Coronavirus" clinic at Tel Aviv Hospital, Israel.
Chinese Center for Disease Control and Prevention Chief Epidemiology Expert Wu Zunyou on October 13 , the State Council’s Joint Prevention and Control Mechanism, , analyzed at a press conference on , saying that generally speaking, people who have been vaccinated have a risk of sequelae after infection with the new coronavirus, which is much lower than those who have not been vaccinated.
"If you want to conduct updated research on the sequelae of new coronavirus in China, it is recommended to monitor and count the epidemic data in Shanghai, Jilin and other places caused by Omickron strain . "Kim Dongyan, a virologist professor at the University of Hong Kong, said that the sequelae of new crown involves the psychological and mental health levels, and in the future, multiple disciplines such as psychiatry and psychology need to work together to cope with each other.
A study published in the Journal of the American Medical Association on September 7 showed that factors such as depression, anxiety, worry, perceived stress and loneliness before the new crown infection increased the risk of sequelae of new crown. At the same time, after infection with the new crown, these types of psychological distress may also increase the risk of daily life disorders by 15% to 51%.
"Quantitizing the number of patients with COVID-19 sequelae may help decision makers better guide people to recover, return to workplaces or schools, and restore their mental health and social life." The aforementioned study published in the Journal of the American Medical Association wrote.
Sharp comment:
Research by global scientists has shown that the new coronavirus will affect humans in the long run. The serious and bad consequences of the long-term COVID-19 pandemic have begun to emerge.
According to the global COVID-19 pandemic, after five years of spread, the "living with the virus" country led by the United States is basically just like the captain of the US anti-epidemic team, Mr. Fauci , declared, "Every American will win the COVID-19 pandemic, and no one can escape!" In less than three years of the pandemic, the two current US presidents, Trump and Biden , were both infected and diagnosed with the COVID-19 pandemic! The Biden administration is now hard to speak. Iron facts prove that except for China's active anti-epidemic model of "dynamic clearance" in the world, which is truly effective, the anti-epidemic model of any other country has failed!
With the current anti-epidemic method in the United States, five years after the COVID-19 pandemic, the entire American society will have as many as 70 million citizens plagued by the COVID-19 pandemic, and this number will remain for a long time and rise steadily! More than 10% of the working-age workers in the United States will partially or permanently lose their ability to work! The loss of social labor will bring trillions of dollars in economic losses to the United States every year. If the huge expenditure on treatment and recovery for these national patients who have been troubled by the new crown, many families in the American society may experience bankruptcy around 2025, and the United States will not rule out bankruptcy before 2030.
The recovery of "long-term COVID-19 patients" will be a very huge blue ocean market in the global health rehabilitation field during the COVID-19 pandemic and in the future. After the COVID-19 pandemic lasts for five years, it is expected that except for a few countries such as China and North Korea, citizens of most countries on earth will have been infected with the COVID-19 virus more or less once. By then, the "long-term COVID-19 patients" will account for more than 20% of their total population. The total number of people in other countries after deducting the total population of a few countries such as China is about 6.5 billion. The total number of "long-term COVID-19 patients" in the world will reach about 1.3 billion in the long run.
If future technology advances, these "colonial patients" can be fully recovered. We conservatively estimate that it takes at least $10,000 to recover a "new crown patient" and that the potential scale of this rehabilitation treatment market will be 13 trillion US dollars! If half of these costs are borne by the health care system of the patient's country, it is expected to drag down the financial and insurance institutions of many countries, and these countries will go bankrupt one after another! If all these costs are borne by the "coronavirus patients" themselves, many of these patients and families will also be on the verge of bankruptcy!
Which companies can get a share of this very huge blue ocean market for long-term COVID-19 treatment and recovery, which will be very large in the future? Scientists and healthcare companies from all over the world are still in the exploration stage. However, some companies that have been deeply involved in chronic diseases and health management for a long time are likely to be one step ahead and become the first person to try it out in ! I don’t know if there will be a company in China that will lead one step ahead and become the ultimate giant in this market!
Scientists' research results have shown that the original methods of responding to the new crown epidemic in some countries with "stayed to fight the epidemic" are incorrect. Americans are finally understanding the consequences of repeated infection with the new coronavirus at the cost of millions of lives of their own citizens. But some American politicians still turn a blind eye, listen, and do whatever they want!
If the world's new crown epidemic is no longer raging, it is necessary to reduce infection and prevent the spread of the new crown virus! How to reduce repeated infections of the new coronavirus, we must strengthen COVID-19 testing, and physical isolation of patients is the best choice!
I am Retanta Ge & the old farmer of the revolution
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