{"id":6711,"date":"2023-08-22T17:18:13","date_gmt":"2023-08-22T17:18:13","guid":{"rendered":"http:\/\/wp.cov19longhaulfoundation.org\/?p=6711"},"modified":"2023-08-22T17:18:13","modified_gmt":"2023-08-22T17:18:13","slug":"covid-19-boosts-risks-of-health-problems-2-years-later-giant-study-of-veterans-says","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=6711","title":{"rendered":"COVID-19 boosts risks of health problems 2 years later, giant study of veterans says"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">SARS-CoV-2\u2019s public health impact is worse than that of heart disease or cancer, study claims; others say the work may overestimate harm for the general population.<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>21 AUG 2023<\/strong>  BY<a href=\"https:\/\/www.science.org\/content\/author\/catherine-offord\">CATHERINE OFFORD<\/a><\/li>\n<\/ul>\n\n\n\n<p>Three-and-a-half years since SARS-CoV-2 spread around the world, scientists are still documenting the virus\u2019 myriad effects on human health. What\u2019s clear already is that those effects can continue long beyond the original infection.<\/p>\n\n\n\n<p>Now, researchers have attempted to quantify this long-term harm using a massive database of U.S. veterans\u2019 health records. They found a dramatically increased risk of dozens of conditions including heart failure and fatigue, sometimes years postinfection. Overall, the team estimates, COVID-19\u2019s public health impact is more than 50% greater than that of cancer or heart disease.<\/p>\n\n\n\n<p>Other researchers say the conclusions broadly reflect what physicians have seen. However, several cite drawbacks in the study\u2019s statistical analysis that could have led it to overestimate harm to the general population. \u201cThe authors have done a good job in doing the analysis, but there are some limitations and those limitations are not small,\u201d says Maarten van Smeden, a medical statistician at the University Medical Center Utrecht. \u201cYou have to take this with a little grain of salt.\u201d<\/p>\n\n\n\n<p>To assess COVID-19\u2019s impact, Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and the VA Saint Louis Health Care System, and colleagues analyzed data from the U.S. Department of Veterans Affairs. In previous studies of this data set, the same researchers identified an elevated risk of&nbsp;<a href=\"https:\/\/www.science.org\/content\/article\/covid-19-takes-serious-toll-heart-health-full-year-after-recovery\">heart attack<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.science.org\/content\/article\/covid-19-patients-face-higher-risk-brain-fog-and-depression-even-1-year-after-infection\">mental health disorders<\/a>&nbsp;up to a year after infection.<\/p>\n\n\n\n<p>This time, the team looked at 80 health problems\u2014from fatigue and other symptoms commonly associated with Long Covid to neurodegenerative disease\u2014and general risk of death or hospitalization up to 2 years postinfection. They included data from about 140,000 people who tested positive for SARS-CoV-2 in 2020 and 6 million people with no record of infection that year.<\/p>\n\n\n\n<p>In the 3 months postinfection, people who\u2019d had COVID-19 had higher rates of death and many health conditions including heart failure, diabetes, Alzheimer\u2019s disease, and depression. The differences between groups declined over time. Yet even among people who weren\u2019t hospitalized, the risks for&nbsp;<a href=\"https:\/\/doi.org\/10.1038\/s41591-023-02521-2\">about one-third of the health problems studied remained elevated<\/a>&nbsp;2 years later, the researchers report today in&nbsp;Nature Medicine. These people had about a 13% increased risk of diabetes compared with the no-infection group, for example.<\/p>\n\n\n\n<p>The figures were starker for people hospitalized with COVID-19: Two years postinfection, this group had elevated risks for about two-thirds of the outcomes studied. Compared with controls, they were about 50% likelier to suffer heart failure and more than twice as likely to receive an Alzheimer\u2019s diagnosis.<\/p>\n\n\n\n<p>\u201cThis is a rigorous study that matches what we\u2019ve been hearing from [clinicians and patients] for years,\u201d says Francesca Beaudoin, a clinical epidemiologist at the Brown University School of Public Health who was not involved in the work. Although COVID-19 is directly causing some of these health problems, she adds, it could exacerbate others or accelerate their onset.<\/p>\n\n\n\n<p>Al-Aly\u2019s team also translated its results into disability-adjusted life years (DALYs), a measure of healthy lifetime lost because of disease or disability. (The metric, although controversial because of assumptions it makes about how disability affects quality of life, is used in policymaking to quantify public health impact.) The team calculated that SARS-CoV-2 infection led to over 80 DALYs per 1000 people who weren\u2019t hospitalized, and more than 640 DALYs per 1000 people who were. Cancer and heart disease each have DALYs of about 50, says Al-Aly, who consults for Gilead Sciences. \u201cEighty is an astronomically high number.\u201d<\/p>\n\n\n\n<p>However, some scientists say it\u2019s hard to extrapolate from the study\u2019s patient pool to the general population. People who caught SARS-CoV-2 in 2020 were unvaccinated and would have had earlier variants of the virus, not the ones circulating now. What\u2019s more, the veteran population was about 90% male, 70% white, and had an average age over 60.<\/p>\n\n\n\n<p>\u201c[Older] men are some of the people most afflicted by acute COVID,\u201d says Shawn Murphy, a neurologist and bioinformatician at Harvard Medical School and Massachusetts General Hospital. Although the authors tried to correct for this statistically, still, \u201cWe need to be careful about doing these extrapolations.\u201d<\/p>\n\n\n\n<p>There are other potential sources of bias, too. It\u2019s unlikely everyone in the \u201cuninfected\u201d group\u201498% of people in the study\u2014actually avoided infection all year, van Smeden says. Some probably had mild cases that didn\u2019t require health care. If so, the \u201cinfected group\u201d really means \u201cpeople who had more severe infection,\u201d which could magnify COVID-19\u2019s lingering harms, he says.<\/p>\n\n\n\n<p>The infected group may also have been on average less healthy than controls, says epidemiologist Justin Lessler of the University of North Carolina at Chapel Hill. He notes, for example, that hospitalized patients were five times likelier to be diagnosed with tobacco use disorders in the 3 months following infection. He doubts COVID-19 caused them to start smoking\u2014some probably smoked before or would have started anyway. \u201cWhat we may be seeing here is \u2026 &nbsp;people with poor health who are having severe COVID and continue to have poor health afterward.\u201d<\/p>\n\n\n\n<p>Duke University statistician Fan Li adds that greater use of health care\u2014a typical consequence of getting COVID-19\u2014increases a person\u2019s chances of being diagnosed with other conditions. This also skews apparent differences between infected people and controls, and isn\u2019t adequately addressed in the study, she says.<\/p>\n\n\n\n<p>Al-Aly argues these issues don\u2019t substantially affect the study\u2019s findings, adding the team controlled for as many differences between infected and uninfected people as possible. He says the elevated disease risks are \u201cvery likely the result\u201d of SARS-CoV-2 infection and that, if anything, the work underestimated COVID-19\u2019s effects.<\/p>\n\n\n\n<p>Researchers did agree on the seriousness of the virus\u2019 long-term harms, and the importance of studying them. The new paper highlights multiple conditions\u2014including diabetes, neurodegenerative disorders, and muscle diseases\u2014that merit further investigation in connection with SARS-CoV-2 infection, Murphy says.<\/p>\n\n\n\n<p>Post-COVID-19 illness \u201cis going to be a lingering effect for many years,\u201d he adds. \u201cWe need to put enough work into [not only] finding treatments for it, but being able to respect the disability claims that people are going to have. Those claims are well founded.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>SARS-CoV-2\u2019s public health impact is worse than that of heart disease or cancer, study claims; others say the work may overestimate harm for the general population. Three-and-a-half years since SARS-CoV-2 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":6814,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[101,289,290],"tags":[],"class_list":["post-6711","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19","category-long-haul-disease","category-long-term-effects"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/6711","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6711"}],"version-history":[{"count":0,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/6711\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/6814"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6711"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6711"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6711"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}