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Tuesday, September 22, 2020

Looming Health Crisis: Long Term Effects from Covid-19 - Ron DePinho

Long-Term Sequelae of Covid-19 We haven't yet engaged in this conversation. I haven't hitherto brought it up on this blog although it has been on my mind for several months now. Our communal perception seems to have been (and perhaps continues to be), "If you got infected and didn't die, you're ok. No harm, no foul." But, is that the case? Now that we are at a death toll of 200,000 in the US with millions of infection survivors, perhaps it's time to talk about the possible outcomes among the survivors. While it may be months to years for us to recognize the sequelae of the SARS-COV2 infection, we know from similar viral illnesses what may be at hand. Post-infection health morbidities include: - Long-term Neuropsychiatric Sequelae like demyelinating and neurodegenerative disorders as well as encephalopathies. - Long-term cardiac damage from myocarditis - Long-term vascular damage from microthrombosis - Long-term pulmonary damage - A predisposition to more severe illness from other diseases. That is one condition "primes" the body to be more susceptible to other diseases. This often takes decades to recognize. Loss of system-wide organ reserve. Every challenge to the body results in a step down in one's organ function reserve (like taking stair steps down). Organ function reserve may be thought of as akin to driving distractedly on a 10-lane highway. You can be absentminded and deviate from your lane without running off the road. Now, imagine as the miles pass, the highway progressively narrows. At a 9-lane highway, still good--you don't appreciate any consequence. So it is for 8-,5-, 4-lanes. But, what happens when you're now on a single-lane highway? Your risk of running off the road and into a ditch with any deviation in course is high, high, high. This is how illness affects the body's reserve. We lose lanes on the highway. We now have millions that have survived this pandemic with fewer lanes. When I see young adults discharged from the hospital with fibrotic lungs, my heart breaks because I know what they have lost even though they feel "normal". They effectively are walking out with the lungs of someone twice as old. And, where will that 20-year-old be when they are 40, 60 years old? What quality of life will they have at 50 living with the lungs of a 70-year-old? Yes, while 95% of us will survive a COVID-19 infection with no to little perceived symptomatic impact, we have indeed "lost lanes" which may manifest later on in our lives. A mask seems a pragmatic balance of safety and economy. https://ift.tt/1VMjaZw
from Rajesh Harrykissoon, MD

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