Why COVID-19’s long-term health effects are a cause for concern

The effects of the coronavirus on the human brain are ‘variable,’ according to one specialist, but can be dramatic. (AFP)
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Updated 11 August 2020

Why COVID-19’s long-term health effects are a cause for concern

  • Survivors could face a number of ailments given the disease’s multi-organ effect on the human body
  • Latest strain of coronavirus has been described as an invisible enemy, slowly revealing new symptoms

DUBAI: What was first identified as another respiratory disease akin to the common flu has taken the lives of over 600,000 people around the world in just six months.

The latest strain of the coronavirus has been described as an invisible enemy, slowly revealing new symptoms as the global scientific community continues investigations into it.

Since the first outbreak of the coronavirus disease (COVID-19), traced to a wet market in Wuhan, China, in late 2019, the infection quickly developed into a full-fledged pandemic, with over 15 million cases reported to date. Symptoms have multiplied, leaving puzzled experts determined to find a cure.

Findings published this month appear to confirm growing concerns about the infection’s link to serious and potentially fatal brain disorders as well as cardiovascular complications.




Chief Scientific Officer Dr. Jeff Drew carries out research into the virus at the Stabilitech laboratory in the UK. (AFP)

“We’re seeing things in the way COVID-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, after the publication of new research in the scientific journal Brain.

Common flu-like signs such as fever, dry cough and sore throat were the first set of symptoms reported at the start of the pandemic. However, the list rapidly expanded to include shortness of breath, loss of taste and smell, nausea and several more symptoms just months later.

Today, the biggest concern among health professionals is the virus’ insidious impact on the brain, with more than 300 studies of COVID-19 patients worldwide showing neurological abnormalities.

One study published in Brain involving 43 patients — 24 males and 19 females — confirmed a range of neurological complications in mildly affected and recovering patients.

Commenting on the new findings, Gregory Poland, an infectious diseases and vaccine expert at the Mayo Clinic in Rochester, Minnesota, said the virus’ impact on the brain is “variable” and can range from having no visible impact to causing “large vessel occlusions,” known more commonly as “very large strokes.”

With the virus refusing to discriminate based on age or color, severe cases have been reported among young and relatively healthy individuals as well as those with pre-existing conditions and the elderly.




Gregory Poland, an infectious diseases and vaccine expert at the Mayo Clinic in Rochester, Minnesota

“Obviously, the risk goes higher the more severe the disease; large vessel occlusions in young people have occurred with moderate to severe COVID-19 cases. But it can happen to people anywhere along that spectrum,” Poland told Arab News.

In the neurologic realm, the study’s findings showed that patients suffered from encephalopathy; stroke; inflammation of the central nervous system; peripheral nerve problems; cognitive and mental health issues, with delirium, psychosis and several cases of Guillain-Barre syndrome, an immune reaction that attacks the nerves and causes paralysis.




Dr. Taoufik Al-Saadi, chief medical officer and chair of the Neurology Department at the American Center of Psychiatry and Neurology in the UAE

Other symptoms included depression, anxiety and brain fog as well as a loss of smell, taste and sleep in mild and asymptomatic patients.

Another study, “Neurological associations of COVID-19,” published on the Lancet Neurology website, confirmed that a growing number of case reports and series from around the world described the same array of neurological manifestations, noting the virus is of a scale not seen since the 1918 influenza pandemic.

According to Poland, “health care systems are recognizing that there’s going to be a greatly enhanced need for rehabilitation and recovery centers after the COVID-19 pandemic” as a result of the latest outcomes.

His views are echoed by Dr. Taoufik Al-Saadi, chief medical officer and chair of the Neurology Department at the American Center of Psychiatry and Neurology in the UAE, who pointed out that although most individuals are inclined to experience a mild or asymptomatic disease course, some have required ventilatory support.

Data suggest that “one in five infected individuals are hospitalized, and one in 10 individuals are admitted to the intensive care unit (ICU), requiring ventilatory support, due to acute illness in response to this infection,” he said.

“The main issue in survivors of these cases is the physical, cognitive and mental impairment that may persist for several years beyond hospital discharge. Indeed, 80 percent of ICU survivors with confirmed COVID-19 may follow that course,” Al-Saadi told Arab News.

Cases of memory impairment, depression, anxiety, post-traumatic stress-like disorders have all been reported in up to 30 percent of these patients and may last up to several years following hospital discharge, said Al-Saadi.

“These complications would certainly affect survivors of this disease in all aspects of their everyday life whether functioning at work, home or in the social sphere,” he said.

Additionally, cognitive, physical and mental problems could result in chronic pain conditions, further causing sleep disorders, which could ultimately affect the overall quality of life. What frightens the scientific community even more is that the long-term impact of such neurological effects has not yet been determined.

However, the virus’ potential long-term health effects do not stop at causing damage to the brain. Scientists are increasingly recognizing the cardiovascular side effects of the virus, with reports of markers of cardiac injury even in young people.

According to Poland, cases of COVID-19 have resulted in inflammation of the heart (myocarditis), decreased heart-muscle function (cardiomyopathy), irregular heart rhythms (arrhythmias) and dilation of coronary and other blood vessels due to vascular inflammation as well as blood clots.

For patients with a prior history of cardiovascular disorders and increased risk factors, such as hypertension and diabetes, chances of heart complications significantly rise when infected with COVID-19.

The British Heart Foundation confirms these findings, noting that this strain of the virus has been found to increase the risk of blood clotting or thrombosis, leading to cardiovascular problems and, in some cases, organ failure.

The term “COVID toe” has also been coined in reference to painful red or purple swollen patches on the feet, usually the toes of infected patients, a condition known as Chilblains and typically associated with exposure to cold weather.

Some experts have linked COVID toe to blood clots and other neurological issues caused by the virus.

Examining the plethora of symptoms and conditions triggered by the virus, Poland believes experts must not yet discuss the long-term health effects of COVID-19 on patients as research is still in its infancy.

“What we can say is that early indicators of pulmonary fibrosis and scarring are irreversible. We have seen myocarditis and cardiomyopathy, some of which can improve, but we don’t know if they will completely improve,” he said.

Poland also referred to a group of patients he calls the “long-haulers” who have developed “almost a chronic fatigue-like symptom” accompanied by an assortment of symptoms as result of infection with the virus. For these patients, the virus’ impact is long-lasting.

Evidence of kidney and liver damage has also been reported in cases around the world, with no clear indication of the long-term consequences.

Similarly, the impact of COVID-19 on pregnant women and their unborn children is yet to be defined with certainty.

With science yet to answer so many questions, Poland’s prognostication is no more reassuring than the available findings on virus. “My guess,” he said, “is that young, healthy people will recover, and older people will have a more difficult time getting back to baseline, if at all.”

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Twitter: @jumana_khamis


Philippines anti-terror campaign gets US boost

US National Security Advisor Robert O'Brien (R) and Philippine Foreign Minister Teodoro Locsin (L) pose with precision-guided munitions among other defence articles during a turnover ceremony at the Department of Foreign Affairs office in Manila on November 23, 2020. (AFP)
Updated 24 November 2020

Philippines anti-terror campaign gets US boost

  • Missiles will help armed forces fight Daesh-aligned groups in country’s south
  • Donald Trump pledged to provide the $18 million worth of missiles in a phone conversation with Philippine President Rodrigo Duterte in April

MANILA: The Philippines on Monday received nearly $18 million worth of weapons systems from the US to help the government in its anti-terror fight, officials said.

Visiting US National Security Adviser Robert O’Brien highlighted the transfer of precision-guided munitions to the Armed Forces of the Philippines (AFP) in the presence of Foreign Affairs Secretary Teodoro Locsin, Jr.
“On behalf of (American) President (Donald) Trump … I am pleased to transfer a package of precision-guided missiles, munitions ... to the Armed Forces of the Philippines,” O’Brien said.
Locsin, on behalf of the Philippines government, received the package which included 100 tube-launched, optically tracked, wire-guided (TOW) 2A missiles, 12 improved target acquisition systems (ITAS), and 24 mark 82 (MK-82) bombs.
O’Brien said a US military plane delivered the smart weapons which will aid the Philippines military in its fight against Daesh-aligned groups operating in the southern part of the country.
“It’s a fight that’s been bravely undertaken by the men and women of the Philippines Armed Forces,” he added. According to O’Brien, the transfer underscored Washington’s strong and enduring commitment to its “critical alliance” with the Philippines.
“We hope these precision-guided missiles and munitions will help the AFP protect lives in Mindanao and end the needless suffering imposed by ISIS-East Asia,” he said.
The adviser added that America had been at the forefront in its fight against Daesh and that US forces in the Middle East had destroyed 100 percent of its physical caliphate.

HIGHLIGHT

US National Security Adviser Robert O’Brien said a US military plane delivered the smart weapons which will aid the Philippines military in its fight against Daesh-aligned groups operating in the southern part of the country.

“That was a caliphate the size of Great Britain extending across Syria and Iraq. It was destroyed under President Trump’s orders. Further, President Trump gave the orders for a daring nighttime raid that led to justice being brought to Abu Bakr Al-Baghdadi, the founder and leader (of Daesh).
“Now, President Trump is standing with (Filipino) President (Rodrigo) Duterte as we combat (Daesh) here in Southeast Asia,” O’Brien said.
Locsin expressed gratitude for the weapons donated by the US. “This is the fulfillment of a promise made by US President Donald Trump to President Duterte during their phone call in April.
“We are looking forward to training on the use of these weapons with the best and undisputed military power in the world and the only one in history selflessly dedicated to the freedom and independence of other countries whatever threat in the world,” he said.
The foreign secretary pointed out that the “smart bombs” would further boost the AFP’s capabilities in “neutralizing identified or specific threats to national security, particularly in counterterrorism operations.”
Meanwhile, AFP military spokesman, Maj. Gen. Edgard Arevalo, told media that “these smart munitions with such capability and precision will aid immensely the AFP in ridding the country of terrorist menaces.”
He said: “We may have been successful in counter-terrorism operations — most notably in Marawi — with ordinary munitions fitted in our legacy aircraft. But with the advent of these missiles and munitions, we are certain that they will greatly boost our campaigns and contribute to the global drive to fight and defeat terrorists.”
In a separate message, O’Brien added that the US welcomed Duterte’s recent decision “to extend the US-Philippines Visiting Forces Agreement (VFA).”
Locsin in a note to O’Brien earlier this month had conveyed the president’s decision to suspend the abrogation of the VFA by another six months, to enable both sides to find a “more enhanced, mutually beneficial, mutually agreeable, and more effective and lasting arrangement on how to move forward.”
The VFA was scheduled to be terminated on Aug. 9, but the Philippines government in June suspended the move in light of “political and other developments in the region.”
The suspension was delayed for six months until December, but the Department of Foreign Affairs said it could be extended for half a year more.
“We look forward to the VFA continuing to facilitate our closer cooperation in combatting terrorism,” said O’Brien.
The VFA is the bilateral agreement that establishes the rules by which military personnel, vessels, and aircraft may enter the Philippines. It also stipulates how criminal offenses committed by US military personnel should be prosecuted.
Besides addressing the problem of terrorism, O’Brien said the US also hoped to expand its cooperation with the Philippines on a range of security challenges, such as disaster relief and maritime security.
He also welcomed recent statements by Duterte and Locsin at the US-ASEAN Summit and the East Asia Summit, calling on all nations, “including a certain large nation in the neighborhood,” to respect international law in the South China Sea and reiterated the US’ commitment to defend the AFP if it came under armed attack in the disputed territory.
“As we approach the 70th anniversary of our Mutual Defense Treaty next year, we celebrate the strength of our important alliance, and we look forward to working hand-in-hand for generations to come. Together, the US and the Philippines will continue to ensure peace and prosperity in the Indo-Pacific region,” said O’Brien.
The US official also expressed condolences to the Philippines for the lives lost and devastation caused by super-typhoon Goni, and typhoon Vamco.