Even the healthy face long-COVID risks

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Savannah Brooks has been an athlete her whole life. She enjoys kickboxing and has trained for mixed martial arts competitions.

But in April, the 30-year-old Minneapolis woman tested positive for COVID-19. It didn't make her sick enough to need hospitalization. Still, lingering fatigue and a racing heart rate accompanying even the mildest exertion mean she's now relying on a wheelchair for walks around her neighborhood.

For someone who's been the "picture of health," post-COVID medical problems are frustrating and unnerving. Especially hard: not knowing how long it will last. "I think if this can happen to me, it can happen to anyone," Brooks told an editorial writer.

Commendably, Brooks has been open about her health challenges. Her recent Twitter thread went viral, providing an essential public service. While many wrongly downplay COVID's threat to healthy people, this vaccinated Minnesotan's story illustrates how much remains unknown about the virus, particularly its potential long-term health effects.

Experts such as Mayo Clinic's Dr. Greg Vanichkachorn have sounded the alarm about the sheer number of people who may grapple with persistent complications — even if their illness was mild. A muscular new analysis from the U.S. Centers for Disease Control and Prevention (CDC) underscores the need to take these concerns seriously.

The CDC report focused on the incidence of post-COVID conditions among Americans ages 18 and up who survived the virus. Researchers drew upon an electronic health record system that included 63.4 million unique adult records in 50 states. Included in the data were those diagnosed or with positive tests in an inpatient, emergency department or outpatient setting. A drawback: vaccination status wasn't included in the analysis.

Two critical points emerged.

The study separated adults into two groups by age: 18-64 and 65 and up. It made sense to do so. The elderly are at the greatest risk of dying from COVID, and those in this analysis were also at higher risk for lingering conditions. One in four survivors 65 or older "experienced at least one incident condition that might be attributable to previous COVID-19."

But the gap between them and the younger survivors studied was narrower than might be expected. One in five Americans in the 18-64 group experienced an "incident condition."

The study lists 26 incident conditions potentially linked to infection. The breadth of organs and functions that could be affected is sobering: heart attacks, heart rhythm abnormalities, pulmonary embolism, chronic kidney disease, musculoskeletal pain, neurological disorders, difficulty sleeping, as well as asthma and other respiratory symptoms.

"The most common incident conditions in both age groups were respiratory symptoms and musculoskeletal pain,'' the study authors stated.

Overall, "COVID-19 survivors have twice the risk for developing pulmonary embolism or respiratory conditions" than those who were not infected.

Mayo's Vanichkachorn, who treats patients with long COVID, told an editorial writer that the study's size strengthens the medical community's concerns about the number of people affected. In addition, he said, the findings should help struggling patients get the care they need.

Doctors will now be more informed of risks. The study should also help convince patients to seek care even if others doubt they need it, particularly younger people. "This is not just all in someone's head," Vanichkachorn said.

Medical care for post-COVID conditions generally takes a holistic approach. It includes treating symptoms, as well as physical therapy and other rehabilitative services. Trying to rush the return to normal often is counterproductive, Vanichkachorn said.

Policymakers also need to get involved. Because COVID was so widespread, millions of people may now struggle with ongoing medical needs. That will impact health care capacity, families and a workforce where labor already is in short supply. Thoughtful preparation to meet these challenges and help patients like Savannah Brooks is vital.