Revealed: Scars of Covid-19 could last for life as doctors warn of long-term damage to health

Survival is the first step, but recovery can take a long time - Getty Images Europe
Read More: What Are The Long-Term Effects Of Coronavirus On The Body?
One in three patients recovering from coronavirus could be lifelong with long-term lung damage, chronic fatigue and mental disorders.
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Experts said there is growing evidence that the virus could cause persistent or even permanent trauma, including brain impairment and an increased risk of Alzheimer's.
The NHS guidelines observed by The Telegraph suggest that around 30 percent of patients recovering from Covid-19 may have damaged and scarred lung tissue if they follow patterns of similar diseases.
This could amount to around 100,000 of the 300,000 people who have so far been tested positive in the UK. Restricted testing during the pandemic means that the number may be even higher.
Some estimates suggest that around 3.5 million people in the UK are likely to have been infected by Covid, meaning that more than 1 million people may face long-term consequences.
In an interview with The Telegraph, the head of the new NHS recovery center at Covid said she was concerned about how little was known about how long the consequences could last.
Dr. Hilary Floyd, clinical director at the NHS Seacole Center, said she was shocked by how young many of her patients were. Healthy people in their forties and fifties when the virus appeared were now faced with long-term fatigue and disability.
"You can always have some degree of debilitation"
Dr. Floyd told The Telegraph: "These are people who were independent, they could run their own business, go to the gym, swim, be active - now they're at the point where they can't get up."
"We currently have a few patients in their forties. We really didn't expect that. We expected them to get older, we saw a lot in the fifties and sixties that really have problems, especially because their expectation to get back to normal is much higher. "
She added, "You can always have some degree of debilitation."
The NHS guidelines for general practitioners and nonprofits warn that up to half of patients treated in intensive care units for the virus may have “persistent physical, cognitive, and psychological impairments,” including chronic fatigue.
So far, around 13,000 patients have received such treatment. And one in ten patients discharged from hospital in England after treatment for Covid-19 has an acute heart injury.
In many cases, fatigue and shortness of breath are so severe that patients can only have short bursts of 10 minutes of supervised activity at a time, said Dr. Floyd.
Many patients also have problems coping with the psychological effects of changes in their health. Local therapists, she said, adding, "There's a lot of fear."
For clinicians, the most scary aspect of the crisis is that so little is known about the long-term consequences of the virus, she suggested.
"We don't know how long-term is long-term. We don't know whether the generation now in their fifties and sixties will be much more fragile or have an increased risk of dementia in 20 years."
The center at Headley Court in Surrey, formerly a decommissioned military hospital, opened four weeks ago and can ultimately treat up to 300 patients.
Prof. Peter Openshaw, member of the government's Advisory Group on New and Emerging Respiratory Viruses (Nervetag), said: “We are fairly alarmed at the number of people who need follow-up care after a hospital stay.
"Many suffer long-term effects, especially those who have had a serious illness."
He said that intensive care patients would normally need about a year to get better, while some never did.
Prof. Openshaw, immunologist at Imperial College London, said there was particular concern about patients with extensive blood clots that could disrupt blood supply to parts of the lungs and lead to slow recovery.
Others suffer from "chronic scar pneumonia" due to inflammation of the lungs, he said.
The immunologist said the picture of long-term effects has only gradually become clear. He believed that about one in ten patients who were hospitalized with the disease would have "fairly persistent problems".
The primary care and community service guidelines issued by NHS England, involving general practitioners and other care providers outside of hospitals, suggest that almost one in three people who suffer from Covid could suffer long-term harm if they follow the pattern of similar viruses .
“About 30 percent of the survivors of the global SARS outbreak caused by SARS-CoV and the coronavirus (MERS-CoV) of the respiratory syndrome in the Middle East had persistent physiological impairment and abnormal radiology associated with fibrotic lung disease. Lung fibrosis [lung damage and scarring] is anticipated to be an important sequela that is the result of Covid-19, ”it said.
"We learn on the hoof"
Health officials will start a recovery program for all patients suffering from Covid next month. A website provides advice for anyone who has trouble recovering from the virus, tracking symptoms, and advising those in need of special rehabilitation help on the right treatment.
The NHS guidelines suggest that one in seven cases treated by intensive care units could suffer long-term or permanent brain damage. Seventy percent of all of these patients suffer from delirium, and in every fifth case this becomes a "found cognitive impairment," the document warns.
Slight damage to brain function can be observed in about a quarter of patients with acute shortness of breath, it is said. And it warns that this, in turn, can increase the risk of degenerative diseases like Alzheimer's.
Experts are particularly concerned about the risk of persistent or chronic fatigue and say that immediate treatment is needed to reduce the risk of long-term syndromes.
Dr. Janet Scott, a post-viral episode specialist and clinical lecturer at the MRC Center for Virus Research at the University of Glasgow, said: “At Covid-19, the main problems are probably the respiratory system, so we can take advantage of what happens to other people who have similar breathing problems had.
“Forty percent of people with acute respiratory problems that people with Covid-19 suffer from have trouble coping with daily activities afterwards.
"With SARS, some had problems up to two years later."
Dr. Scott added: “Some will experience post-traumatic stress, anxiety, or depression. Some groups of patients with chronic fatigue syndrome fear that there will be a peak in ME, but not all post-viral fatigue is chronic fatigue syndrome - and it will be important to diagnose the underlying cause of any fatigue - even if it persists. "
However, she said the lack of testing in hospitals has hampered efforts to determine the extent of long-term complications.
Lessons from other diseases suggested that long-term side effects could be common, she suggested.
“After Ebola, every survivor was affected in some way and 70 percent had pain syndrome. Around 80 percent had a moderate or severe disorder compared to about 11 percent in the general population, ”she said.
Prof. John Hurst, professor of respiratory medicine at University College London, said that while the NHS was well organized to cope with the acute epidemic, it was not planned enough to respond to the long-term needs of those who have had difficulty to recover from Covid.
“In North London, we mostly followed people over the phone and find that about one in five has persistent symptoms four to six weeks later.
"This includes shortness of breath and cough, but also fatigue, which gets through very strongly."
Prof. Hurst, member of the British Thoracic Society's Science and Research Committee, added: “We would expect some to continue to suffer from pulmonary fibrosis. We want to identify them early, but there is no central way to do that. We learn on the hoof. "
Case studies

"I actually wrote my will"
Louise Barnes
Louise Barnes, 46, from Suffolk, is one of the many patients who, three months later, pay the price for the suspected coronavirus infection.
The former teacher has described the “terrible” symptoms she still suffers from, including nighttime shocks that she compared to a fit, nausea, tinnitus, and chest tightness.
Ms. Barnes, a so-called "long tail" patient, was only wiped once for Covid because hospitals did not routinely test suspected cases in the early days.
She said the long-term effects had created such feelings of loneliness that she set up a self-help group online with nearly 1,000 members, almost all of whom have similar effects.
“When I first got sick, it was only assumed that you would continue to recover. People talked about recovery within a week or two, but what actually happens is really scary. "
Ms. Barnes, who has an autoimmune disorder, first developed Covid symptoms on March 18, including stinging headache, itchy sore throat, and chest tightness.
After speaking to NHS 111 and doing an online exam, an ambulance came to her house and took her to the hospital because of her fever. She was held overnight.
She was swabbed and sent home the next day, but never got the result because the test turned out to be faulty. But she continued to suffer and returned to the hospital twice.
"The pressure on my lungs was terrible," she said. "I actually wrote my will. I didn't think I would survive it at all. "
She said that many members of her post-Covid group had antibody tests, but the results were almost always negative, even for those who were diagnosed with the virus.
"It's very lonely," she added. “There is not much support and we need more help. How many others out there feel that way and think it's just them?
"Many people's families don't think they're still sick. Symptoms come and go, but I don't seem to be getting any better and I'm very worried about the future."
"I was out of breath for months"
Prof. Peter Piot - Graham Turner / The Guardian
Prof. Peter Piot, director of the London School of Tropical Medicine, is one of the world's leading experts in viruses.
Three months ago, he developed Covid with a high fever and a splitting headache and was hospitalized for oxygen treatment. Prof. Piot is one of those who have suffered from long-term consequences for months.
He said that many others - possibly Boris Johnson, who was in Covid's intensive care unit - may have difficulty getting over the condition and feel deprived of energy.
“After the acute phase, many people have… after the virus is brought under control, it has long-term consequences. In my case, my lungs became stiff and this was a result of the body's inflammatory response. It took me out of breath for months and so many people have other problems, chronic lung problems, kidney failure, ”he told the BBC Andrew Marr Show.
When asked if the prime minister would likely be able to complete the hours required by his job after being seriously ill with Covid, Prof. Piot said: "It all depends on how good a team is around you is. "
He said: "It is certainly not exactly the same type of energy that you can use [afterwards]. But you know that things get better very quickly in some cases. not at all in others. Some people have months and months of chronic fatigue. I am not familiar with the state of the prime minister, so I do not know. "

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