Many suffering from long-term aftereffects of COVID-19

By Masanori Tonegawa and Naoko Kagemoto / Yomiuri Shimbun Staff Writers

16:30 JST, October 25, 2021

An increasing number of people are suffering from long-term aftereffects of the novel coronavirus, with the diverse range of symptoms including fatigue and cognitive issues. Some are even experiencing post-COVID-19 syndrome for more than a year.

Hospitals and governments are trying to ascertain the situation involving post-COVID-19 syndrome and expand assistance to those struggling with lingering aftereffects.

Multiple symptoms

A man in his 40s who was infected with the virus last December is still suffering from fatigue and shortness of breath. He tried to continue working through such steps as reducing his workdays, but ultimately resigned due to the difficulty of being at his workplace.

“I was overwhelmed mentally and even contemplated suicide,” the man said.

He is being treated at Kodaira Hospital in Toda, Saitama Prefecture, a facility that began examining people who suffer from COVID-19 aftereffects in January.

By the end of September, 446 patients with such symptoms had undergone medical examinations. Hospital director Makoto Kodaira said: “Since the fifth wave of infections this summer, there has been a conspicuous number of patients in their 20s to 50s, people in the prime of their working life. Most of them report multiple symptoms.”

According to surveys conducted by research teams from Keio University and elsewhere of patients hospitalized at 27 medical institutions across the country, the most common symptoms half a year after infection were fatigue or weariness (21%), difficulty breathing (13%), sleep disorders (11%), difficulty thinking (11%), and hair loss (10%).

A survey released earlier this month by the National Center for Global Health and Medicine found that one in every four infected patients suffers from lingering health problems even half a year after they recovered from the acute phase of the illness. About 10% said they had post-COVID-19 symptoms a year after recovery.

Women were more likely to develop such symptoms, with twice as many women as men suffering from fatigue, and three times as many experiencing hair loss. Such symptoms as loss of smell or taste tend to appear more often among young people and thin persons, the survey showed.

Post-COVID-19 syndrome is not limited to adults. A survey in Britain showed that 3.1% of infected children aged 5 to 11 and 5.1% of those aged 12 to 17 experienced such symptoms as fatigue even four weeks after infection.

Unknown mechanisms

However, there is little understanding of how these diverse post-COVID-19 symptoms develop. In a number of cases, no abnormalities were found through blood tests or image diagnosis, which resulted in there being no medical examination or treatment of people suffering from aftereffects.

Many patients also suffer from lingering health problems because there are few medical institutions capable of examining and treating such cases and because people don’t know where to seek a consultation.

The World Health Organization this month unveiled for the first time its definition of COVID-19 aftereffects. It described such cases as illnesses that require such a response as: Symptoms that cannot be attributed to any other illness develop within three months after infection is confirmed and continue for at least two months.

It noted that some symptoms started developing when a person is infected, while others emerged only after a patient recovered from the acute phase of the infectious disease. Sometimes symptoms return after signs of of recovery.

Overseas studies have been showing that the risk of aftereffects declines with vaccination and that aftereffects were mitigated with a post-infection vaccine. Nonetheless, the Centers for Disease Control and Prevention of the United States have said further research is necessary to judge the efficacy of vaccines.

Guidelines for diagnosis

Given the serious state of affairs involving patients with aftereffects of COVID-19, the Health, Labor and Welfare Ministry plans to draw up a manual for doctors that is focused on treating such patients and to make it public as early as this month.

Some local governments have also been arranging support systems for these patients, and working to ascertain the details of the situation.

The Saitama prefectural government had seven medical institutions in the prefecture establish a section this month for outpatients suffering from aftereffects, and set up a system in which patients can be introduced to one of these institutions via their regular doctor. The local government said it will compile records of cases of aftereffects, thereby creating a system under which many medical institutions will be able to examine and treat patients with aftereffects.

The city government of Kobe will establish a telephone consultation service staffed by nurses next month, introducing patients to medical institutions based on their inquiries and complaints, while at the same time collecting information about the current situation involving such patients.

Similar efforts are being made by other municipal governments, including the ward offices of Sumida and Setagaya in Tokyo, and the prefectural government of Osaka and the metropolitan government of Tokyo. However, such medical care systems are not yet established nationwide.

Satoshi Kutsuna, a professor at Osaka University who is knowledgeable about the aftereffects of infectious disease, said: “Aftereffects are considered to be a form of the disease, so this should prompt the development of support systems among local governments, and examination and treatment systems among medical institutions. They should quickly make progress in ascertaining the situation.”