COVID-19 can kill even months after recovery – new study

On Apr 27, 2021

COVID-19 survivors have an almost 60% increased risk of death up to six months after infection compared to non-infected people, according to a massive study published over the weekend in the peer-reviewed journal Nature.

That is the equivalent of about eight extra deaths per 1,000 patients over six months.

“When we are accounting for COVID-19 deaths, the actual total of deaths is much higher,” Ziyad Al-Aly, director of the Clinical Epidemiology Center at Washington University in St. Louis and the Chief of Research and Education Service at Veterans Affairs St. Louis Health Care System, told The Jerusalem Post. He was the lead researcher on the study.

Al-Aly said that most deaths caused by long-term COVID-19 complications are not recorded as COVID-19 deaths. As such, he explained “what we are seeing now is only the tip of the iceberg.”

To reach their conclusion, Al-Aly and his research team leveraged data from the US Department of Veterans Affairs electronic health databases. The study involved more than 87,000 COVID-19 patients: 74,435 users of the Veterans Health Administration (VHA) with COVID-19 who survived at least the first 30 days after diagnosis and were not hospitalized and close to 5 million VHA users who did not have COVID-19. In addition, it included 13,654 hospitalized patients with COVID-19 and 13,997 who were hospitalized with flu.

The veterans were mostly men (about 88%), but there were still more than 8,800 women with confirmed cases who were analyzed.

All patients survived at least 30 days after hospital admission, and the analysis included six months of follow-up data.

The report showed that even those patients who were not hospitalized with severe disease could have health implications months later. Ailments could include respiratory conditions, diseases of the nervous system, mental health diagnoses, metabolic disorders, cardiovascular and gastrointestinal conditions, and poor general well-being.

“Even people with mild disease, some people who got COVID and seemed fine with just a fever and a cough, months down the road they have a stroke or a blood clot – some manifestation related to COVID,” Al-Aly said. “The risk is small, but it is not trivial.”

Israel’s Prof. Cyrille Cohen called the report “concerning” and stressed that “in this study we are not talking about severe cases. These are people who were not supposed to die at all.”

Of course, the risk of death and the associated health challenges were increased with the severity of the disease and showed that hospitalized patients who required treatment in an intensive care unit were at the highest risk for health complications and death.

Among patients who were hospitalized with COVID-19 and who survived beyond the first 30 days of illness, there were 29 excess deaths per 1,000 patients over the following six months – a 50% increased risk of death compared to hospitalized flu survivors, the study showed.

“It is really remarkable that such a virus can produce this huge number of long-term consequences,” Al-Aly told the Post.

He said that it is unclear if the same percentages would directly translate outside the United States, to other countries like Israel, since there are differences in the characteristics of every population. Nonetheless, he said, it is a powerful indication of the long-term burden that the disease will cause.

Al-Aly said that for now the only solution to stop these effects is not to contract COVID-19.

“The best way to prevent long-COVID is to prevent COVID. The best way to prevent COVID is vaccination,” he said.

Cohen agreed. He said that when people are considering not vaccinating “because I am young and not at risk of severe disease or death, I think the issue of long-COVID with the percentages we are seeing now is something that people should take into account.”

He admitted, however, that there is still little data regarding the long-term effects of the vaccines, as well, and responded to a report that a small number of people who took the Pfizer vaccine in Israel have experienced potentially deadly heart inflammation.

The interim analysis, which was reviewed by the Post, showed that during the first three months of Israel’s vaccination campaign some 62 cases of myocarditis or pre-myocarditis were reported mostly by people under the age of 30.

More than 5.3 million Israelis have had at least one dose of the coronavirus vaccine.

Prof. Nadav Davidovitch, director of the School of Public Health at Ben Gurion University of the Negev, told the Post that the study was too preliminary to draw a direct connection between vaccination and the myocarditis…