The death toll from COVID-19 is 130,000 (as of 10/1/2020, 220,000 dead) and rising. There is a number of startling revelations now that the virus has been studied longer, from the hospitals on the front lines. Those revelations have to do with secondary and post infection syndromes that are far more devastating than previously thought, and can overshadow the death toll, if we continue to reopen, or try to reopen schools, especially in hot spots.

Diseases Accompanying COVID-19

One of the most important aspects of the illness is the diseases showing up along with the illness and those that are coming after recovery. All of them in much higher numbers than the death rate.

The Illness Background

These illnesses can be severe, life threatening, long term and sometimes permanent. Overall in patients who get the virus, 20% are presenting with some form of accompanying disease, or post infection issue. Keeping in mind the rate of infection for the country is now at 60,000 per day, that is 12,000 per day. The mortality rate is about 1.4% which is around 840 deaths per day.

The Numbers Can Not Be Ignored

In 15% to 45% there is some type of complication with the course of the disease, reported in many early small series studies. To be sure, that is between 9,000 and 27,000 people daily. On a scale that is easy to see, that would be between 270,000 to 990,000 per month. Now with further study these disease are more prominent and presenting in closer to 20% of the cases. Which is 360,000 instances per month, with no increase in the rate of infection. Unfortunately that is not the case.

Can Present Whether Symptomatic or Not

All secondary disease can come in symptomatic and asymptomatic forms of COVID-19. Complications are now specific presentations of disease that is being seen repeatedly. These can be neurological, hepalogical, Respiratory and Cardiac, diseases.

The Resulting Disabilities from Long Term ICU Stays

There is also accompanying symptoms and issues like losing the ability to walk and talk, memory issues and range of motion in arms and legs. Joint pain and minor symptoms could be signs of more severe illness and/or a long lasting post affect of COVID-19

At Oxford, the studies are showing a range of illness that include . . .

In the Neurological areas

people are experiencing a number of illnesses accompanying COVID-19.

Delirium/Psychosis (Unreality and Non-comprehension)
Inflammatory Syndrome (Brain swelling)
Peripheral Neurological Disorders (Guillian-Barre Syndrome)(Weakness or Paralysis of the limbs)

In the Respiratory effects

of COVID-19. In the severe cases of COVID-19, where an ICU bed is necessary a large percentage of patients develop Acute Respiratory Distress Syndrome, (ARDS) which causes lung damage.

The lung damage lasts a long time, years, and causes sensitivity to infection, trouble with normal respiration and scarring of the walls of the lung. This is a secondary syndrome other than pneumonia and the development from acute COVID-19 can lead to death.

The disease after COVID-19 infection decreases is Pulmonary Fibrosis (scarring of the lungs)

Liver Damage

In the case of liver damage there had been signs and symptoms of gastroenterology effects, such as nausea, vomiting and stomach pain. The small series studies had shown as effect that SARS CoV-2 was directly effecting liver cells. Causing some damage that could only be repaired over time. The length of time would depend on severity of the COVID-19 disease itself and how much the virus had developed in the liver.

In the study reported on by NCBI Liver Disease was very prominent in patients with COVID-19, with a higher degree of severity in older patients, who also had a higher degree of severity to COVID-19 overall. This is now changing, as the studies are developing, younger patients in general are presenting with these issues, along with ARDS. Recovering patients are usually treated for some time, but effects can last a significant amount of time.

Heart Related Damage

There are some very startling developments in the cases of heart damage due to COVID-19. Many people are thought to have died from COVID-19 in the early stages of the outbreak, who had been wrongly labeled as Myocardial Infarction deaths. The numbers of misdiagnosed deaths could be a staggering number, and in all estimates as much as 10% higher death toll than previously thought.

In the article by NCBI, perhaps the most troubling in this scenario is of all hospitalized patients heart injury due to COVID-19 is showing in 3 out of 6 patients, and to be accurate that is 50%. This number has not changed with the recent spike in younger patients and is the leading cause of death in patients under the age of 45.

Here are the types of cardiac symptoms, and again, these when the patient is recovered can cause a weak heart for life, and could even need a transplant.

Cardiac Chest Pain
Fulminant Heart Failure (heart rate and percentage of blood flow slows so much the heart can’t function)
Cardiac Arrhythmia(s) (Heart beat is not steady, too fast, too slow, intermittent)
Cardiac Death

The cardiac symptoms are showing in healthy patients and patients with underlying conditions. It had been a delayed study due to misdiagnosis of the cardiac episodes as the primary disease, instead of the actual COVID-19 primary disease.

Post Infection Syndrome

is a development of symptoms of another secondary disease after viral infection has resolved (recovered patient).

The symptoms show around 30 days after recovery and can be, but are not limited to . . .

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)

Extreme fatigue that is debilitating and can last up to 20 months. In patients with cases of COVID-19 a similar syndrome that is more severe has shown in patients that have recovered. At around the 30 day mark.

      • People with ME/CFS are not able to function the same way they did before they became ill.
      • ME/CFS changes people’s ability to do daily tasks, like taking a shower or preparing a meal.
      • ME/CFS often makes it hard to keep a job, go to school, and take part in family and social life.
      • ME/CFS can last for years and sometimes leads to serious disability.
      • At least one in four ME/CFS patients is bed- or house-bound for long periods during their illness.

In all cases COVID-19 can last up to 100 days, and these syndromes are very common, some happening in 50% of patients. The secondary illness can come with other illnesses and happen in all age groups. As the pandemic progresses these secondary diseases are becoming more widespread and better understood. Thus far the syndromes are becoming more common, and more severe, as patients present with illness.

Seek the advice of a medical professional with some track record of treating illnesses that can be related to COVID-19. When deciding when and how a child might have in-person instruction, be sure to get the opinion of medical doctors who live in the immediate area. They would know how and when such a decision could be balanced with local case loads of COVID-19.