To Your Good Health: Persistent aftereffects of COVID affect energy, senses and more

Published 4:29 pm Tuesday, September 28, 2021

DEAR DR. ROACH: Could you address problems that may or may not be aftereffects of COVID-19? The problems seem to be common among people who have had COVID-19, but not acknowledged by all medical professionals. — A.C.S.

ANSWER: Although the likelihood of dying from COVID-19 is “only” about 1.8% — meaning 938,000 deaths in the U.S. alone due to COVID by the best estimates as of this writing, including unreported deaths — many people who survive COVID-19 are left with persistent symptoms. The most common physical symptoms are: fatigue or low energy, which can be profound; shortness of breath, especially with exertion; chest pain or tightness; and cough. However, many people have other symptoms, including persistent changes in smell and taste, joint pains, headache, dizziness, poor appetite and poor sleep.

The brain and mind can be affected as well. Twenty-four percent of people discharged from the hospital had PTSD, whereas 18% had new onset of memory issues, and 16% had difficulty concentrating. These numbers are even worse when looking at survivors of intensive care. Forty percent of hospitalized patients were unable to return to normal activities within two months of hospital discharge.

Among those who had milder disease (not requiring hospitalization), about a quarter of people 18-34 years old had persistent symptoms, compared with half of those over 50.

I’m not sure what medical people you have been talking to. Studies are clear, and those of us who have taken care of many people with COVID-19 know that this disease can cause persistent symptoms ranging from mild to debilitating in a very large number of people. We do not know how long-lasting these symptoms are going to be, or even whether some symptoms may be permanent due to damage to the heart, lungs, brain and other organs.

As always, let me implore those readers who have not gotten the vaccine and who are able to do so to please get the vaccine.

DEAR DR. ROACH: I am an 87-year-old man with high blood pressure, high cholesterol and atrial fibrillation. I am still active, except for severe osteoarthritis of the right shoulder and a torn rotator cuff. I had opinions from two different orthopedic surgeons. The first recommended a complete shoulder replacement as soon as possible. The second advised that due to my age and overall health, it would be best to live with the condition. I can bear the pain for now. I am confused about the way to go. — D.R.

ANSWER: This is a critical decision, and I don’t have enough information about you to give you much help. The key factor is how healthy you are: Doing surgery is a little risky, and even in the best situation you will have a lot of work to do with rehab after surgery. Eighty-seven sounds like a ripe old age, but you might be a really healthy 87-year-old (high blood pressure, high cholesterol and atrial fibrillation are not necessarily threats to your health if they are well controlled), or you might not be in such great shape.

The best person to help you make this decision is your regular doctor. That might be your family doctor, internist or cardiologist, but that person should help you balance the short-term risks against the long-term benefits. I have seen several cases where a joint replacement has made a huge benefit to a person’s quality of life. But if you are going to get it done, you’ll want to get it done soon.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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