“We’re dealing with silos,” Dr. Mylonakis said. “Every time that we have a transfer, something is lost. The patient loses and that may make their other long Covid symptoms worse.”
For example, “if I’m an endocrinologist, I’m going to look at the blood sugar, I’m not going to look at the 14 other systems,” he said. “But the problem with the blood sugar may be because this person has such weakness and fogginess that they cannot go to the supermarket and get healthy foods, so they’re going to order pizza.”
Dr. Mylonakis said the unified nature of the Veterans system may actually make it better at coordinating care and sharing patient information among specialists, so for patients outside that system, the frustration and confusion may add considerable stress that aggravates their symptoms.
Still, the complexity of long-term Covid is abundantly evident within the Veterans system too.
“I have patients that get out of bed for 10 minutes to prepare a salad and they can’t eat it because they’re totally exhausted, so tired by the time they put a small salad together,” said Dr. Al-Aly.
The research showed that Covid survivors were also more likely to be taking a spectrum of medications for their newly emerged health problems, including opioids, which Dr. Al-Aly said was concerning because it might portend another wave of opioid addiction problems in the future.
Dr. Al-Aly and his co-authors Yan Xie and Benjamin Bowe, both at Washington University in St. Louis, also analyzed records of 13,654 patients who had been hospitalized for their initial coronavirus infection. Unsurprisingly, they found that the sickest patients — those who needed intensive care — were at the greatest risk of long-term complications, followed by those who were hospitalized in regular wards, followed by patients who were never hospitalized.
Nonetheless, virtually every category of symptom — from chest pain to shortness of breath to diabetes to muscle weakness — were experienced by at least some of the people who were never hospitalized.