Life after COVID-19: Crisis may be over, but ailments don't always disappear
Months after his hospitalization for COVID-19, Gary Degrijze still can’t grasp a coffee cup handle. Ron Panzok suffers from pain in his left foot. Shirelle White needs supplemental oxygen to breathe.
The three are among the many COVID-19 patients who are enduring the effects of the disease months later. The virus is so new in humans that scientists don’t know how long patients will continue experiencing debilitating long-term effects and whether some of them will have complications the rest of their lives.
"It leads to a lot of frustration," said Dr. Ewa Rakowski, a pulmonary critical care doctor at Stony Brook Medicine, which is preparing to open a specialized center for those with long-term COVID-19 complications. "They want an explanation and want to know when they can expect to feel back to normal, and we just don’t really have that yet."
It’s not just those who were hospitalized with severe symptoms of COVID-19 who are still struggling.
"We are also seeing patients who didn’t require hospitalization or really much medical care, and they’re still coming in with the prolonged symptoms of shortness of breath, fatigue, persistent cough and mental fogginess," Rakowski said.
Degrijze, of Bellport, doesn’t fit most people’s image of someone who almost died of COVID-19. He’s 49 and had to pass a strenuous physical exam every year for the Army Reserve.
"I’ve been perfectly healthy for the majority of my life," said Degrijze, who was a United States Postal Service letter carrier for 26 years and hopes to one day return to delivering mail.
He spent 2 1/2 months at Stony Brook University Hospital — most of that time on a ventilator — and another two weeks in rehabilitation.
Degrijze’s breathing has greatly improved, but, "I have good and bad days," he said. "There are days I might walk halfway around the block and I’m like, ‘I’m starting to feel a little out of breath.’"
Joint pain means he can’t stand or walk for long, and sitting too much leads to lower back pain.
"I have very limited strength in my right arm" because of nerve damage, he said. "I barely have any strength in my wrists. It’s like my fingers are jammed at the knuckles. It’s almost as if I had a stroke, and I didn’t."
Degrijze goes to physical therapy three times a week. Doctors don’t know if his arm and hand will ever fully heal.
"They tell me they don’t know how much strength and mobility in my arm and hand I can get back," he said. "It may be 90%, it may be 70%. They just don’t know."
Like 'walking on rocks'
Other than high blood pressure, Panzok, 66, had no major health problems before COVID-19. He, too, almost died from the virus. He spent about two months in a coma at North Shore University Hospital in Manhasset.
Like Degrijze, he has nerve damage that, in his case, causes pain in his left foot. He used to go on 50-mile bike rides and 5-mile walks, but "now I walk maybe two or three blocks and that’s it. It’s like walking on rocks with no shoes, like pins and needles."
Panzok feels weak when exerting himself, and his muscles ache. He constantly feels a tingling sensation in his foot, even when resting. He had to retire early from his job as a truck driver because it involved picking up heavy boxes — something he can no longer do.
The Fresh Meadows, Queens, man never had kidney problems before COVID-19, but now his kidneys are functioning at only about 30% of the norm, he said. Doctors put him on a strict diet to avoid potassium and phosphorus because his kidneys cannot process the minerals well.
University of Oxford researchers found that 29% of patients they analyzed with moderate to severe COVID-19 had kidney problems two to three months after the onset of the disease. The findings are in a study, published Oct. 19, that also found 64% of patients had breathing problems, 60% had abnormalities in their lung tissues and 55% had significant fatigue.
A U.S. Centers for Disease Control and Prevention study released in July found that, even among COVID-19 patients aged 18-34 with no chronic medical conditions, one in five hadn’t returned to their pre-coronavirus health two to three weeks after receiving a positive test result.
Even so, those with pre-COVID-19 health conditions such as heart or lung problems are more likely to have severe bouts of the disease and are more likely to have long-term complications, said Dr. Tarika James, chief medical officer of the nonprofit Long Island FQHC, which operates eight health centers in Nassau County.
"If the heart was already weak to begin with, if it already had challenges, you add the COVID and it’s even worse," she said.
The inflammation triggered by COVID-19 can damage heart tissue and lead to the heart trying to pump harder, increasing blood pressure and the risk of heart failure, James said.
Likewise, inflammation and scarring exacerbate existing lung problems, so "now you have a worsened asthma, a worsened COPD [chronic obstructive pulmonary disease], lower lung capacity than before," she said. "It just takes whatever the chronic condition was and makes it worse."
COVID-19 patient urges prevention
White, 55, of Valley Stream, had severe asthma and other respiratory problems before COVID-19, and that has helped complicate her recovery, said Dr. Arthur Trust, her longtime pulmonologist.
White was on a ventilator for about two weeks in April. Ventilators save lives, but they also can damage the trachea, and in White’s case, the ventilator caused scarring and inflammation that narrowed her air flow so much that she "couldn’t really talk because she would be gasping for air," said Dr. David Zeltsman, chief of thoracic surgery at Long Island Jewish Medical Center in New Hyde Park.
On Aug. 12, he removed a 3-centimeter section of the trachea and then sewed the ends together.
White still has a hoarse voice and some difficulty breathing, but she said during a recent news conference at Northwell Health that she is now "able to breathe 100% better than what I was before surgery." Even so, she said she had to retire from her job as an investigator for the state mental health office's quality management division because of her illness.
White, who donned an "I survived COVID-19" face mask, urged people to wear masks and practice social distancing.
"If you have to go through what I went though, you’ll take this COVID very seriously," she said.
COVID-19’s health aftershocks
Many people continue to suffer effects of COVID-19 months after they contracted the coronavirus. Among the most common long-term effects are:
- Shortness of breath
- Kidney damage
- Blood clots
- Heart muscle damage
- Liver damage
- Cognitive problems
- Nerve damage
- Joint pain
- Anxiety and depression
SOURCES: University of Oxford, Stony Brook Medicine, Mayo Clinic