Infectious Disease Specialist Warns of Long-Term COVID-19 Effects

With the COVID-19 pandemic about half a year in, signs are pointing toward much more long-term effects of infection, one doctor on the frontlines of Washington State’s outbreak warns.

Francis Riedo, an infectious disease specialist at EvergreenHealth in Kirkland, says he’s seen a handful of “peculiar” symptoms that persisted long after infection which was not the norm for other viral infections.

“We’re seeing patients coming in the clinic four weeks, six weeks, two months, even three months after their infections, complaining of debilitating fatigue, persistent headaches, muscle aches, difficulty concentrating, even changes in their sense of smell and taste,” Riedo said during a press conference with Gov. Jay Inslee Aug. 13. Among other COVID-19 related discussion, the governor and Riedo touched on some potential effects of the disease now coming to light as the state approaches seven months since the first confirmed death of the disease in late February.

Inslee said a recent survey from the Centers for Disease Control and Prevention showed 35 percent of respondents say they had not returned to their previous health two to three weeks after receiving a positive test, in contrast to the 90 percent of influenza patients who said they had returned to prior health in that time period.

“We are not dealing with the common flu,” Inslee remarked. 

Riedo said early on clinicians involved with handling COVID-19 realized that the disease “was not just influenza,” with patients experiencing heart, gastrointestinal and neurological symptoms beyond what would present with the flu. 

“We think about the common flu, you get sick, you’re out for a week, maybe two weeks, you might feel tired for a little bit longer, but pretty soon you’re back to work,” Riedo said. “The changes here (with COVID-19) are really significant.”

Riedo said one of the most debilitating of the long-term symptoms was “crushing fatigue,” limiting individuals to only a few hours of activity a day.

“This is a totally novel virus so we have a clean slate — no immunity, no protection — and we’re seeing the consequences of it,” Riedo remarked.

While he applauded efforts in business and education sectors on adhering to preventative measures, Inslee said he still felt that issues remained in social gathering settings. He reasoned that younger individuals may be more likely to take part in gatherings that could spread the disease, saying infections in individuals under 40 had gone from 22 to 45 percent of the total.

Riedo also touched on treatments and the potential for a vaccine. While investigating the disease he said that researchers discovered remdesivir, an antiviral drug, showed effectiveness in improving patients’ conditions, as well as some benefit from using steroid medications to “modulate” the immune system, something he said wasn’t the usual case for other types of viral infections. He added that hydroxychloroquine, another drug touted by some, did not show effectiveness.

Outside of treatments Riedo said healthcare workers in Washington were “working very diligently” toward a vaccine, mentioning that one being developed by Kaiser Permanente was entering a broad tial phase.

Riedo also acknowledged the effect the disease has had on families with more than 150,000 who had the disease dead in the United States. He said the mental health aspects were just becoming apparent.

Riedo said that the longer-term effects will likely become clearer in the coming months with follow-ups in patients.

“Early on five-and-a-half months ago we were trying to figure out what the clinical presentation was,” Riedo said. “Now I think we’re at a point where we understand many of those, although we’re still discovering new manifestations.”