NHS guidance on the long-term effects of Covid-19

NHS guidance on the long-term effects of Covid-19

Lung damage

Some 30 per cent of survivors of SARS and MERS experienced persistent physiological impairment and changes suggesting damage and scarring to the lungs. The new NHS guidance warns that such lung disease is also likely to be an important consequence of Covid-19. So far, there have been around 300,000 people in the UK who have tested positive for Covid, which could suggest around 100,000 could suffer lung damage However, limited testing means these numbers are likely to significantly underestimate the scale of disease. Research by King's College London suggests around 3.5 million people have now been infected with Covid-19.

An array of long-term complications

Post-intensive care syndrome is used by medics to describe a combination of persistent physical, cognitive and psychological impairments. NHS England warns that this is present in 56 per cent of ICU patients at 12 months following prolonged ventilation. Around 13,000 Covid patients have so far been treated in ICUs, more than half of whom were ventilated.

Weakness

In general, between 25 and 50 per cent of those discharged from intensive care units are left with “intensive care acquired weakness”. But the guidance warns of anecdotal evidence the figure may be still higher among Covid patients.

Brain damage

Mild cognitive impairment may persist at one year in about one quarter of patients who suffer acute respiratory distress syndrome, the guidance notes. This can impact on managing finances, driving, and returning to work. The advice goes on to warn: “There is evidence that coronavirus can affect the hippocampus, which can lead to impairments of memory and may predispose to the development of neurodegenerative conditions such as Alzheimer’s disease.”

The guidance says “people are reported to have changed to their personality and cognitive impairments such as reduced attention, impulsivity, disinhibition, disorientation and reduced working memory”. Seventy per cent of ICU patients will suffer delirium, and in one in five cases, this will become “established cognitive impairment” the document warns.

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