COVID-19: Some patients still suffering 18 months after first diagnosis

“We see chronic coughs, prolonged loss of smell and altered taste. And you may have heard of brain fog, this delayed sort of cognitive thinking, short-term memory changes, things like that.” — Dr. Sharry Kahlon

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During this pandemic, healthcare workers have been on the front lines, lauded as heroes but also targeted by anti-vaccine mandate protesters. Postmedia went behind the scenes and spoke with a range of Fraser Health Authority staff for this five-part series to see how they’re coping. Here is part four:

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Your age, whether you’re collecting a pension or getting your legs under you career-wise, isn’t a safeguard against the long-term effects of COVID.

Almost as soon as the Post-COVID-19 Recovery Clinic in Surrey was up and running, Dr. Sharry Kahlon started seeing people coming in their 30s and 40s, complaining of draining, lingering effects from the disease.

And it doesn’t seem to matter whether they’d needed to be hospitalized when they were sick or if they isolated in the confines of their home.

“There really isn’t one specific patient population (suffering long-term effects),” said Kahlon, the medical director of the Surrey Memorial long-term clinic at the Jim Pattison Outpatient Care and Surgery Centre.

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It’s too early to tell, 19 1/2 months after the province first enacted emergency legislation to try to contain the virus, if these long-term effects will peter out in time or if they are permanent.

“We just don’t know,” Kahlon said. “But there are patients who still exhibit symptoms at the 18-month mark.”

So, that nephew or neighbour who scoffs because they caught COVID and brags about being asymptomatic, they’re just lucky.

Long-COVID patients struggle physically and mentally.

They are unable to return to their pre-COVID life, unable to engage with their families, their occupations.

The exercise and activities they used to find joy and pleasure in, they’re no longer able to pursue.

“It’s not just, ‘Oh, I feel a bit short of breath,’” Kahlon said. “Some people are debilitated by this.

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“And the mental health has been really, really hard for people, being in a pandemic and not being able to return to your previous level of function. It’s been really hard for patients’ mental health, we see that a lot in the clinic.

It’s absolutely as onerous as the physical effects, she added, compounded by not knowing when or if long-COVID will ever end.

Kahlon , a general internal medicine specialist at Surrey Memorial Hospital as well as medical director at the hospital’s post-COVID-19 recovery clinic, said along with post-exertional malaise — brain fog in the vernacular — many patients have not regained their sense of smell and taste.

The long-COVID clinic at the Jim Pattison outpatient care and surgery centre is one in the Lower Mainland seeing individuals who have ongoing, long-term effects of COVID-19 more than three months after infection. The other clinics are at St. Paul’s Hospital, Vancouver General and Abbotsford Regional.

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The clinics follow patients still exhibiting COVID-19 symptoms up to 18 months after becoming infected. It’s about treatment, but also real-time research.

“All the data hasn’t been analyzed (yet) in terms of specific key features of individuals that would predispose them or make them more susceptible to this,” Kahlon said.

“The lung concerns we see can include ongoing shortness of breath, even if there aren’t changes on CT-scans or lung-function tests. They still experience a sensation of feeling short of breath.

“We see chronic coughs, prolonged loss of smell and altered taste. And you may have heard of brain fog, this delayed sort of cognitive thinking, short-term memory changes, things like that.

“So really what we’re finding is, as we know COVID can affect a number of the body systems in the acute phase when you’re unwell, even long term it can have effects on multiple body organs.”

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Some of the information and treatment strategies around long-COVID symptoms is gleaned from experiences with other viruses in the past, she said, including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

“Some of the data in terms of how do we manage these long symptoms do come from that. We have seen (long-term symptoms) in other viral conditions.

“But as we’re learning about it, that may change.”

The clinic has gone from being open part time and seeing about eight patients a week when it opened in January, to being open five days a week, being pre-booked up, seeing new patients, following up for 18 months.

Between the four clinics, more than 2,500 patients with ongoing long-COVID symptoms have been seen.

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“(Long-COVID) definitely exists, and there’s definitely a need to support these individuals,” Kahlon said.

gordmcintyre@postmedia.com

twitter.com/gordmcintyre

Coming tomorrow: Part 5, contact tracers


Part 1 —  Respiratory therapists see ICUs fill up with non-vaccinated patients

Part 2 —  Health officers find themselves branching out because of pandemic

Part 3 — Nurses overworked, stressed out and overflowing with care and concern for their patients


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