Army Public Health Center provides update on Long COVID risks

By Douglas Holl, Army Public Health CenterNovember 17, 2021

According to the Centers for Disease Control and Prevention, Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. The Centers for Disease Control and Prevention and Army Public Health Center experts recommend getting vaccinated against COVID-19 as soon as you can is the best way to prevent getting COVID-19 or Post-COVID conditions or health problems also referred to as Long COVID. (Army Public Health Center photo illustration by Graham Snodgrass)
According to the Centers for Disease Control and Prevention, Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. The Centers for Disease Control and Prevention and Army Public Health Center experts recommend getting vaccinated against COVID-19 as soon as you can is the best way to prevent getting COVID-19 or Post-COVID conditions or health problems also referred to as Long COVID. (Army Public Health Center photo illustration by Graham Snodgrass) (Photo Credit: Graham Snodgrass) VIEW ORIGINAL

ABERDEEN PROVING GROUND, Md. – It’s been nearly a year since the Army Public Health Center first reported about long COVID and there have been a number of studies on this issue as well as some recent media reporting about how this may be impacting service members, civilians and their families.

“Lingering symptoms of COVID-19 can persist for weeks or months after initial infection,” said Dr. John Ambrose, Army Public Health Center senior advisor for Clinical Public Health & Epidemiology. “In fact, up to 37 percent of those infected with SARS-CoV-2 can have mild versions of COVID-19 symptoms. However, it is notable that those older than 65 and those with chronic medical conditions are more likely to suffer from long COVID.”

According to the Centers for Disease Control and Prevention, Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. Even people who did not have COVID-19 symptoms in the days or weeks after they were infected can have post-COVID conditions. The Department of Health and Human Services (DHHS) has also provided guidance that long COVID can be claimed as a disability under the Americans with Disabilities Act (ADA).

The most commonly reported symptoms, according to a DHHS FAQ about long COVID and ADA eligibility, include:

  • Tiredness or fatigue
  • Difficulty thinking or concentrating (sometimes called “brain fog”)
  • Shortness of breath or difficulty breathing
  • Headache
  • Dizziness on standing
  • Fast-beating or pounding heart (known as heart palpitations)
  • Chest pain
  • Cough
  • Joint or muscle pain
  • Depression or anxiety
  • Fever
  • Loss of taste or smell

This list is not exhaustive. DHHS also says some people experience damage to multiple organs including the heart, lungs, kidneys, skin and brain.

A study of 273,618 electronic health records of COVID-19 survivors, published Sept. 28 in the academic journal PLOS Medicine, found that more than one-third of the COVID-19 patients had long COVID symptoms 3–6 months after a SARS-CoV-2 infection. The study also noted that more than 46 percent of the patients aged 10–21 years had at least one long COVID symptom during the 6-month period after the SARS-CoV-2 infection. Similarly, more than half of the nonhospitalized individuals also experienced one or more long COVID symptoms.

Ambrose agrees with studies showing long COVID can affect younger age groups, but the reasons for whom it affects are currently unknown.

“It should be noted that children affected by long COVID are relatively rare,” said Ambrose. “Most children recover from COVID quickly. It is suspected that children with other chronic health conditions may be at a higher risk for development of long COVID.”

Parents can now further protect their children as the CDC recommends everyone ages 5 and older get a COVID-19 vaccine to help protect against COVID-19.

The CDC’s Morbidity and Mortality Weekly Report published Sept. 17 said higher rates of long-lasting symptoms after recovery from COVID-19 have been found among older adults, females, Blacks, and persons with pre-existing conditions.

A recent article published on Army.mil highlights the experiences of a Fort Carson 30-year civil service veteran and a Directorate of Public Works (DPW) housing manager, Debra Lamb, who contracted the COVID-19 virus late in 2020 and according to the article “experienced a harrowing ordeal before partially recovering months later.”

After her initial illness, she was discharged from the intensive care unit at the UCHealth Memorial Hospital in Colorado Springs with a diagnosis that included short-term memory loss, lung damage and congestive heart failure. And though she was back at work for DPW a few weeks later, she continued to feel less than 100 percent, and ultimately chose to go on a heart defibrillator to avoid a chance of heart failure.

“My heart was beating at about 25 percent,” said Lamb. “Doctors prescribed medication to improve my condition, but after six months, those didn’t seem to work well, so my doctors gave me three options — continue on the heart medication, allow them to implant a heart defibrillator or take a chance of heart failure. I chose the defibrillator.”

The article said doctors implanted the defibrillator in late June 2021, but Lamb’s not sure she’s noticed significant improvement.

“I don’t know if I feel better because I’ve convinced myself that I do or if it’s actually happening,” Lamb said. “It’s certainly better than imminent death, though. Now, I’m considered a COVID-19 ‘long termer.’”

Ambrose says despite these risk factors, it is possible for healthy service members to suffer from symptoms of long COVID. Symptoms could have long-term impacts on quality of life and personal readiness.

In an Army Times article published Sept. 17, three Soldiers were interviewed about their experiences with long COVID. One senior noncommissioned officer reported continuing symptoms more than a year after his initial infection. They included enduring shortness of breath, brain fog, fatigue, dizziness and short-term memory loss, which he felt might keep him from being able to do his job as a soldier.

“I’m currently working about two, three hours a day and will max out at about 10 hours a week,” he said. “I don’t believe I am an asset to my organization…I cannot get on a plane and deploy after a year [of recovery]. That should be a no-brainer that I am separated…I don’t see the benefit of maintaining myself as an active-duty soldier.”

Ambrose says the likelihood of Soldiers being separated from Service due to long COVID symptoms is low.

“While it is possible that long COVID patients could be separated from service if they develop severe symptoms, the risk of separation due to long COVID is unlikely,” said Ambrose. “While long COVID can last weeks or months, symptoms do eventually resolve. As a result, it is unlikely service members will be separated.”

Vaccination is one of the strongest protections from contracting Long COVID said Ambrose.

“While studies are still on-going, preliminary information suggests that vaccination does offer some protection from long-term complications related to COVID-19,” said Ambrose. “In fact, a recent study published by the New England Journal of Medicine reported that only 19 percent of those with breakthrough infections suffered lingering COVID-19 symptoms six weeks post infection.”

The CDC says the best way to prevent post-COVID conditions is to prevent COVID-19 illness. For people who are eligible, “getting vaccinated against COVID-19 as soon as you can is the best way to prevent getting COVID-19 and can also help protect those around you. Stopping a pandemic takes all the tools in our toolbox.”

Important Ways to Slow the Spread of COVID-19

  • Get a COVID-19 vaccine as soon as you can.
  • Wear a mask that covers your nose and mouth to help protect yourself and others.
  • Stay 6 feet apart from others who don’t live with you.
  • Avoid crowds and poorly ventilated indoor spaces.
  • Wash your hands often with soap and water. Use hand sanitizer if soap and water aren’t available.

The U.S. Army Public Health Center enhances Army readiness by identifying and assessing current and emerging health threats, developing, and communicating public health solutions, and assuring the quality and effectiveness of the Army’s Public Health Enterprise.