COVID-19 School of Medicine

Risk of death from COVID-19 lessens, but infection still can cause issues 3 years later

New findings on long COVID by Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system reveal that COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year post-infection compared with people who have not had the virus. However, the three-year death risk marks a significant decline compared with such risk at previous time points post-infection. The study also shows that even people with mild COVID-19 still experienced new health problems related to the infection three years later. (Photo: Getty Images)

New findings on long COVID — long-term effects on health experienced by many who have had COVID-19 — present a good-news, bad-news situation, according to a study at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.

The bad news: COVID-19 patients who were hospitalized within the first 30 days after infection face a 29% higher risk of death in the third year compared with people who have not had the virus. However, the three-year death risk still marks a significant decline compared with such risk at the one- and two-year marks post-infection. The findings also show that even people with mild COVID-19 were still experiencing new health problems related to the infection three years later.

The good news: The increased risk of death diminishes significantly one year after a SARS-CoV-2 infection among people who were not hospitalized for the virus. This demographic accounts for most people who have had COVID-19.

The new research, published May 30 in Nature Medicine, tracked the virus’s health effects in people three years after being infected with the original strain of COVID-19 in 2020. That year, about 20 million people tested positive for the virus in the U.S. The new study assessed the risk of death and 80 adverse health conditions in people three years after being diagnosed with COVID-19.

“We aren’t sure why the virus’s effects linger for so long,” said senior author Ziyad Al-Aly, MD, a Washington University clinical epidemiologist and a global leader in long COVID research. “Possibly it has to do with viral persistence, chronic inflammation, immune dysfunction or all the above. We tend to think of infections as mostly short-term illnesses with health effects that manifest around the time of infection. Our data challenges this notion. I feel COVID-19 continues to teach us — and this is an important new lesson — that a brief, seemingly innocuous or benign encounter with the virus can still lead to health problems years later.”

Up to 10% of people infected with the virus experience long COVID, according to federal data.

Al-Aly’s prior research has documented COVID-19’s damage to nearly every human organ, contributing to diseases and conditions affecting the lungs, heart, brain, and the body’s blood, musculoskeletal and gastrointestinal (GI) systems.

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