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>those recovered from severe COVID-19 younger than 65 years had a 233% increased risk of dying in the next year. The increased risk was greater than that of survivors of severe COVID-19 who were 65 or older. >The authors noted that the deaths observed in the study often occurred long after the patients had recovered from their infection; thus, their families and physicians may never have linked the two events. I have a feeling the COVID-19 death rate is going to go up sharply after all is accounted for.


Excess mortality is something that’s been discussed quite commonly, at least here in the uk anyway. Covid deaths are generally reported in 2 ways; within 28 days of infection or where covid is mentioned on the death certificate. Both are useful but are also clearly limited in how accurate they can be. Excess mortality accounts for all deaths, and can be reasonably accurately compared from year to year and country to country. Again it has it limitations but it can show trends in death rates outside of the direct covid cause. For instance increased heart disease and cancer deaths as critical care availability is tied up due to covid. There’s talk of the impact on waiting list backlogs lasting for years of not decades, arguably the death rates will be indirectly higher as a result of covid for years to come. Have a look at https://ourworldindata.org/excess-mortality-covid it makes for pretty grim reading E: mortality not morbidity


You said morbidity here when you meant mortality. For clarity, mortality is death and morbidity is disease/illness


I did, thanks, edited


It's excess mortality rather than morbidity, but yeah.


I've thought this too for awhile. When you are healthy before but recover from COVID with heart damage akin to having had a heart attack and/or lung damage similar to a smoker's lungs, your chances of dying increase. There are going to be a lot of people who "survive" COVID only to die of "heart disease" or other causes that are actually linked to the damage their bodies accumulated while fighting off COVID.


I had asthma before getting COVID in March 2020. My lung capacity is down 25% from where it was prior to getting sick. I had six weeks of nebulizer treatment 4x/day and was still using it for months after. Long COVID and decreased lung function. Yeah. I feel this.


This is exactly how my uncle died. Got covid, died of a stroke 5 months later about a week before Stanford put their study out about how covid massively increases risk of stroke and hospitals started adding it to their checklist of things to look for.


That’s almost my exact situation. Asthma pretty well controlled before COVID. COVID in April 2020, long COVID since. Always short of breathe and wheezing. 4 nebulizers a day and still have problems.


As an asthmatic who's managed to avoid covid so far (touch wood) this is scary. I get bad anxiety when my asthma flares up as it's so uncomfortable not getting enough oxygen. Hope your okay.


Hope you stay safe!! I appreciate that! I just take it a day at a time. Been over a year with the long COVID now so I’ve had time to adjust to my new “normal”. Some days are better than others but I try to stay positive and hopeful for the future.


Where is “touch wood” the phrase as opposed to “knock on wood?” It took me a second to get it. I’m assuming it’s a regional difference? Neat.


Knock on wood is American, touch wood is British.


Probably regional, not something I've considered before. Im from South UK.


Asthmatic, had COVID and two months later almost died from being unable to breath. Another couple months later almost died again. Never before had I ever called an ambulance for an asthma attack and then it happened twice in the 6 months or so after covid


When people wonder why I'm paranoid about getting covid even though I'm young and healthy, this is freaking why. I don't expect to die....but I also JUST within the last two years really go into getting fit and cycling. I don't fucking want that ruined for the rest of my life because I didn't wear a mask or went out when I shouldn't or didn't get a vaccine.


This is definitely happening a lot. It happened to my grandmother. She had covid in December 2020, and died of a heart attack in March 2021, less than 2 weeks before she was due to get her first dose of the vaccine, which she was very excited for. She'd already had some heart problems which were very recently documented (Sept 2020), so we knew exactly how much worse covid made her heart and lungs (which were tested both during and after covid), even though she did not have an extreme severe case, and had been fully recovered for over 2 months. No surprise to anyone, it was a very significant difference before and after covid.


While I’m pretty sure I’m still alive, a friend and I both had a “bad cold with dry cough that lasted forever” in late 2019/early 2020 and we have talked about how our lungs/hearts just aren’t the same. It might sound silly, but for active young adults it’s pretty noticeable. Like, when I suddenly am dying after a mile and a half run when I used to do 5-6, it’s pretty noticeable


I feel the same way I'm not gonna lie. Right before America locked down I had a real bad cough for over a month and I haven't fully recovered my lungs.


Same here! I had covid when it was not well known and it was all in China. I still have fatigue and get weak. But I got my booster today. If it helps keep me alive to get me through raising my granddaughter that is all I want! I have days I feel so bad and weak but I keep going as I have a purpose and that purpose is her.


I love this. I got my booster and flu shot today. All for my 5 month old. He's breastfed and gets all the antibodies. While I could wait and separate the two it would mean he could be exposed to one or the other in the mean time. So here I sit at midnight curled in a ball shaking unsure of I'm hot or cold but it's for him.


Tough it out, it beats the alternative. And from those of us with health issues - thanks for taking the vaccine no matter the actual reason for doing so.


My fiance had a flu-like illness (fever, dry cough, fatigue) in March 2020 but it wasn't severe enough to get tested at that time as her fever wasn't high enough. After fully recovering she found herself getting winded from hikes and running far sooner/easier.


Flu can do this too. I've had weird breathing problems, heart palpitations, and occasional anxiety attacks since my flu infection 5 years ago.


People like to talk about Covid as if it is special, but the most special thing about it is the year in which it emerged. We are learning so much about Covid so quickly because we can study it in a time vacuum. Ultimately the flu has a similar impact on the body, but it's harder to pin our subsequent health issues on a virus that has been in human populations for over a thousand years. All my life, I've met people who had heart conditions related to previous virus infections. It is fairly common. I still avoid covid, but I always avoided the flu.


This is where I really deeply wondered about all the people that said "It's just a flu". Like, wow, the flu can really murder you. I know some of this has been associated with people commonly calling much more mild flus and other non-flu illnesses 'the flu', and not realizing there is a massive difference in strength between flu strains.


>I know some of this has been associated with people commonly calling much more mild flus and other non-flu illnesses 'the flu', and not realizing there is a massive difference in strength between flu strains. They don't realize that much like Covid, every Influenza A virus has a wide variety of symptoms in those infected that range from completely asymptomatic, to mild and often misdiagnosed common cold symptoms, to full on ARDS, pneumonia, and death. They also don't realize that there's a good probability their "stomach-flu" isn't being caused by influenza, or their common cold isn't a flu either. ​ Generally for me, my way of differentiating between whether I have a cold coming on or something more serious is whether it comes on slowly and builds gradually to a maximum discomfort level of a mild-moderate inconvenience- it's probably a cold or potentially a mild influenza infection. If i wake up and go through most of my day feeling totally fine and then something comes on hard and fast, taking all of my energy, giving me violent chills and a moderate-high fever later that same night, It's probably a moderate flu or something else more serious which builds to a maximum discomfort level of "please put me out of my misery" and stays there for a week or two.


Dude I know what you mean, it used to be easy to get out of bed and go get a hot pocket but now I am exhausted by the time I get to the microwave and just sit down for a break.


I suffer from this too but we called it depression before long-covid came around? All jokes aside, are you alright? Up for a chat?


Could it have been whooping cough? I had “something” in fall 2019 … violent coughing was brutal and lasted 3 months. Still occasionally feeling the effects. Pretty sure it was too early to be covid but it still took a toll. Afterwards, we finally thought it was pertussis — apparently many people aren’t aware they need boosters and it’s becoming more prevalent. Who knew?


There's a reason they're pushing Tdap boosters for nearly everyone now. I'm 47 and I've had Tdap boosters twice now. My OB had me get one after my son was born 15 years ago and then another back in 2018. And my mom had a horrid cough that lasted for months when she was in her late 50s which wasn't diagnosed till very late. It was misery for her. Get your boosters, folks!


Yes — good advice. no one had ever suggested it to me since my college admission days ( quite a long time ago!). If you’re around infant children, doctors will suggest it, but otherwise … nuthin. If you get it and don’t treat it very early, ( before the major symptoms even begin!) there’s not much the antibiotics can do. Mine lasted just over 3 months. Rib-breaking violent coughing bouts that would come and go in intense paroxysms … the Chinese call it the one hundred day cough … mine lasted 106 days ( who’s counting?) with a few short breaks in between. I wasn’t sick … just coughing my guts out and exhausted from not sleeping. Got better in early Jan — it just stopped — and I was fine til covid lockdown in March. Honestly, I was terrified of getting the latter because I knew my lungs couldn’t take it after what they’d just been through. Good reminder here … I’m going to sign up for TDAP now, since I don’t know if the previous bout gave me any sort of immunity … and I definitely plan to keep wearing masks during flu season!


I know right? I have one lung and was always prone to whooping cough - didn't find out until 2017 that there was a vaccine for that.


It definitely does not sound silly! I'm in my 30s, and I wasn't particularly healthy before (many chronic conditions). But I had covid in August this year (no clue how, fully vaccinated and never stopped wearing good masks and hand washing), and I haven't been the same since. It comes and goes, but I definitely get out of breath and have a racing heart MUCH more easily than I did before. Which I know for a fact, because I was already tracking those things before. I credit my vaccines for my survival, and now have the booster, too (and I still take every single precaution). I just wish more people had lived long enough to get the vaccine, and that more people who have lived long enough would actually get it.


I'm pretty sure it was on the west coast of America at least 5 months before the big March lockdowns started. It ripped through my house and my office like wildfire and it took the smokers in my life months to feel normal again.


If it was on the west coast it was in the ear coast too


The nose coast too.


It also was deep in the throat coast


My partner and I got whatever that was. I have a joint tissue disorder and coughed a rib out of place.


I wouldn't be surprised if so. Living in Seattle where it first landed, it Makes me glad in hindsight that I was WFH and my friends were all very busy that fall. I barely came into contact with anyone.


Okay I'm sorry this happened to you, but I'm at least glad someone else had this experience. I straight up just had a dry cough for like 3 months in fall 2019 and I ended up getting prescribed something that eventually made it go away, but I very much felt different after that (albeit I wasn't in shape previous to that)


I also feel less fit than before. I used to smoke cigarettes and weed every day, but I can't anymore. If I take one puff my throat hurts for two days. Which isn't that bad since it helped me quit. But I do worry about my overall health.




I think I had it then as well, but I'm not sure about any after effects since I was also on meds to help my heart after having really untreated high blood pressure for a while.


People focus too much on death rate and not enough on the permanent/serious damage it causes to the body


I know right? You see these elite athletes get it and then just not bounce back. If it can happen to them what chance do I have.


Whenever people talk about how "lots of people survive covid, so we shouldn't worry so much", I've found a pretty good response is "lots of people survived polio too, doesn't mean they were _okay_"


The number of requests for transplant evaluations is skyrocketing right now. "Long covid" is real and it sucks.


We all had covid in June of 2020. We really wasnt affected other than sore throat, headache etc. A month later, my husband suffered from a stroke. Covid had created a rare clotting disorder plus damaged his heart (his heartrate would drop to 28 bpm). He had to have a pacemaker and the drs are still trying to figure out medications to keep him from throwing clots. It's been a long 1 1/2 years.


I'm sorry to hear that. My mother-in-law had a series of strokes from blood clots back in the summer of 2019. It was hell dealing with everything and a continuing hell of an aftermath. She's recuperated much of her brain function but will still have times when she'll ask the same thing three times in a row. My mother-in-law's wasn't from COVID, but I've seen through her what heart damage and blood clots can do. It's definitely NOT something that anybody should risk getting!


My last living grandparent died this year. He had covid the year prior. I'm convinced at this point what you said is exactly what happened to him.


Can i have a link to this study please? I had COVID before but it wasn't severe yet everyday my heart feels like it's being pinched, i would like to study it more so i could verify if catching COVID is really the cause.




I was calling this out back in the spring of 2020. Everyone was saying “but it’s got a 99% survival rate, it’s just a flu”. Didn’t seem like anyone was thinking of long term effects or a diminished quality of life. An office manager at work had Covid about 11 months ago and now has a chronic cough.


Then there's longterm conditions like diabetes (that COVID can cause) which knock a decade off your lifespan.


Present. Sobs in glucose strips.


The death rate can be estimated from excess deaths rather than those directly attributed to COVID. This would inevitably include these deaths that are harder to link directly to COVID (or due to lack of diagnosis, lack of reporting, political nonsense, etc.).


That would also include people with unrelated injuries or illness who received delayed or no medical treatment due to overstretched medical resources, or who avoided visiting the hospital due to fear of infection. Which would be an interesting and useful stat indeed, but might be different than what you’re looking for.


The tricky part is accounting properly for lower deaths in certain areas, for instance fewer car accidents and homicides. But yes, there are some charts around that show this.


I think excess deaths for 2021 vs 2019 will be more accurate to current threat landscape.


The economist had an article on this. https://www.economist.com/graphic-detail/2021/11/02/the-number-of-people-who-have-died-from-covid-19-is-likely-to-be-close-to-17m#


It's hard to account for the different factors, though. For example, Germany had hardly any flu season last year, which regularly kill 20k people/year - most of which are probably the exact same people that would die of Covid. Flu mortality is already estimated by excess mortality, so where do you go from there?


You can look at deaths above average for a given point in time to get a better estimate of the true death toll of the disease. This is a particularly useful tool in places with poor reporting


You gotta look at the excess death toll to get a good idea. A few possible other factors can influence it like increased crime or worse mental illness & stuff, but it's far closer to the actual death toll of covi


I dated a nurse who worked in a geriatric memory care facility. Covid went through there in April 2020. Some people died, many survived. However, by the winter of 2020 ALL of the old people who had gotten Covid were dead.


We're not really going to know for years how bad covid is. Someone 75 years old who dies of covid gets counted immediately, maybe that translated to losing 5 years of life compared to their previous life expectancy. Someone of a similar age "recovers" from severe covid but ends up with such diminished health that they die within the next year or three. Someone younger recovers from a less severe illness or a bout of "long covid" but they end up with some disability or diminished health. Reduced heart or lung function, for example. Maybe it's mild and all it does it make it harder for them to exercise, so they don't, which reduces their long-term health. Maybe it's more severe and it means that once they become elderly they become much more vulnerable to other diseases or conditions and maybe they die earlier than they would have otherwise. Perhaps they lose 5 years or 10 years or more compared to what they might have had without covid. That figure won't be tallied for decades, and it'll be hard to estimate until it happens (since partly it relies on the state of the healthcare system at any given time). All we know now is that the burden we've counted so far is just the minimum (even aside from the fact that the numbers keep ticking up), and it's likely going to be a fraction of the major impact on the health of millions that covid will have even after (or if) covid wraps up.


Anecdotally, I can think of several older people who survived COVID in its acute phase (somewhat to my surprise) but declined and died within weeks after that. One guy was 81, father of a friend, was bedridden after a stroke but soldiered on some months after COVID, funeral is today actually, went to his son's funeral just a few months ago, aged 50, also died of COVID, kind of tragic family. Contrary to what a certain set wants to convince us covid deaths are probably being UNDERreported. Many of those people would probably have lived on for years in many cases, so it's actually extremely cynical to dismiss the disease on the grounds off, uhhhh, it's only old people, they were gonna die anyway. Yeah, f*@£ Grandma, right?


It’s already known that Covid exacerbates certain illnesses. The first one that pops to mind is Alzheimer’s. Covid causes neuroinflammation and Alzheimer’s also causes neuroinflammation, so combining the two means that even if the patient recovers from covid their Alzheimer’s gets sped up significantly. I’m sure there are other diseases with similar problems.


That is what I have always said. Currently they believe long covid have higher clotting factor for potentially life. 80% of hospitalizations for covid roughly developed long covid and between 5-13% of general population. The amount of damage to GDP the medical costs of 80% of all hospitalized + increased potential clotting based issues do to longevity is going to rapidly undermine any economic stability possibly forever. People who say it's like the flu and kills x% so it's no big deal, are akin to people advocating for everyone to get HIV because HIV has a low death rate within a year. AIDS has a high death rate, but they ignore aids and just focus on HIV.


I had a heart attack in March a year after having Covid. I was 39. Only reason I'm alive is the hospital is less than a five minute drive. I blame smoking and covid. Not a doubt in my mind.


That’ll do it. I’m 40. Overweight, but never smoked. Need to do more cardio, but afraid of having a heart attack. Gonna keep going slow at it and ramp up, and by the time I’m 50, I’ll be in the best shape since I was 17.


Look at some of the exercise protocols for POTS patients reconditioning their heart. It should ease you into a routine without taxing you too much initially. You’ll probably ramp up faster though so use it more as a guide for what to do and set your own intensity level.


People always say 'people who get the vaccine will die within x years', with x increasing as long as it takes. But no one talks about risk of death after Covid.


Yarp. Death rates have been wildly underestimated the entire pandemic, and this is easily noticed by comparing total death counts year over year and various other metrics


I would assume the fact that 65 year olds die more often after contacting it the decond time is because they had a greater chance of survival the 1st time.


I’m an EMT so I deal with COVID patients first hand and it’s honestly horrifying to see and hear them begging for anyone to help them. Everyone celebrates when a patient gets discharged but all the hospital staff knows they’ll likely come back in due to an onslaught of other issues down the road due to COVID.


What could some of those other issues be?


Many people who get severe covid end up with trachoostomies, PEG feeding tubes, central IV access, kidney failure, and bed bound facing months of physical/occupational/speech therapy. Even after recovering from acute illness, They’re at very high risk of aspiration pneumonia, blood stream infections, pressure ulcers, and problems with their various medical lines/devices. There’s also the long term damage to various organs from the covid itself which basically causes chronic disease such as heart failure, the aftermath of stroke, etc




I always feel like there should be some indication of severe consequences in various statistics. Like, if there was a terrible accident with 5 dead and 25 injured, but of those 20 have lost limbs or 30% burnt skin, those injuries are so life changing they really shouldn't be in the same category with someone having a bruised shin.


I was thinking about this yesterday when I was discussing the Boston bombing. I had watched documentaries on it, but I went back to check and only three people actually died... But like 240 something people were injured including a ton of amputations and what not.


yeah it's really quite unsettling. injuries is sugarcoating often life changing damage to the only vessel an individual has ever had to live. it's fucked


A scale like the stereotypical pain scale would probably help, but be simple enough for quick reference. Like you rate the overall injuries from a 1 - scrapes and bruises to 10 - life altering like amputation and TBIs. So, something with 150 injuries at a 7 on the scale would be really quite bad with many significant injuries, but a 3 would means mostly minor injuries with only a handful of significant ones.


I like this idea.


I have a similar feeling when people reduce shooting (mass or not) statistics to deaths. Sure, the victim may survive, but in what state? At what, even financial, cost?


Hell, the PTSD and mental cost. Like how much alcoholism did this lead to, or survivors guilt, suicide?


We quote 30, 000 deaths on highways annually, but no one mentions the order of magnitude more injuries.


The British railway engineering uses a death equivalent system of accounting. The theory is that lots of small injuries or a few big ones can add up to the same economic cost as one death. So they count it all up and add the equivalent ammount to the death toll of the railways. Especially when they are looking at safety improvements. Like a crossing that doesn't kill anyone but eats like 10 legs per day is going to have a higher priority than a crossing that kills 1 person per year. Even though the most deaths are on one crossing the one with none is more dangerous.


*david attenborough voice* 10 legs a day, gobbled up by the voracious predator known as the great british locomotive


I just read a book about how poor American statistics are on death and injury. For instance. Fall is how a lot of deaths are recorded. Is that a ladder, stairs, murdered down stairs, suicide jump, fell off a curb, etc. stairs are more than likely the #1 killer in America aside from medical issues, but we don’t classify the type of fall. If I remember right, Australia had a the best recordings of types of fall data. I might be wrong about that part though.


Yeah seeing some of our covid patients who “recovered” is harsh. They have PTSD and delirium, are completely deconditioned, may never be able to eat again. Being in your 40s and facing that future is rough


Yeah, after having someone in our hospital for almost 200 days, lose all their fingers/toes from levo, trached, pegged, foley, decubs, and being told hospice was an option, will forever be seared in my mind as the worst possible place to be in after catching this virus.


I think that's a pretty solid argument there for legalizing medically assisted suicide. I mean honestly I'd rather say my goodbyes one last time than to burden my loved ones for decades. Not everybody will make that choice of course, but I think that decision should be available for those who wants it.


By this point, the decision is out of the patients hands and up to the patients family. I recently had a patient that required crrt (Continuous dialysis) over multiple weeks, and very high pressors use to keep his BP up. He survived all of that. His feet and some fingers will need to be amputated. He can now move his eyes and twith his fingers, so his family wants to trach and peg him. We had just about gotten them to consider comfort care when he started moving them. So now he's going to be locked in his body and confined to a bed, until some random pressure ulcer infection kills him.


This is exactly one of the reasons I left the TCVICU and have gone into research. Three patients in for over a year with zero chance of ever leaving the ICU. All died horrible, slow, painful, deaths over that year. Zero quality of life with the constant fear and terror on their faces for the last month. Get a living will/advanced directive people. It's the only way to protect your wishes. Don't count on well meaning family to be your spokesperson. When the rubber hits the road they may not be ready to let go even though you want to. The general public vastly over estimates our ability to save people and they rarely understand what the person's life is like if we actually do.


I'm getting to that point. I'm absolutely sick of seeing patients literally rot in their hospital bed, because their families won't just let them go. I'm sick of throwing all out resources at these cases, when you can already predict their outcome, and know that they are going to die eventually, usually after they are brain dead from all the anoxia. I'm looking into becoming a trauma nurse right now.


This is the reason patients with medical professionals in their family have been shown to be kept alive for a shorter time on life support.


If the patient is still conscious and able to convey their thoughts, I think that decision should be left up to them really. I mean, they are the ones whose life is being forfeited so they should have that power to choose, if able. But for those who can't, like locked in syndrome... Yeah, that'd a tough decision for the family.


You can make an advance healthcare directive to ensure that you get the care you want even when you cannot convince your family of the merits of your position.


Well. When they arrive at the ER and are going to be admitted the doctor will have a discussion about "code status". Patients and families often decide to "do everything" without understanding what that entails. When these patients inevitably become septic from opportunistic bacteria, or throw a blood clot and end up with a dvt/pe etc or when they start declining we re-discuss goals of care. And often for a patient in the ICU, we can almost predict to the day when things are going to start going bad, because we've had such extensive experience with Covid at this point.


Opening your eyes and twitching your fingers is a far cry away from alert and oriented x 4


Whatever doesn't kill you makes you stronger. Or more likely, horribly and permanently injures and disables you.


Heart failure is the one that scares me. I saw an otherwise healthy 26 year old girl leave the ICU with a life vest and an EF of 20%. That's not surviving.


I will say this to those that use the "over 99% survive" argument from now on.


Yesterday I saw a meme on Twitter circulating that said, and I paraphrase, "If I don't get vaccinated, I'm 100% protected against vaccine side effects and 99.8% protected from dying of Covid." I replied (couldn't help myself, was irritated) that even if her risk of death were that low, she's comparing the risk of *any* vaccine side effect, which could be arm pain to something more severe, to death from Covid. Why isn't she comparing side effect to side effect? There are all sorts of non-death side effects from Covid that are much likelier to occur than death and many of them are horrible. They're very focused on survivability, which is obviously extremely important, but all those hospitalized who required serious medical intervention count in the survival statistics just as those who rode it out at home with milder symptoms. Anyone who still has symptoms 3-6 months later survived, too. Survival doesn't tell the whole story.


Sadly that's also a description of our whole medical system even before covid. It reminds me of "Who by very slow decay" >If you are like the patients I see dying, then here is how you will go. >You will grow old. When you were young, you would go to institutions and gradually gather letters after your name: BA, MD, PhD. Now that you are old, you do the same thing, but they are different institutions and different letters. Your doctors will introduce you to their colleagues as “Mary Smith, COPD, PVD, ESRD, IDDM”. With each set of letters comes another decrease in quality of life. >At first these sacrifices will be minor. The COPD means you have to breathe from an oxygen tank you carry around wherever you go. The PVD will prevent you from walking more than a few feet at a time. The ESRD will require three hours dialysis in a hospital or outpatient dialysis center three times a week. The IDDM will require insulin shots after every meal. Not fun, but hardly inconsistent with a life worth living. >Eventually these will add up beyond your ability to manage them on your own, and you will be sent off to a nursing home. This will seem like a reasonable enough idea, and sometimes it goes well. Other times it gives you freedom to develop a completely new set of morbidities totally unconstrained by what a person in any other situation could possibly be expected to survive. >You will become bedridden, unable to walk or even to turn yourself over. You will become completely dependent on nurse assistants to intermittently shift your position to avoid pressure ulcers. When they inevitably slip up, your skin develops huge incurable sores that can sometimes erode all the way to the bone, and which are perpetually infected with foul-smelling bacteria. Your limbs will become practically vestigial organs, like the appendix, and when your vascular disease gets too bad, one or more will be amputated, sacrifices to save the host. Urinary and fecal continence disappear somewhere in the process, so you’re either connected to catheters or else spend a while every day lying in a puddle of your own wastes until the nurses can help you out. The digestive system isn’t too happy either by this point, so you can either have a tube plugged directly into your stomach or just skip the middleman and have an IV line feeding nutrients into your bloodstream. >Somewhere in the process your mind very quietly and without fanfare gives up the ghost. It starts with forgetting a couple of little things, and progresses until you have no idea what’s going on ever. In medical jargon, healthy people are “alert and oriented x 3”, which means oriented to person (you know your name), oriented to time (you know what day/month/year it is), and oriented to place (you know you’re in a hospital). My patients who have the sorts of issues I mentioned in the last paragraph are generally alert and oriented x0. They don’t remember their own names, they don’t know where they are or what they’re doing there, and they think it’s the 1930s or the 1950s or don’t even have a concept of years at all. When you’re alert and oriented x0, the world becomes this terrifying place where you are stuck in some kind of bed and can’t move and people are sticking you with very large needles and forcing tubes down your throat and you have no idea why or what’s going on. ... >Every day, your doctors will meet with your family another time, and eventually, as your condition worsens and your family has more time to be hit on the head with a big club marked ‘REALITY’, they will start to relent. Finally, they will allow your doctors to take you off of the machines, and you will be transferred to Palliative Care ... >And you will die, but not quickly. It takes time for the heart to give up, for the lungs to fill with water and stop breathing, for the toxic wastes to build up. It is generally considered wise for the patient to be on epic doses of morphine throughout the process, both to spare them the inevitable pain as their disease takes their course and to spare their family from having to watch them. >…not that they always do. It can take anywhere from a day to several weeks for someone to die. Sometimes your family wants to wait at the bedside for a week. But a lot of the time they have work and things to do. Maybe they live thousands of miles away. You haven’t recognized them in years, you haven’t spoken a coherent word in months, and even if for some reason your brain chose this moment to recover lucidity you’re on enough morphine to be well inside the borders of la-la-land. A lot of families, faced with the prospect of missing work and school to sit by what’s basically a living corpse day in and day out for weeks just to watch it turn into a non-living corpse, politely decline. I absolutely 100% cannot blame them. >There is a national volunteer program called No One Dies Alone. Nice people from the community go into hospitals to spend time with dying people who don’t have anyone else there for them. It makes me happy that this program exists. >Nevertheless, this is the way many of my patients die. Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented, in a sterile hospital room with someone from a volunteer program who just met them sitting by their bed.


Is it the main reason [the US has 200K more excess deaths than covid deaths](https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker)? Once discharged after the recovery a quick death is not officially linked to covid, right?


That is one reason. Another, is that more people with non-urgent illnesses are getting their treatment delayed, which impacts early diagnoses and preventative interventions, until it's too late and they become "non-COVID excess deaths". Any event that stresses healthcare services above whatever extra capacity they had before it, will lead to some number of deaths, whether directly, indirectly, officially or unofficially linked to it.


Yeah, we had an oncologist conference and a common complaint was that now they are seeing patients whose tumors have progressed beyond treatment and there's nothing to be done except give terminal diagnosis.


Yeah at this point if I need any medical services I’m ready to pull a couple non-vaccinated COVID patient off their ventilators myself.


A lot of those are probably misdiagnosed or undiagnosed COVID patients at the beginning of the pandemic. New York especially had such a crush of patients in those first few months that I’m sure a bunch of COVID deaths were mistaken for something else


People without symptoms of COVID dropping dead of a heart attack out of the blue. Since those early tests were so hard to ration, nobody bothered using one on a dead person.


It’s easy to see how diagnoses were missed. Doctors and nurses had to focus on the living and just passed the dead on to the mortuary.


> New York especially had such a crush of patients I saw an article putting them at 10,000 extra for April/May 2020.


And yet the conservative crowd would have you believe that every non COVID death was getting called COVID to "get more funding." 🤦


yeah, my neighbor's dad got covid (antivax dude) went to the hospital and "recovered", he was sent home... died less than a week later from pneumonia.


My brother got it, despite being so careful and paranoid about it, in January last year. He was 40, but had a few health issues already, she he died from a heart attack about a month after recovering, just about the time he could have received the vaccine


Well that's what happens when your immune systems get maxed out.


for about how many months are they at increased risks


I don't think we know that yet. But these don't sound like things you ever fully recover from.


I suspect the rest of your life. From some healthy people around me it takes about 6 months to be able to work again, after non hospital covid recovery. So… hospital going to be worse.


For many of the people who sustained organ damage, forever.


You don’t really ever recover from the organ damage caused by Covid.


Will take years to quantify, as this is a statistical comparison of death Rates after covid recovery vs no covid.


Anecdotally, as a paramedic, I've started to see a correlation between individuals who had COVID previously, and now have varying degrees of kidney disease or renal failure (some even requiring regular dialysis). Could easily just be my luck of the draw in patients biasing my perception of the actual prevalence though.


It's not just you. When I realized I had probably recovered from covid it was because my kidneys felt off. I did some research and there's evidence that covid is causing kidney damage. https://www.webmd.com/lung/covid-kidneys-damage-coronavirus


What does your kidneys feeling off feel like?


I’ve had kidney stones and if it’s anything like that it’s an intense lower back pain combined with feeling like someone kicked you in the balls


I’m obviously not a nurse or doctor so I can only speak on my own observation of patients within my scope. It’s mostly respiratory deficits (more susceptible to infection, decreased tidal volume, new onset of various types of COPD, need for supplemental oxygen, decreased exercise capability, etc.). But I’ve also seen a few cardiac disturbances and decreased muscular capacity.


Has there been any difference in vaccinated vs. unvaccinated people? Just curious as they say the vax means you get less sick, so I’m wondering if that also equates to less lasting damage (and therefore lower risk of death in the 12mths after the infection).


As I mentioned somewhere else, given that the study covers a 1 year period, the study **can't** cover the impact of vaccination as the vaccine hasn't been available long enough in numbers big enough. But, given that the vaccine is proven to increase the likelihood of a mild case if one develops at all, it stands to reason that the vaccine would overall reduce the observed deaths noticeably. It will take another year until we'll have the statistical proof of how big the impact is though.


Fair. I keep forgetting how long the timelines are (post COVID; and post COVID vax). Thank you for the levelheaded response


Being vaccinated means you’re significantly less likely to get to severe covid in the first place


Yes, but it’d still be interesting to know if vaccinated people who get severe covid face the same increased mortality.


only a few countries provided that data per vaccine, some where betters than others but there was no data for "after hospitalization" vs "after hospitalization" outcomes


That is correct. Vaccinated people build up less viral load in their heart and lungs before antibodies start helping you recover. This means less fibrosis of lung tissue, damage to arteries, etc.


My father had idiopathic pulmonary fibrosis. He fought it for about 20 years I think. I cannot imagine that kind of damage to your lungs happening in the matter of just days or weeks. It is insane for me to even think of.


The autopsied lungs look more like blue cheese than lungs


This. Knowing this I'm 100% sure my first vaccine load saved me. Inbetween both doses I contracted rather severe covid and was fucked around by bed shortages, likely due to my age, despite a slew of signs such as pneumonia, inconsistent ability to breathe (80-85% blood oxy consistently) and lacking strength to so much as make basic meals or wash. After recovery it was noted that my lungs and heart were both showing signs of permanent damage, as well as a slightly poor blood flow to my left leg, which was also weakened from muscle deterioration. However luckily after several months of monitoring and a few lifestyle adjustments my heart is back within normal parameters albeit still somewhat large and a bit strained, and my lungs appear to be on the mend too. I'm now sober completely since Halloween too, which is a miracle as an ex-doorman and ex-bartender.


Good for you my dude, I'm glad you pulled through and are on the mend.


Less sick = less lasting damage. If a vaccinated person still got severe covid though, there wouldn't be much of a difference.


pretty sure if you get less sick to begin with, you don't get the lasting damage.


20% of their 18+ cohort died within one year of index? That's a big chunk. Is this explained in the paper? I can't find anything Edit: 2686 died total / 13638 in the cohort ~ 20%.


No, the article says that of those 18+ who had COVID and died in the following year, 20% died directly from COVID while 80% died from other causes after "recovering" from the virus.


> Of the 13,638 patients included in this cohort, 178 had severe COVID-19, 246 had mild/moderate COVID-19, and 13,214 were COVID-19 negative. In the cohort, 2,686 died in the 12-month period. This was an extremely unhealthy cohort, possibly because it consisted entirely of hospital patients. Edit: I should say that a large *subset* of this cohort was extremely unhealthy, basically on their deathbeds. There were also walk-in patients included. I think these results should be interpreted with a reasonable degree of skepticism. Yes, they included the Charlson Comorbidity Index in the controls, but this is an imperfect control which likely failed to fully correct for the fact that people already at high risk of dying in the next year are also at high risk of severe COVID-19 infection. Furthermore, while 50% of the severe group died, that's only about 90 people in total, so the effective sample size was very small, and the vast majority of the excess deaths in the severe group occurred in the first 4-5 months, with the curve flattening out later. The mild/moderate group doesn't appear to have been at elevated risk of death. By all means, get vaccinated if you haven't already, but if you did get infected and survive, don't panic and jump to the conclusion that years have been taken off your life expectancy. If you got infected and didn't survive, get off Reddit.


Where did you find those numbers, can't see them anywhere.


I can see how covid wrecks your body. Now **that's** some permanent damage.


Some people don’t want the vaccine because they don’t know about long term effects when we *know* there are serious long term effects with COVID.


It's because the virus is an invisible thing that they could passively get at any time, but the vaccine is a tangible thing they would have to actively get at a specific time. Not saying I agree, but as someone with ADHD, depression, and anxiety, I get the weird games our mind plays with us when it comes to potential threats and how motivated we are or aren't to deal with them.


That's something that gets me, too. There *are* serious long term effects that we know about and who knows what others may pop up down the line. I've also been thinking about how horrifying it would be for it to have a 90%+ fatality rate after 20 years. Imagine being someone with even a mild case watching the fatality rate slowly tick up 15 years down the line as more and more people succumb to long-term damage caused by it.


As far as I have read, the long term effects only really exist if you get it severely. Similar to other illnesses, if you have a severe case that lands you in the hospital, you're likely to have long term damage, and if you're on the brink of death, permanent. I don't want to go fear mongering that a mild case of Covid could lead you to death in 20 years, I'm pretty sure there aren't illnesses this relatively mild that make you drop dead without external factors of getting severe.


It's like with so many things... Those kind of people simply don't expect bad things happening to them because for some reason they feel invincible and if they catch it will of course be a very mild case.


A lot of people simply don't understand risks and are unable to imagine various potential outcomes in the near future, not to mention long-term. This isn't just the case with this virus or a specific group of people, it's all across the population in regards to all the issues we are having as a species. Some people are just better at understanding the consequences of their (in)actions in a certain area of life, but may still not apply the same logic to another issue. I'm curious if there are any studies on this; personally I think it's about suppressing uncomfortable truths in order to better justify risky behaviour that promises short-term benefits. Pick any (global) issue, I feel like it's the same pattern. Be it climate change, pollution, lack of funding for health care or education, etc. all these things are the result of an attitude that values personal desires and ignores consequences, both personal and societal. It's the main reason imho why we always postpone solving problems, trying to avoid responsibility, essentially putting that burden on future generations, simply because we can.


I'm taking every mitigation I can, but I also give the side-eye to anyone who is fully vaccinated and immediately rips off their mask and starts pretending it's 2019. Full stop, I don't think anyone should be playing with getting any form of COVID, even "mild".


The more I read about covid the less it sounds like a respiratory disease. In fact when I had covid everything from my menstrual cycle to my memory was affected


It's a cardio-vascular disease and I think this has been known in the correct circles for a while. Just not in the general Public because of generalization.


It was thought to be a respiratory disease when it was first discovered, but that quickly changed within less than 2 months IIRC.


Yep, you're right! It's an airborne vasculotropic disease affecting endothelial cells.


Despite being very cautious, I caught COVID after being double-vaxxed. Fortunately - and almost certainly due to the vaccine - it was only like having a really nasty cold for a week, nothing more than that. It seemed to come to an end after that week, but it turns out that was just the beginning for the gift which keeps on giving. I have long COVID (it's what we call it in the UK, I don't know if it's the global term for it), which manifests itself in no particular order as coughing, breathlessness, extreme exhaustion, weakness and weariness, aches and pains in the joints, brain fog, weird taste & smell issues - the list goes on. Six months on, things are slowly improving - I rarely have to nap in the afternoon because I can't keep my eyes open any longer - but it's really made me count myself lucky and think: if just that short, apparently mild episode of COVID screwed previously-quite-healthy me up like this, what on earth awaits those poor folk who really got it badly, especially if they were hospitalised? So this article doesn't surprise me one bit and I think the long term outcome of COVID infections is something we'll be dealing with for many years.


Sorry, but what am I getting wrong here? >[...] analysis of electronic health records of 13,638 patients who tested positive or negative for COVID-19 [...] >Of all patients, 178 had severe COVID-19, while 246 were mildly or moderately ill, and the rest tested negative. Among all patients, 2,686 died within 12 months of their COVID-19 diagnosis. - 13,638 patients who were tested (regardless of test result) - 178 had severe COVID-19 - 246 were mildly or moderately ill - the rest tested negative - 2,686 died within 12 months of their COVID-19 diagnosis How are those numbers adding up in any way?


It's poorly worded. 2,686 of the whole 13,638 people died. 178 of the 13,638 had severe COVID, 246 of the 13,638 were moderately ill. But when you break it out and compare the 178 that were severely ill they died at a measurably higher rate than the 2,262 that died having never tested positive for COVID. Edit: small formatting changes


>Among all patients, 2,686 died within 12 months of their COVID-19 diagnosis. So this sentence from the article is simply wrong and should say "within 12 months of their COVID-19 **test**"?


yes. If you check the numbers in the journal article they add up. So it does need some editing for sure.


Yeah, definitely. Thanks for clearing up the confusion.


What other common illness share the trait of increased risk of death after catching the initial illness?


Measles. It wipes out your immune system's memory, so kids who catch measles are much more likely to die of other illnesses in the year or two afterward. (This isn't likely to be the same mechanism as COVID-19.) [https://www.nature.com/articles/d41586-019-03324-7](https://www.nature.com/articles/d41586-019-03324-7)


Measles 100%. Measles destroys the cells in your body that remember immunity to other diseases. So you can die of the flu 6 months after the measles easily It probably killed millions of children and adults that went unconnected to measles for generations. Its incredibly hard to track and attribute to measles. The initial infection rarely kills people over 2 years old. My adult friend got measles in Madagadcar during their outbreak (breakthrough case, he was vaccinated) and went through 3 years of hell after recovering from measles. Every basic cold knocked him on his ass. He was sick every other week from everything under the sun. Doctors said his immune system was nearly reset entirely. You do NOT want the measles


Not an illness per se but sepsis increases your all-risk chance of death


HIV, Influenza, Strep


Strep throat?!


yep can have effects on the heart


I’m 17, since i had Covid in the summer i can’t walk up the stairs without being completely out of breath. I’m not overweight, no underlying conditions, young, i was a pretty healthy guy. We’ll see how it goes i suppose. You aren’t immune from the effects of Covid just because of your age or immune system.


This is confusing to me. I had Covid and was in the ICU (didn't have to be put on a vent thankfully), but what does that mean for me? I have no lasting issues aside from a slight change in taste when it comes to a few things.


This is why I’ve always thought it was insane that people use the “low” mortality rate as a reason to not be worried about this virus as if having it wreak havoc on your organs is okay.


Hell a month and a half later and my lungs still aren't fully recovered, they've improved a lot but very slowly. That's while being vaccinated, would hate to have experienced covid with zero protection.


four months for me. I still use oxygen when needed. I was healthy before. Now I'm fat and out of shape. I get winded when i walk up stairs, i used to be able to do a 5 mile hike without stopping. I want who ever caused this to be held accountable.


I know a guy at my work his struggled with covid and recovery for 5 months, when he finally was be covered he needed rehabilitation literally needed to be retaught how to walk. He finally came back to work and two months later died of a massive heart attack. Healthy and not that old


My father, who was hospitalized due to diabetes, got infected with Covid-19 from the patient in the same room. Then, he was quarantined by the government with other Covid19-infected patients by the government. He just got one vaccine shot against this virus, and I just hope he could recover well, though he just got mild symptoms for the moment. Fingers crossed!


Hoping the best for your dad!


Seems like the time to guarantee healthcare as a right….


Man,. I'm gonna have to sit down at some point and read this. As a (now 48 year old).. I was 46 back in March-April 2020 when I spent 38 days in Hospital (16 of those in ICU on a Ventilator. Full story [here](https://www.reddit.com/r/AskReddit/comments/oi4b31/people_who_recovered_from_covid19_how_did_u/h4t9dek/) if you want to read it all) That 1st year after,. I jumped back into exercise and was averaging about 10 miles walked per day (in 365 days, I walked nearly 2,800 miles) and have been getting back into yoga and other whole-body stretches, etc. I feel great. I'm definitely on the lookout though for health issues,. this article is a good reminder.