Long COVID's lethal impact: Thousands of U.S. deaths linked to persistent virus effects

Written by Jakob A. Overgaard

Jan.03 - 2024 1:31 PM CET

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The COVID-19 pandemic has brought to light a lesser-known but increasingly significant threat: long COVID. This condition, characterized by lingering health problems long after the initial infection, is proving to be not just debilitating but also deadly.

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A recent report from the U.S. Centers for Disease Control and Prevention (CDC) reveals a concerning statistic: at least 4,600 Americans have lost their lives to long COVID since the pandemic began.

This figure, derived from death certificate data, includes 1,491 deaths in 2023 and 3,544 fatalities from January 2020 through June 2022. As reported by Medscape.

The introduction of guidelines in 2023 for reporting long COVID as a cause of death is expected to provide a more accurate count of these fatalities.

Robert Anderson, PhD, the CDC's chief mortality statistician, anticipates that these guidelines will increase awareness among certifiers about the impact of long COVID, although he does not expect a dramatic change in trends.

Long COVID is diagnosed when symptoms persist for at least three months post-infection and were not present before the illness. As of late last year, approximately 7% of American adults have experienced long COVID, according to a CDC estimate from September 2023.

The new data underscores the ongoing public health threat posed by long COVID, which is likely to escalate even as the pandemic recedes. For instance, COVID-19 was the third leading cause of death in the U.S. in 2020 and 2021, and the fourth in 2023.

Nearly 1% of the over one million COVID-19 related deaths since the pandemic's onset have been attributed to long COVID. The proportion of COVID-related deaths due to long COVID peaked at 1.2% in June 2021 and 3.8% in April 2022, coinciding with periods of reduced fatalities from acute infections.

Mark Czeisler, PhD, a researcher at Harvard Medical School, expects an increasing proportion of COVID-19 associated deaths to be linked to long COVID. The condition can lead to severe, life-threatening complications affecting major body systems, as outlined in the CDC's guidelines for identifying long COVID on death certificates.

This means long COVID is often an underlying cause of death in cases involving heart, lung, brain, or kidney issues.

The risk of dying from long COVID is higher for at least six months following mild infections and for at least two years after severe cases requiring hospitalization. Age, race, and ethnicity are significant risk factors. For example, half of the long COVID deaths from July 2021 to June 2022 were among individuals aged 65 and older, with another 23% in the 50-64 age group. Death rates also varied by race and ethnicity, with the highest being among American Indian and Alaskan natives.

The disproportionate impact of severe acute infections on Black and Hispanic populations may have resulted in fewer survivors developing long COVID, potentially limiting fatalities in these groups. Additionally, undercounting of long COVID deaths in these populations could be due to challenges in accessing healthcare or recognition of symptoms by healthcare providers.

Distinguishing between deaths caused by long COVID and acute infections remains challenging, influenced by factors like adherence to CDC guidelines by medical examiners. Ziyad Al-Aly, MD, chief of research at the Veterans Affairs, St. Louis Health Care System, notes that long COVID is often under-diagnosed, and deaths are frequently misattributed. The development of an accurate test for long COVID, such as a potential blood test, could revolutionize diagnosis and contribute to a more precise fatality count.

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