Long-term COVID Damage: the great unknown

Reportedly, 27% of COVID-19 survivors have symptoms from the disease that are still present some 6 to 9 months after they test negative for the virus.

Two commonly diagnosed conditions are CFS and POTS:

  • POTS (postural orthostatic tachycardia syndrome) is a” disorder of the autonomic nervous system, which controls involuntary functions such as heart rate, blood pressure and vein contractions that assist blood flow.”(1) Diagnosis is simple; treatment is not. To diagnose, the patient lays on a flat surface for a few minutes, and blood pressure and heart rate measurements are taken. The patient then stands or the surface is tilted to an almost standing position. With POTS, the heart rate will increase by between 30 and 120 beats per minute within ten minutes of the change in position. POTS often coincides with autoimmune disorders in which the body’s immune system is attacking health tissue.
  • CFS (chronic fatigue syndrome) is more difficult to diagnose and some physicians may mistake it for a psychological disorder. Patients report difficulty in standing for any length of time and brain fog.

POTS and CFS can co-exist in the same patient.

Prior to COVID-19, there were an estimated 4 million Americans with POTS. Now, obviously, the number is much larger. Are we going to see a substantial increase in demand for heart transplants?

The problem is that there may be as few as 150 physicians in the US familiar enough with these conditions to treat them. Further there are no drugs specifically developed for these diseases. There are some that can be used off-label to ease symptoms.

The lack of experienced physicians means that many patients may receive an incorrect diagnosis when they seek treatment. Once correctly diagnosed, many will have no access to a doctor know knows how to manage these diseases. As usual, that’s going to hit people in smaller cities and rural areas quite hard. People are going to have to travel for competent care, further complicating life and budgets. The need for travel isn’t factored into most health insurance plans.

Now there are several key questions to which we don’t have answers, and that’s what’s driving life and health insurers crazy:

  1. How long is long term?
  2. What will the impact be on healthcare costs? For how long?
  3. Will these diseases shorten life expectancy? By how much?
  4. For consumers, does that change thinking about when to start taking Social Security payments? Planning for work during your older years? Planning for retirement, if you have that luxury?

Uncertainty will make it harder to qualify for private insurance, and drive costs up, as insurers struggle to make sure they have enough cash on hand to pay claims. Until we have actual experience that we can use to predict what’s going to happen, this is strictly casino. And that will make for some pretty bad ulcers among those who have to make decisions.


  1. https://www.medscape.com/viewarticle/952288?src=mkm_covid_update_210602_MSCPEDIT&uac=153634BV&impID=3416386&faf=1

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