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Surviving COVID-19 may be just the beginning of the fight for some patients, local doctors say

Months into the crisis, several First Coast doctors are weighing in, saying coronavirus is proving to cause deadly after-effects for some.

JACKSONVILLE, Fla. — The medical community still isn’t sure whether COVID-19 survivors are immune to recurrence. That’s bad enough, but as the crisis now reaches to several months long, doctors say they’re starting to see patterns of potentially lifelong and life-threatening conditions among some who get over Covid-19.

“Debilitating fevers, chills, brain fog,” Mayo Clinic infectious disease specialist Dr. Mohammed Reza said.

The list goes on.

“Encephalitis, that is, inflammation to the brain,” U.F. Health infectious disease specialist Dr. Frederick Southwick said.

Then there's the cardio-vascular and brain issues.

“[COVID] can cause you to have clotting, that can cause you to have stroke, which can cause you to have a heart attack, and that can lead to arrhythmias, and that can lead to cardiomyopathy, where the heart muscle becomes larger and does not pump as well,” Reza said.

As the conversations went on, the size of the words seemed to mirror the gravity of the implication: COVID can kill indirectly, even after the person afflicted survives it.

When we read Baptist Health pulmonary and critical care specialist Dr. Danny Pulido a list including lung scarring, stroke, embolism, blood clotting, heart damage, neurocognitive issues, and male infertility, he said “I definitely think it’s a very good generalized list of what we’ve been seeing in the hospital, in the ICU.”

Reza said, “We’re learning new things about this virus that we didn’t expect, on a daily basis.”

While perhaps unexpected, the developments don’t seem to have entirely surprised the doctors, at least not in hindsight.

Pulido said Covid-19 first attacks the lungs. 

“But then as the virus then starts to take more of a systemic effect and causing more generalized inflammation, it starts to inflame the vascular blood vessels all throughout the body,” he said.

And blood vessels feed vital organs.

“This virus really attacks all parts of the body,” Southwick said.

But he clarified that damage to the lungs alone – what he called “in situ” clots - can be enough to kill.

“At autopsies we see small blood vessels throughout the lungs, that have clots in them. And we think this is a serious complication that can lead to death,” he said.

“[COVID] can cause you to have lots of other symptoms such as affecting your gut,” Reza continued. “It can cause you to have problems with your kidneys. “Your body’s immune system kind of goes into this potentially fatal overdrive, at least this multi-organ failure.”

As gloomy as the news is, the doctors acknowledged that not every COVID survivor’s after-effects have proven severe, and Pulido said the COVID patient turnaround at Baptist Health has become quicker.

But he also said the demographics are shifting.

“We’re starting to see a wide variety of age groups now; we’ve had 20-year-olds, 30-year-olds, already starting to trickle into the ICU,” he said.

It's a problem he said could make older relatives of those young adults more vulnerable to becoming infected.

The doctors said mental health can also be a casualty.

“Just depression, anxiety from all those things they’ve experienced,” Reza explained, saying some patients who require ventilator support can suffer post-traumatic stress disorder from “having a tube shoved down their throat to help them breathe.”

The doctors agreed the discoveries should concern anyone, whether they’ve beaten coronavirus or not.

“Unfortunately, no,” Southwick responded when asked whether there’s anything COVID survivors can do. “You are really what I would say, a sitting duck.”

The doctors agreed, recent discoveries should be enough to change the minds of people who don’t take measures to prevent receiving or transmitting coronavirus. Southwick had strong words for anyone protesting face mask mandates as a violation of their liberties.

“What an individual is saying if they don’t want to wear a mask is, ‘I have the right to infect you’.”

All that on top of that still-unanswered question about whether surviving coronavirus begets immunity.

“If you were tested positive and recovered, you’ve still got to take all precautions,” Pulido said. “It doesn’t mean you’re now bulletproof and can walk around without any kind of protection.”

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