Young people and the prolongation of COVID-19: underreporting, undertreatment

John Volecek, 41, of Richmond, Virginia, was diagnosed with long-term coronavirus infection in May 2022. Although his acute infection was mild, the severe fatigue he initially experienced never went away, even after the rest of his family recovered.

“When I wake up in the morning, I feel like I haven't slept at all,” Boreczek said. “This exhaustion never goes away.”

An urban planner who once cycled to work every day and spent his weekends cycling was forced to quit his job and eventually found himself barely able to take a quick walk as a symptom of the coronavirus. The symptoms were post-exertional malaise, that is, severe fatigue after a physical or mental activity that had been tolerated. His poor sleep, fatigue, and dysautonomia (a disturbance in the autonomic nervous system that causes dizziness, heart rate changes, and nausea) made it nearly impossible to share housework with his wife. She has to do most of the cooking, cleaning, and caring for her two sons, ages 6 and 8.

This occurs over an extended period of time during the prime working years, when young and middle-aged adults are at their most productive and busiest in their lives, often in the midst of caring for aging parents and raising children. This is an increasingly familiar story for people affected by the new coronavirus infection. And this group is among those most affected by the lingering coronavirus, both because of the number of patients with the disease and the emotional and economic burden it places on this age group. According to Centers for Disease Control and Prevention (CDC)6.9% of adults aged 18 to 34 and 8.9% of adults aged 35 to 49 have the disease, compared to 4.1% of those aged 65 and older, who are least likely to suffer from long-term coronavirus disease. It is.

In a recently published study, scientific reportresearchers found that in a population of California residents with long-term COVID-19 infections, older adults (who were initially sicker) developed more severe symptoms associated with the condition. I discovered that there is. However, researchers also found that younger people (18 to 49 years old) were more likely to experience symptoms that reduced productivity and quality of life. They suggested that this is both because they have a lot to do in the day and because they have a long life ahead of them with a chronic illness.

“Although the majority of California’s population falls into the 18-49 age group; [so] We expect the highest overall burden to be among these populations,” said study lead author Sophie Chiu, a researcher in the California Department of Public Health's Division of Infectious Disease Control. .

Impact on work and life productivity

Adults, especially middle-aged adults, say they tend to have many competing stressors during this time. Nisha ViswanathanMD, Director of the UCLA Health Long COVID Program. “Patients may need to relieve some of the pressures in their lives for their health, but this may not be possible because they have so many other people relying on them,” she says.

The situation is different for older people, who may have more severe symptoms due to underlying health conditions. But older Americans are also more likely to be retired and have no children to rely on financially. Previous studies have shown the strain that prolonged COVID-19 infections are placing on the workforce. Research published in August 2023 issue lancet community medicine 5.8% of participating long-term COVID-19 patients reported occupational changes, such as moving to part-time or remote work, including 1.6% who dropped out of the workforce completely. I found out that there is.

Midlife is also a time when patients don't have time to get the care they need. The chronic nature of long-term COVID-19 infections means treatment can be time-consuming and expensive, all while supporting spouses, children and, in some cases, elderly parents. It depletes the resources of patients who are In a study published last month, Disability and Health Journal Patients with long-term COVID-19 infection are significantly more likely than unaffected patients to have housing instability and financial worries, such as worries about rent or mortgage payments. It turned out to be expensive.

Economic burden due to long-term COVID-19 infection

The process of applying for long-term disability can also be complicated for people who are unable to work. This is especially true for people who are unable to perform even basic tasks such as filling out forms or processing disability claims due to illness. Those applying as a result of long-term coronavirus symptoms will be required to provide all records related to long-term coronavirus, as well as medical history, onset of symptoms, and current treatment.

Still, many patients complain that their claims have been denied, which can be financially dire for families already struggling to make ends meet. Still, experts say it's important to understand that as of July 2021, the spread of the coronavirus has been prolonged. considered a disability Under the Americans with Disabilities Act (ADA).

“While prolonged COVID-19 infection is recognized as a disability under section 504 of the ADA, there are daily violations of the ADA by failing to provide the accommodations necessary for work to those with prolonged COVID-19 infection. I can see it,” he said. David PutrinoPh.D., Nash Family Director of the Cohen Center for Recovery from Complex Chronic Illness at Mount Sinai in New York City and a renowned expert on the long-term coronavirus.

He added that short-term and long-term disability claims can be denied due to a lack of diagnostic tests to prove a patient has a disability. “This is nonsense and unreasonable because the CDC does not require blood tests to diagnose long-term COVID-19 infections. It's up to the doctor's discretion,” Putrino said.

Viswanathan agreed. She said it was especially difficult for many of her patients to suffer long-term disabilities. That's because there is no long-term COVID-19 blood test to prove a patient has the condition. “As a result, many patients, especially younger patients, may have to return to work in some capacity,” Viswanathan said.

Impact of prolonged coronavirus outbreak on quality of life

To make matters worse, many of these patients are mild cases of acute COVID-19 infection and have fewer underlying conditions, so this cohort is likely an underestimate, so the full impact is still unknown. is. Some people have long-term COVID-19 infections that go undiagnosed.

“Many of the impacts on productivity and quality of life for this group remain hidden,” he said. Dr. Ziyad Al Alia world expert on the long-lasting novel coronavirus and director of research and development at the Department of Veterans Affairs St. Louis Health System in St. Louis.

Unfortunately, Boreczek's influence on life is not so hidden. He is unable to work, which is causing financial stress for his family. He spends most of the day in bed in order to help his wife with some things when she gets home from work. He could no longer ride a bicycle and as a result lost many of his friends associated with his favorite hobby.

But he remains hopeful and, above all, grateful to his family. His wife and children gave him the strength to keep going, even on difficult days. “I don’t know what I would do without them,” Boreczek said.