SARAH MCCAMMON, HOST:
More than 5 million Americans have been sickened by the coronavirus. Most have had mild to moderate symptoms and recover in two to four weeks, but some suffer moderate to severe symptoms for months after their initial infection. NPR's Patti Neighmond and has more.
PATTI NEIGHMOND, BYLINE: Hannah Davis is a music composer and data researcher in New York. When she became sick with COVID-19 in late March, she figured she'd get over it pretty quickly. She had a fever and knew she had to isolate.
HANNAH DAVIS: I've had basically a nonstop fever. And so I was alone for the first two months.
NEIGHMOND: Two months, not two weeks like she thought. She's 32. And now, more than four months after she got sick, life is far from normal. She has fever nearly every day, suffers abdominal problems, headaches, muscle aches and a feeling that her body has forgotten how to breathe.
DAVIS: It really just changes you. It's a really long time to be kind of so actively sick. It changes your relationship to other people. It changes your relationship to yourself and to the world. And it's just no joke.
NEIGHMOND: But the problems that worry her most are neurological. At times she's forgotten her partner's name. Recently she forgot she was cooking and started a fire. And the way she now interacts with the world, she says, is greatly diminished.
DAVIS: So it's changed even my future in that, you know, I'm going to have to spend even more months recovering from this in a more active way.
NEIGHMOND: A recent telephone survey by the CDC finds three weeks after being sickened by coronavirus, one-third of adults say they still haven't returned to their usual state of health. Even so, infectious disease specialist Dr. Preeti Malani, chief health officer at the University of Michigan, says most people have mild to moderate symptoms during illness and recover in a few weeks.
PREETI MALANI: But there are these individuals that don't feel well for months, and exactly why remains a mystery. And what portion it is, whether it's a very small number or it's a substantial number, is also not known.
NEIGHMOND: And reports more doctors are hearing about sound a lot like symptoms still suffered by Hannah Davis.
MALANI: Difficulties breathing for an extended period of time. They have fatigue. They lose weight. They become debilitated.
NEIGHMOND: In general, she says, the problems echo the severity of the disease. Sicker patients with more complications have a more difficult recovery. But the real conundrum comes from patients like Davis who are young and healthy.
MALANI: And understanding what makes them different. Is it just bad luck? Or is there something about their genetic predisposition or something about the virus and how it interacts with that person?
NEIGHMOND: There are suggestions that blood type, gender or race may be involved. But to get answers, Malani says large studies should track people after infection to figure out why some people may be susceptible. Neuropsychologist Jim Jackson at Vanderbilt University Medical Center says critically ill patients in the ICU often have long-term symptoms, including PTSD, anxiety, physical disability and cognitive impairment.
JIM JACKSON: In COVID survivors, who themselves are often in the ICU, we are seeing the same sort of thing. We're seeing really striking functional problems, quite severe cognitive problems, very debilitating mental health issues.
NEIGHMOND: Which are unique to coronavirus patients.
JACKSON: They are suffering alone. They're without the support of family. Often they're without the support of friends. When they return home, unfortunately they won't be able to be greeted with typical rituals. People won't be bringing casseroles over.
NEIGHMOND: And patients endure continued isolation, which only adds to anxiety. Jackson says patients are better prepared when medical providers explain what to expect after the ICU, things like cognitive problems, nightmares, anxiety and depression.
JACKSON: And when they know that, and these land on their doorstep like a 300-pound gorilla, they know what to do. Education is really a key.
NEIGHMOND: Dr. Hallie Prescott, a lung and critical care specialist at the University of Michigan, says whether hospitalized for COVID-19 or isolated at home, most patients will have to fight for recovery.
HALLIE PRESCOTT: People are going to feel fatigued. They're going to feel exhausted. They may feel like they need an extra one or even two hours of sleep at night. So, like, you're going to feel a difference. And it can feel like it's taking a really long time to recover.
NEIGHMOND: Even if they're exhausted, patients shouldn't give up on activities and exercise, she says. Go slowly, build stamina and strength, which will pay off for most patients in four to six weeks. Patti Neighmond, NPR News.
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