Reported COVID-19 cases, hospitalizations, and deaths have continued to rise at alarming rates in the Midwest and other regions across the nation. The Midwest has seen a surge, particularly in rural areas. Last month, Missouri, for instance, had an outbreak of positive cases in the southwest, according to the Missouri Department of Health and Senior Services (DHSS).

Nationally, the Centers for Disease Control and Prevention (CDC) notes that more than 5 million cases have been reported, as we near 200,000 deaths.

Long-Term Effects of COVID-19

While most regional and national cases do not require hospitalization or end in death, doctors and researchers now have concerns about the long-term health effects of the new coronavirus on patients and survivors. A growing body of evidence shows that the respiratory virus affects not only lungs, but also other internal organs, including the brain, the heart, and the kidneys.

The Lungs

COVID-19 is known for its effect on the lungs. Many patients develop pneumonia and require hospitalization for respiratory support.

Patients with severe pneumonia may also develop acute respiratory distress syndrome (ARDS). Indeed, a study, published in Respiratory Medicine, found that 36 of 138 hospitalized patients in Wuhan, China required intensive care — and 22 developed acute respiratory distress syndrome (ARDS).

Scarred pulmonary tissue, reduced lung capacity, and lung failure are potential health effects for people with COVID-19 pneumonia and ARDS.

The Brain

Research by the University College London links this infection to neurological and neuropsychiatric illnesses — even for people with mild symptoms. Researchers analyzed medical data of 43 hospital patients, aged 16-45, in the United Kingdom and found: 10 patients had “temporary brain dysfunction” with delirium, 12 had brain inflammation, eight had strokes, and eight had nerve damage.

Their results, published in Brain, does not detect a direct attack on the brain. However, the complications can be critical in severity.

The Heart

Research shows that some individuals infected with COVID-19 develop heart problems. Researchers in China, for example, examined the data of 41 admitted patients, aged 18-65, at a designated hospital in Wuhan. Their findings, published in The Lancet, found that 12 percent had abnormal heart ultrasounds — and acute cardiac injury.

This virus also affects blood vessels as noted by the results of a recent study. For this study, published in JAMA, researchers analyzed the data of 3,334 hospitalized patients, aged 18 and older, at a large health system in New York City. They found that 16 percent had at least one blood clot. Blood clot characterizations included: venous or deep vein thrombosis (DVT), pulmonary embolism (PE), acute myocardial infarction (MI) or heart attack, ischemic stroke, and other systemic thromboembolism.

Blood clots have been resulting in heart attacks and strokes for a number of COVID-19 patients, including those without typical risk factors.

The Kidneys

Patients also risk the development of acute kidney injury (AKI) as a result of COVID-19, according to research published in Kidney International. Researchers examined the autopsies of 26 deceased patients in Wuhan, China and found that nine of the 26 had acute kidney injury (AKI).

COVID-19 patients with pre-existing chronic kidney disease (CKD) are more vulnerable to kidney damage than those without it, as noted by another study, published in Annuals of Medicine. However, some patients without CKD also developed kidney problems during their hospital stays.

Kidney injury is becoming more common — and the virus’ effect on these vital organs has been serious, the National Kidney Foundation explains: Many patients now need dialysis because of AKI, while others have lost kidney functions. Non-functioning kidneys prove fatal over the long-term.

At Risk Groups

Older adults, particularly those with underlying medical conditions, are most at risk for these long-term health outcomes. Deceased COVID-19 patients in one Italian study, for instance, were primarily elderly, with an average age of 81. About 67.2% had three or more pre-existing health conditions, most commonly hypertension, heart disease, and diabetes.

Non-elderly adults, aged 18-64, including those with underlying medical conditions, however, are not excluded from risk. CDC data shows that a significant number is contracting COVID-19 and requiring hospitalization, including ICU intensive care. This is true for those with pre-existing medical conditions — and those without.

People of color and low-income households are also risk groups due to health disparities and social determinants of health. Kaiser Family Foundation data shows that American Indian/Alaska Native (34 percent) and Black adults (27 percent) are more likely than White adults (21 percent) to have more severe illnesses with COVID-19. It also shows that about 35 percent of households with income less than $15,000 are at higher risk for more severe illnesses than nearly 16 percent of households with income more than $50,000.

Flu Season during the Pandemic

A second wave of COVID-19 outbreaks is expected in the fall and will coincide with influenza, or flu, season.

Both viruses have symptom similarities but different causes as noted by the CDC: The flu is caused by Type A and Type B influenza viruses. COVID-19, in contrast, is caused by the SARS-CoV-2 virus.

The CDC believes individuals can possibly be sick with the flu and COVID-19 simultaneously, so preparation is important.

In his editorial, published by Science Advances, Dr. Benjamin Singer, pulmonologist and critical care specialist at Northwestern Medicine, provides a couple ways to do so on an individual level: vaccinate against the flu, particularly older adults who are vulnerable to both diseases, and practice social distancing.

How COVID-19 Spreads

COVID-19 primarily spreads from person to person with ease, according to the Centers for Disease Control and Prevention (CDC). Infected individuals fall into one of three groups: symptomatic (have the infection and shows symptoms), asymptomatic (have the infection but show no symptoms at all), or pre-symptomatic (have the infection but symptoms do not develop until up to 14 days later).

Whether a symptomatic, asymptomatic, or pre-symptomatic carrier, what typically happens during transmission is: An infected person (with or without symptoms) coughs, sneezes, or talks — and releases respiratory droplets that mixes with the air. A non-infected person, within 6 feet of the infected person, breathes this air into their lungs through their nose or mouth — and also contracts the virus.

Many scientists believe transmission can also be airborne in poorly ventilated areas through inhalation. In other words, a non-infected person may enter an environment where an infected person has talked, coughed, or sneezed hours earlier, and within minutes, become infected by the lingering aerosol droplets.

There is also the possibility of surface transmission. Research shows the virus can remain infectious on surfaces for hours before disintegration. If a non-infected person first touches a contaminated surface within this time period — then touches their eyes, nose, or mouth, they can become sick.

Slow the Spread

COVID-19 is a serious disease with potential long-lasting health effects for people of different demographics, but particularly for society’s most vulnerable: older adults, people of color, and low-income households.

Let us treat it accordingly.

As researchers and medical professionals continue to learn more about COVID-19 through data gathering, studies, and research to provide better care, we should engage in the CDC’s precautionary measures to promote safety.

Educate yourself. Wear face masks and coverings properly. Stay at least six feet apart from others in public. Wash your hands regularly. Self-isolate when sick.

Protect yourself and others.