More than one million people around the world have been deemed recovered from the coronavirus, but beating the initial sickness may be just the first of many battles for those who have survived.
Some recovered patients report breathlessness, fatigue and body pain months after first becoming infected.
Small-scale studies conducted in Hong Kong and China's Wuhan show that survivors grapple with poorer functioning in their lungs, heart and liver. And that may be the tip of the iceberg.
The coronavirus is now known to attack many parts of the body beyond the respiratory system, causing damage from the eyeballs to the toes, the gut to the kidneys.
Patients’ immune systems can go into overdrive to fight off the infection, compounding the damage done.
While researchers are only starting to track the long-term health of survivors, past epidemics caused by similar viruses show that the aftermath can last more than a decade.
According to one study, survivors of severe acute respiratory syndrome, or Sars, suffered lung infections, higher cholesterol levels and were falling sick more frequently than others for as long as 12 years after the epidemic coursed through Asia, killing almost 800 people.
What these chronic issues ultimately look like – and how many patients ultimately experience them – will have huge implications for patients, the doctors who treat them, and the health systems around them
Sars infected 8,000 people. With more than 4 million - and more every day - infected by the coronavirus, the long-term damage to health could strain social safety nets and health-care infrastructures for years to come as well as have implications for economies and companies.
The prospect led Nicholas Hart, the British physician who treated Prime Minister Boris Johnson, to call the virus “this generation’s polio” - a disease that could leave many marked by its scars and reshape global health care.
“What these chronic issues ultimately look like – and how many patients ultimately experience them – will have huge implications for patients, the doctors who treat them, and the health systems around them,” said Kimberly Powers, an epidemiologist at the University of North Carolina at Chapel Hill, who is developing models on the virus’s spread to inform public-health efforts.
Hong Kong’s hospital authority has been monitoring a group of Covid-19 patients for up to two months since they were released.
They found about half of the 20 survivors had lung function below the normal range, said Owen Tsang, the medical director of the infectious disease centre at Princess Margaret Hospital.
The diffusing capacity of their lungs - how well oxygen and carbon dioxide transfers between the lungs and blood - remained below healthy levels, Dr Tsang observed.
A study of blood samples from 25 recovered patients in Wuhan, the city where the virus first emerged, found that they had not fully recovered normal functioning regardless of the severity of their coronavirus symptoms, according to a paper published on April 7.
In another study, CT scans taken over a month of 90 Wuhan coronavirus patients found that of the 70 discharged from the hospital, 66 had mild to substantial residual lung abnormalities on their last CT scans, which showed ground-glass opacity, said a March paper published online in Radiology.
Chronic cardiac complications could arise in patients even after recovery as a result of persistent inflammation, according to an April 3 paper by doctors at the Cedars-Sinai Medical Centre in Los Angeles. They based their analysis on patient data from Italy and China.
For clues on how Covid-19 may leave its mark, doctors and researchers are looking to the experience of Sars.
Some survivors suffered long-term effects years after they first succumbed to the disease, which is part of the same family as the new coronavirus.
Researchers in China analysed 25 Sars patients 12 years after they contracted the virus, contrasting their results with a control group who were not infected with Sars.
The study found that more than half of the recovered patients suffered another lung infection since their bout with Sars and also had higher cholesterol levels.
Additionally, half the patients had at least five colds in the previous year – a characteristic no one in the control group shared, said the 2017 paper published online in Scientific Reports.
“These data demonstrated that the recovered Sars patients had a poor quality of life 12 years following recovery, and were susceptible to inflammation, tumors, and glucose and lipid metabolic disorders,” researchers wrote.
Doctors such as Dr Tsang at Hong Kong’s Princess Margaret Hospital said looking at former Sars patients is potentially instructive.
Among survivors of the Sars outbreak of 2003, chronic fatigue and impaired lung function have been found in follow-up studies after two to four years.
“This is so new that I don’t think anyone is able to tell what is the percentage of patients who will recover, what is the percentage of patients who will not recover and have long-term sequela,” said Michelle Biehl, a critical care pulmonary doctor at the Cleveland Clinic in Ohio, using the medical term for chronic conditions after a disease.
Tracking and figuring out how Covid-19 affects the body even after recovery could inform governments budgeting for social safety nets, doctors that see patients long term, and businesses as they set policies such as sick and disability leave.
These issues could be even more crucial as public health officials say there’s a possibility the virus may become a seasonal affliction.
Economies and companies looking to get people back to work will need to understand how and if Covid-19 affects human health in the long run and its scope.
“There is such a wide range in the way the illness affects people. The various stakeholders need solid data to help them understand the breadth and duration of long term effects,” said Jessica Justman, a professor of medicine in epidemiology at Columbia University.
There is some hope: Early intervention could play a role in longer-term outcomes of coronavirus patients, said Ivan Hung, a professor of medicine at the University of Hong Kong.
Prof Hung said in April that 90 per cent of about 200 discharged patients he oversaw at a clinic at one of the city’s hospitals appear to be making a full recovery a month out.
He attributed the success to Hong Kong’s “early diagnosis and early treatment” of patients, which leaves the virus with less time to wreak havoc on the body.
This may not be possible in many countries like the US and UK where testing is uneven and inadequate, and only those with serious symptoms are getting treatment.
Still, larger-scale studies in virus hot spots are needed to separate the physical legacy of the virus from how patients feel immediately after fighting off the infection.
It will be crucial for scientists to track and quantify how Covid-19 affects such factors as oxygenation and breathing rate, said Roberto Bruzzone, a visiting professor at the University of Hong Kong, whose research focuses on cell biology.
Hospitals and researchers will have begun patient registries to start gathering data to study survivors over time as well.
“We need an epidemiological study that may be feasible in places like Wuhan, New York City, Milan or Paris - where there has been a huge group of infections with a wide variety of symptoms,” Prof Bruzzone said.
Winners
Ballon d’Or (Men’s)
Ousmane Dembélé (Paris Saint-Germain / France)
Ballon d’Or Féminin (Women’s)
Aitana Bonmatí (Barcelona / Spain)
Kopa Trophy (Best player under 21 – Men’s)
Lamine Yamal (Barcelona / Spain)
Best Young Women’s Player
Vicky López (Barcelona / Spain)
Yashin Trophy (Best Goalkeeper – Men’s)
Gianluigi Donnarumma (Paris Saint-Germain and Manchester City / Italy)
Best Women’s Goalkeeper
Hannah Hampton (England / Aston Villa and Chelsea)
Men’s Coach of the Year
Luis Enrique (Paris Saint-Germain)
Women’s Coach of the Year
Sarina Wiegman (England)
RESULTS
2pm: Handicap (PA) Dh 40,000 (Dirt) 1,200m
Winner: AF Senad, Nathan Crosse (jockey), Kareem Ramadan (trainer)
2.30pm: Maiden (PA) Dh 40,000 (D) 1,000m
Winner: Ashjaan, Fabrice Veron, Eric Lemartinel.
3pm: Maiden (PA) Dh 40,000 (D) 1,700m
Winner: Amirah, Conner Beasley, Ali Rashid Al Raihe.
3.30pm: Handicap (PA) Dh 40,000 (D) 1,700m
Winner: Jap Al Yaasoob, Szczepan Mazur, Irfan Ellahi.
4pm: Sheikh Mansour bin Zayed Al Nahyan Cup Prestige Handicap (PA) Dh 100,000 (D) 1,200m
Winner: Jawaal, Fernando Jara, Majed Al Jahouri.
4.30pm: Handicap (TB) Dh 40,000 (D) 1,200m
Winner: Manhunter, Ryan Curatolo, Mujeeb Rahman.
World Sevens Series standing after Dubai
1. South Africa
2. New Zealand
3. England
4. Fiji
5. Australia
6. Samoa
7. Kenya
8. Scotland
9. France
10. Spain
11. Argentina
12. Canada
13. Wales
14. Uganda
15. United States
16. Russia
Company%20profile
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UK’s AI plan
- AI ambassadors such as MIT economist Simon Johnson, Monzo cofounder Tom Blomfield and Google DeepMind’s Raia Hadsell
- £10bn AI growth zone in South Wales to create 5,000 jobs
- £100m of government support for startups building AI hardware products
- £250m to train new AI models
Mountain%20Boy
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Results
Ashraf Ghani 50.64 per cent
Abdullah Abdullah 39.52 per cent
Gulbuddin Hekmatyar 3.85 per cent
Rahmatullah Nabil 1.8 per cent
Company profile
Name: Thndr
Started: October 2020
Founders: Ahmad Hammouda and Seif Amr
Based: Cairo, Egypt
Sector: FinTech
Initial investment: pre-seed of $800,000
Funding stage: series A; $20 million
Investors: Tiger Global, Beco Capital, Prosus Ventures, Y Combinator, Global Ventures, Abdul Latif Jameel, Endure Capital, 4DX Ventures, Plus VC, Rabacap and MSA Capital
If you go...
Fly from Dubai or Abu Dhabi to Chiang Mai in Thailand, via Bangkok, before taking a five-hour bus ride across the Laos border to Huay Xai. The land border crossing at Huay Xai is a well-trodden route, meaning entry is swift, though travellers should be aware of visa requirements for both countries.
Flights from Dubai start at Dh4,000 return with Emirates, while Etihad flights from Abu Dhabi start at Dh2,000. Local buses can be booked in Chiang Mai from around Dh50
The biog
Name: Samar Frost
Born: Abu Dhabi
Hobbies: Singing, music and socialising with friends
Favourite singer: Adele
Fifa Club World Cup quarter-final
Kashima Antlers 3 (Nagaki 49’, Serginho 69’, Abe 84’)
Guadalajara 2 (Zaldivar 03’, Pulido 90')
more from Janine di Giovanni
What sanctions would be reimposed?
Under ‘snapback’, measures imposed on Iran by the UN Security Council in six resolutions would be restored, including:
- An arms embargo
- A ban on uranium enrichment and reprocessing
- A ban on launches and other activities with ballistic missiles capable of delivering nuclear weapons, as well as ballistic missile technology transfer and technical assistance
- A targeted global asset freeze and travel ban on Iranian individuals and entities
- Authorisation for countries to inspect Iran Air Cargo and Islamic Republic of Iran Shipping Lines cargoes for banned goods
Virtuzone GCC Sixes
Date and venue Friday and Saturday, ICC Academy, Dubai Sports City
Time Matches start at 9am
Groups
A Blighty Ducks, Darjeeling Colts, Darjeeling Social, Dubai Wombats; B Darjeeling Veterans, Kuwait Casuals, Loose Cannons, Savannah Lions; C Awali Taverners, Darjeeling, Dromedary, Darjeeling Good Eggs
ABU DHABI ORDER OF PLAY
Starting at 10am:
Daria Kasatkina v Qiang Wang
Veronika Kudermetova v Annet Kontaveit (10)
Maria Sakkari (9) v Anastasia Potapova
Anastasia Pavlyuchenkova v Ons Jabeur (15)
Donna Vekic (16) v Bernarda Pera
Ekaterina Alexandrova v Zarina Diyas
Tips for used car buyers
- Choose cars with GCC specifications
- Get a service history for cars less than five years old
- Don’t go cheap on the inspection
- Check for oil leaks
- Do a Google search on the standard problems for your car model
- Do your due diligence. Get a transfer of ownership done at an official RTA centre
- Check the vehicle’s condition. You don’t want to buy a car that’s a good deal but ends up costing you Dh10,000 in repairs every month
- Validate warranty and service contracts with the relevant agency and and make sure they are valid when ownership is transferred
- If you are planning to sell the car soon, buy one with a good resale value. The two most popular cars in the UAE are black or white in colour and other colours are harder to sell
Tarek Kabrit, chief executive of Seez, and Imad Hammad, chief executive and co-founder of CarSwitch.com
Desert Warrior
Starring: Anthony Mackie, Aiysha Hart, Ben Kingsley
Director: Rupert Wyatt
Rating: 3/5
If you go
The flights
Etihad (etihad.com) flies from Abu Dhabi to Luang Prabang via Bangkok, with a return flight from Chiang Rai via Bangkok for about Dh3,000, including taxes. Emirates and Thai Airways cover the same route, also via Bangkok in both directions, from about Dh2,700.
The cruise
The Gypsy by Mekong Kingdoms has two cruising options: a three-night, four-day trip upstream cruise or a two-night, three-day downstream journey, from US$5,940 (Dh21,814), including meals, selected drinks, excursions and transfers.
The hotels
Accommodation is available in Luang Prabang at the Avani, from $290 (Dh1,065) per night, and at Anantara Golden Triangle Elephant Camp and Resort from $1,080 (Dh3,967) per night, including meals, an activity and transfers.
UAE currency: the story behind the money in your pockets
What is a Ponzi scheme?
A fraudulent investment operation where the scammer provides fake reports and generates returns for old investors through money paid by new investors, rather than through ligitimate business activities.
The Vines - In Miracle Land
Two stars
THE BIO
Favourite place to go to in the UAE: The desert sand dunes, just after some rain
Who inspires you: Anybody with new and smart ideas, challenging questions, an open mind and a positive attitude
Where would you like to retire: Most probably in my home country, Hungary, but with frequent returns to the UAE
Favorite book: A book by Transilvanian author, Albert Wass, entitled ‘Sword and Reap’ (Kard es Kasza) - not really known internationally
Favourite subjects in school: Mathematics and science
Adele: The Stories Behind The Songs
Caroline Sullivan
Carlton Books
The specs
Engine: four-litre V6 and 3.5-litre V6 twin-turbo
Transmission: six-speed and 10-speed
Power: 271 and 409 horsepower
Torque: 385 and 650Nm
Price: from Dh229,900 to Dh355,000
About Takalam
Date started: early 2020
Founders: Khawla Hammad and Inas Abu Shashieh
Based: Abu Dhabi
Sector: HealthTech and wellness
Number of staff: 4
Funding to date: Bootstrapped
The design
The protective shell is covered in solar panels to make use of light and produce energy. This will drastically reduce energy loss.
More than 80 per cent of the energy consumed by the French pavilion will be produced by the sun.
The architecture will control light sources to provide a highly insulated and airtight building.
The forecourt is protected from the sun and the plants will refresh the inner spaces.
A micro water treatment plant will recycle used water to supply the irrigation for the plants and to flush the toilets. This will reduce the pavilion’s need for fresh water by 30 per cent.
Energy-saving equipment will be used for all lighting and projections.
Beyond its use for the expo, the pavilion will be easy to dismantle and reuse the material.
Some elements of the metal frame can be prefabricated in a factory.
From architects to sound technicians and construction companies, a group of experts from 10 companies have created the pavilion.
Work will begin in May; the first stone will be laid in Dubai in the second quarter of 2019.
Construction of the pavilion will take 17 months from May 2019 to September 2020.
Our legal consultant
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
The Saudi Cup race card
1 The Jockey Club Local Handicap (TB) 1,800m (Dirt) $500,000
2 The Riyadh Dirt Sprint (TB) 1,200m (D) $1.500,000
3 The 1351 Turf Sprint 1,351m (Turf) $1,000,000
4 The Saudi Derby (TB) 1600m (D) $800,000
5 The Neom Turf Cup (TB) 2,100m (T) $1,000,000
6 The Obaiya Arabian Classic (PB) 2,000m (D) $1,900,000
7 The Red Sea Turf Handicap (TB) 3,000m (T) $2,500,000
8 The Saudi Cup (TB) 1,800m (D) $20,000,000
COMPANY%20PROFILE
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Indoor cricket World Cup:
Insportz, Dubai, September 16-23
UAE fixtures:
Men
Saturday, September 16 – 1.45pm, v New Zealand
Sunday, September 17 – 10.30am, v Australia; 3.45pm, v South Africa
Monday, September 18 – 2pm, v England; 7.15pm, v India
Tuesday, September 19 – 12.15pm, v Singapore; 5.30pm, v Sri Lanka
Thursday, September 21 – 2pm v Malaysia
Friday, September 22 – 3.30pm, semi-final
Saturday, September 23 – 3pm, grand final
Women
Saturday, September 16 – 5.15pm, v Australia
Sunday, September 17 – 2pm, v South Africa; 7.15pm, v New Zealand
Monday, September 18 – 5.30pm, v England
Tuesday, September 19 – 10.30am, v New Zealand; 3.45pm, v South Africa
Thursday, September 21 – 12.15pm, v Australia
Friday, September 22 – 1.30pm, semi-final
Saturday, September 23 – 1pm, grand final
Killing of Qassem Suleimani
The specs
Price, base / as tested Dh1,100,000 (est)
Engine 5.2-litre V10
Gearbox seven-speed dual clutch
Power 630bhp @ 8,000rpm
Torque 600Nm @ 6,500rpm
Fuel economy, combined 15.7L / 100km (est)
Where to buy
Limited-edition art prints of The Sofa Series: Sultani can be acquired from Reem El Mutwalli at www.reemelmutwalli.com
8 traditional Jamaican dishes to try at Kingston 21
- Trench Town Rock: Jamaican-style curry goat served in a pastry basket with a carrot and potato garnish
- Rock Steady Jerk Chicken: chicken marinated for 24 hours and slow-cooked on the grill
- Mento Oxtail: flavoured oxtail stewed for five hours with herbs
- Ackee and salt fish: the national dish of Jamaica makes for a hearty breakfast
- Jamaican porridge: another breakfast favourite, can be made with peanut, cornmeal, banana and plantain
- Jamaican beef patty: a pastry with ground beef filling
- Hellshire Pon di Beach: Fresh fish with pickles
- Out of Many: traditional sweet potato pudding
Fixtures
Tuesday - 5.15pm: Team Lebanon v Alger Corsaires; 8.30pm: Abu Dhabi Storms v Pharaohs
Wednesday - 5.15pm: Pharaohs v Carthage Eagles; 8.30pm: Alger Corsaires v Abu Dhabi Storms
Thursday - 4.30pm: Team Lebanon v Pharaohs; 7.30pm: Abu Dhabi Storms v Carthage Eagles
Friday - 4.30pm: Pharaohs v Alger Corsaires; 7.30pm: Carthage Eagles v Team Lebanon
Saturday - 4.30pm: Carthage Eagles v Alger Corsaires; 7.30pm: Abu Dhabi Storms v Team Lebanon
Who has lived at The Bishops Avenue?
- George Sainsbury of the supermarket dynasty, sugar magnate William Park Lyle and actress Dame Gracie Fields were residents in the 1930s when the street was only known as ‘Millionaires’ Row’.
- Then came the international super rich, including the last king of Greece, Constantine II, the Sultan of Brunei and Indian steel magnate Lakshmi Mittal who was at one point ranked the third richest person in the world.
- Turkish tycoon Halis Torprak sold his mansion for £50m in 2008 after spending just two days there. The House of Saud sold 10 properties on the road in 2013 for almost £80m.
- Other residents have included Iraqi businessman Nemir Kirdar, singer Ariana Grande, holiday camp impresario Sir Billy Butlin, businessman Asil Nadir, Paul McCartney’s former wife Heather Mills.
Hunting park to luxury living
- Land was originally the Bishop of London's hunting park, hence the name
- The road was laid out in the mid 19th Century, meandering through woodland and farmland
- Its earliest houses at the turn of the 20th Century were substantial detached properties with extensive grounds
GOLF’S RAHMBO
- 5 wins in 22 months as pro
- Three wins in past 10 starts
- 45 pro starts worldwide: 5 wins, 17 top 5s
- Ranked 551th in world on debut, now No 4 (was No 2 earlier this year)
- 5th player in last 30 years to win 3 European Tour and 2 PGA Tour titles before age 24 (Woods, Garcia, McIlroy, Spieth)
Specs
Engine: Dual-motor all-wheel-drive electric
Range: Up to 610km
Power: 905hp
Torque: 985Nm
Price: From Dh439,000
Available: Now
Ferrari 12Cilindri specs
Engine: naturally aspirated 6.5-liter V12
Power: 819hp
Torque: 678Nm at 7,250rpm
Price: From Dh1,700,000
Available: Now
The specs
- Engine: 3.9-litre twin-turbo V8
- Power: 640hp
- Torque: 760nm
- On sale: 2026
- Price: Not announced yet
Skoda Superb Specs
Engine: 2-litre TSI petrol
Power: 190hp
Torque: 320Nm
Price: From Dh147,000
Available: Now
SPEC%20SHEET%3A%20APPLE%20IPHONE%2014
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The Sand Castle
Director: Matty Brown
Stars: Nadine Labaki, Ziad Bakri, Zain Al Rafeea, Riman Al Rafeea
Rating: 2.5/5
Various Artists
Habibi Funk: An Eclectic Selection Of Music From The Arab World (Habibi Funk)
2021 World Triathlon Championship Series
May 15: Yokohama, Japan
June 5: Leeds, UK
June 24: Montreal, Canada
July 10: Hamburg, Germany
Aug 17-22: Edmonton, Canada (World Triathlon Championship Final)
Nov 5-6 : Abu Dhabi, UAE
Date TBC: Chengdu, China
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