Long Covid is responsible for thousands of US deaths, report says, but true numbers are likely much higher

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Long Covid is responsible for thousands of US deaths, report says, but true numbers are likely much higher



CNN

Long Covid leaves some people with long-term symptoms, but it can also be deadly. It was implicated in at least 3,544 deaths in the United States in the first 30 months of the Covid-19 pandemic, according to a new report.

The report is the first official attempt by the US Centers for Disease Control and Prevention’s National Center for Health Statistics to quantify the number of long-term Covid deaths in the United States.

Some experts say that finding is likely a gross undercount, considering that up to 30% of people who contract Covid-19 have long-term symptoms, according to the CDC.

The study, released Wednesday, analyzed death certificates in the National Vital Statistics System from January 2020 through the end of June 2022.

The research was difficult because, unlike diseases like cancer or diabetes, there was no specific one in the US Disease code to track long covid during this period.

Not every doctor, coroner, or coroner fills out a death certificate the same way, so the researchers had to develop a program to scan more than a million death certificates for text. As there is no fixed term to describe long covid, they included several key terms in their search, including “chronic covid”, “long covid” and “post-COVID syndrome”.

They found that long Covid deaths accounted for less than 0.3% of the 1,021,487 Covid-related deaths from January 2020 to June 2022. There were also some common elements among the deceased.

The majority of people who died from long Covid were white, elderly and male.

Specifically, 78.5% of the deaths were among non-Hispanic whites. Non-Hispanic blacks accounted for 10.1% of the deaths, followed by Hispanics at 7.8%.

The death rate was highest among non-Hispanic American Indians and Alaska Natives at 14.8 per 100,000 people.

Deaths from Covid-19 have occurred disproportionately among people of color, CDC research shows, and the new report finds more people who identify as black or Hispanic may have died from the original disease before even having a long one Covid could develop. This could explain some of the racial differences in the new findings.

Studies have also found that due to more barriers to healthcare for people of color, some deceased may not have been able to see a doctor to receive an official Covid diagnosis, so it would not be recognized on a death certificate, the report said.

Adults between 75 and 84 accounted for 28.8% long Covid deaths, followed by people aged 85 and over at 28.1% and people aged 65-74 at 21.5%, the report said. In general, older adults are much more likely to die from Covid than younger populations, CDC data shows.

Men accounted for a slightly larger proportion of deaths at 51.5%, in line with other studies which found male gender to be associated with a relative risk of developing severe Covid, 1.29 times of the relative risk for women.

The new report had several caveats, including that the death toll is still preliminary and could change. Additionally, race is not always a reliable element on a death certificate, as studies have shown that thousands of Americans misclassify their race on their certificates. And clinical guidance on what constitutes Long Covid has changed over the course of the pandemic, so death certificates may not fully capture the condition.

The study is a good start, but it takes a “fairly myopic view” of long-Covid death, said Dr. David Putrino, Director of Rehabilitation Innovation at Mount Sinai Health System.

“This is very clearly data from people who became very ill and ended up in the hospital with ongoing organ damage,” said Putrino, who works closely with long-term Covid patients but was not involved with the new report.

He says research is missing a significant number of people who could long contract Covid and die as a result.

For example, studies show that some people who are not hospitalized for an initial infection but have had Covid for a long time develop heart problems. Long Covid would not necessarily be recorded on those death certificates, Putrino said.

“We read every day of people who were previously healthy, get Covid, recover, and then have a heart attack or stroke or pulmonary embolism,” Putrino said.

This research may also miss people with long covid who have died by suicide; the condition would likely not be listed on their death certificates.

“We currently know that suicidal thoughts, suicidal acts, suicidal thoughts and completed suicides occur across the country in people who were previously healthy, had less severe acute Covid infection, but then developed very severe post-acute sequelae,” Putrin said.

He is encouraged that the CDC is addressing the issue of death from long Covid.

“But again, we will continue to get these types of skewed records if we don’t educate doctors that there are many ways Covid can cause death just as there are many ways Covid can cause permanent disability can,” said Putrino.

“People’s lives have been completely ruined by Covid and so this incomplete data point really only captures a small part of the long Covid experience,” he said. “There is more than one way to have your life taken with long Covid. Death is just one of those ways.”

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