The latest issue of Risk & Insurance has a great article on longtail COVID-19 workers’ compensation claims.  They have noted that the most common signs that they are seeing that linger over time are fatigue, shortness of breath, cough, joint pain, chest pain and brain fog as well as muscle pain, headache, heart palpitations, loss of smell and taste long term, concentration and sleep issues, and even hair loss. And, on top of all of that, depression.

These problems are even worse for those who were hospitalized or intubated.  These unlucky people were in intensive care.  The NIH did a study of Post-intensive Care Syndrome (PICS) before the pandemic.  (Post-intensive Care Syndrome: an Overview, J Transl Int Med. 2017 Jun; 5(2): 90–92. Published online 2017 Jun 30. doi: 10.1515/jtim-2016-0016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506407/).  This study gained added relevancy after March 2020.  This study described the symptoms of PICS as new or worsening impairment in physical (ICU-acquired neuromuscular weakness), cognitive (thinking and judgment), or mental health status arising after critical illness and persisting beyond discharge from the acute care setting.  This sounds a whole lot like what the CDC is describing post COVID-19. 

These symptoms can linger for years as we have seen with other respiratory diseases like SARS.  A  2010 study of Hong Kong survivors of SARS showed that 52% had decreased exercise capacity with 6-minute walk and 40% had Chronic Fatigue Syndrome.  COVID-19, like SARS, could lead to an Acute Respiratory Distress Syndrome which could lead to Neuropsychological disability including Neurocognitive impairment, PTSD, Depression. 

All of these symptoms will cause substantial delays in return to work for some employees.  As the Risk & Insurance article notes, we are already seeing this.  There are studies regarding COVID-19 recovery (Rehabilitation After Critical Illness in People With COVID-19 Infection Am J Phys Med Rehabil. 2020 Jun; 99(6): 470–474. Published online 2020 Apr 10. doi: 10.1097/PHM.0000000000001443 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253039/; Potential Effects of Coronaviruses on the Cardiovascular System, JAMA Cardiol. Published online March 27, 2020. doi:10.1001/jamacardio.2020.1286, https://jamanetwork.com/journals/jamacardiology/fullarticle/2763846)  Of course, we have to recognize that these were done in the early stages of the current pandemic and we will need to continually reassess.

Bottom line, we can expect some workers with industrial COVID-19 claims to have long-term effects and have difficulty returning to even modified duties.