Dr. Ziyad Al-Aly has examined dozens of patients hospitalized with COVID-19 in St. Louis, but he still finds it jarring to see how the virus ravages their bodies.
Some have severe damage to their kidneys or liver, while in others, the muscles of the heart are dangerously inflamed.
“It stops you in your tracks, like, ‘What are we dealing with here?’” said Al-Aly, director of the Clinical Epidemiology Center at the Veterans Affairs Health Care System in St. Louis. “Why is this patient having a stroke? Why do they have blood clots all over their lungs?”
Despite reports of serious, long-term health effects associated with COVID-19, some politicians have downplayed the disease, comparing it to the seasonal flu.
COVID-19 is a far deadlier illness than the flu, according to a new analysis from the VA St. Louis Health Care System and Washington University. The study, which analyzed thousands of VA medical records from patients nationwide, found those hospitalized for COVID-19 were four times more likely to need a ventilator and five times more likely to die, compared to patients with the flu.
The analysis also finds COVID-19 carries a much higher risk of certain complications than the flu, including kidney injuries, stroke, septic shock, blood clots and new-onset diabetes.
About 1 in 4 patients hospitalized for COVID-19 without a history of diabetes had to be treated with emergency insulin — about twice the rate seen in flu patients.
“Their blood sugar will shoot up and require huge doses of insulin to bring it down,” said Al-Aly, co-author of the study. “Normally, your blood sugar will be 120 or 110, but in these patients, it was 300 or 400 — just through the roof. And these are people who did not have diabetes before they got COVID.”
The study compared the medical records of 12,676 patients hospitalized with the flu between 2017 and 2019 with those of 3,641 patients hospitalized for COVID-19 from February to June 2020.
Certain groups were at highest risk from complications due to COVID-19, including Black patients with certain pre-existing conditions and those over the age of 75.
But even when accounting for key demographic differences, like race, age and gender, COVID-19 patients consistently had worse health outcomes than flu patients, said Yan Xie, study author and epidemiologist with the VA St. Louis Health Care System.
“COVID-19 is a much, much more devastating disease compared to the seasonal flu,” said Xie, who helped lead the study. “It attacks not only the respiratory systems, it attacks nearly all the major organs in our body — the kidneys, the heart, the pancreas, the liver.”
The vast majority of coronavirus infections, or about 80%, are “mild or asymptomatic,” according to the World Health Organization, and most patients recover within weeks.
But some people, known as long haulers, suffer from COVID-19 symptoms for months, including debilitating physical weakness and confusion. The medical community is only beginning to understand the consequences of these long-term effects, Al-Aly said, but they will likely be a “serious health burden” in the future.
“Even for those people who are lucky enough to survive COVID and make it out of the hospital, they will be forever scarred by the consequences,” he said. “There are serious ramifications, and we all have to be prepared to deal with them.”
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