What COVID-19 Does To The Body (Fourth Edition, April 2024)

Over 130+ Studies On COVID-19 Effects & Prevention

What SARS-CoV-2 Does to the Body (3rd Edition, December 2023)

Since our last edition in December, the CDC has now empowered employers to force workers sick & contagious with COVID-19 to work through an active viral infection, spreading pestilence to others. Along with an uptick in LongCOVID as a result of this past year’s pandemic mismanagement, we also have a growing body of research showing the many harms that even “mild” (not hospitalized) COVID-19 infections can leave on the human body. This round, the largest number of developments have come from understanding COVID-19’s effects on children, the brain, the immune system, and Long COVID - a disability afflicting millions of Americans, including kids.

If you appreciate our work in compiling this critical research, please consider a paid subscription to the Pandemic Accountability Index, or making a onetime donation via Paypal. Your contributions are what make this work viable and growing the public’s understanding of how the SARS-CoV-2 pandemic is harming our bodies is a central function of the Pandemic Accountability Index.

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Children & COVID-19

• The double invisibility of Long Covid in children (Social Science & Medicine)

• Neuroimaging findings in children with COVID-19 infection: a systematic review and meta-analysis (Nature Scientific Reports)

• The long-term neurodevelopmental outcomes of toddlers with SARS-CoV-2 infection in the neonatal period (Italian Journal of Pediatrics)

• Postacute Sequelae of SARS-CoV-2 in Children (American Academy of Pediatrics)

• Understanding Experiences of Youth with Long COVID: A Qualitative Approach (Children, MDPI)

• SARS-CoV-2 and Dengue Coinfection in Filipino Children: Epidemiology Profile, Clinical Presentation and Outcomes (Pediatric Infectious Disease Journal)

• “…pediatricians were more likely to test positive for SARS-CoV-2 than other physicians.” (Croatian Medical Journal)

• Millions of US Children Experience Range of Long COVID Effects (JAMA)

• Autonomic cardiac function in children and adolescents with long COVID: a case-controlled study (European Journal of Pediatrics)

• Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0–5 years in the USA in 2022: a multicentre retrospective cohort study (Family Medicine & Community Health)

• Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 (Journal of Clinical Medicine)

• Assessment of COVID-19 as the Underlying Cause of Death Among Children and Young People Aged 0 to 19 Years in the US (JAMA Network Open)

• Exploring nasopharyngeal microbiota profile in children affected by SARS-CoV-2 infection (Microbiology Spectrum)

• “…nervous system damage in children with SARS-CoV-2 infection is more significant.” (Frontiers in Pediatrics)

• Long COVID in pediatrics—epidemiology, diagnosis, and management (European Journal of Pediatrics)

Cognitive & Neurological Impairment

A brain-scan showing hypometabolism in blue in a LongCOVID patient. From “Brain 18F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics”

• Long-term neurologic outcomes of COVID-19 (Nature Medicine)

• “…people who survived the acute phase of COVID-19 were at increased risk of subsequent incident psychiatric disorders and psychotropic prescriptions.” (Nature Human Behavior)

• COVID-19 Leaves Its Mark on the Brain (Scientific American)

• Multiple Neuroinvasive Pathways in COVID-19 (Molecular Neurobiology)

• Crosstalk between COVID-19 and the gut-brain axis: a gut feeling (Postgraduate Medical Journal)

• Cognition and Memory after Covid-19 in a Large Community Sample (New England Journal of Medicine)

• Cognitive dysfunction after covid-19 (British Medical Journal, Practice Pointer)

• Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment (Nature Neuroscience)

• Blood Markers Show Neural Consequences of LongCOVID-19 (Cells, MDPI)

• Accelerated brain age in young to early middle-aged adults after mild to moderate COVID-19 infection (medRxiv)

• SARS-CoV-2 causes brain inflammation and induces Lewy body formation in macaques (bioRxiv)

• Long Covid and Impaired Cognition — More Evidence and More Work to Do (New England Journal of Medicine)

• Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment (Nature Neuroscience)

• Temporal Association between COVID-19 Infection and Subsequent New-Onset Dementia in Older Adults: A Systematic Review and Meta-Analysis (SSRN)

• Neuronal progenitors of the dentate gyrus express the SARS-CoV-2 cell receptor during migration in the developing human hippocampus (Cellular and Molecular Life Sciences)

• Brain exposure to SARS-CoV-2 virions perturbs synaptic homeostasis (Nature Microbiology)

• “…evidence of pervasive global cognitive impairment, associated with persistently raised brain injury markers, depression symptomatology, and reduced anterior cingulate cortex volume.” (Research Square)

• SARS-CoV-2 infection causes dopaminergic neuron senescence (Cell Stem Cell)

• A Murine Model of Post-acute Neurological Sequelae Following SARS-CoV-2 Variant Infection (bioRxiv)

• Rapid Progression of Dementia Following COVID-19 (NIH)

• Microstructural brain abnormalities, fatigue, and cognitive dysfunction after mild COVID-19 (Nature Scientific Reports)

• “…in the relatively young cohort in the present study, a substantial proportion exhibited cognitive dysfunction several months after recovering” (JAMA Network Open)

• Selective visuoconstructional impairment following mild COVID-19 with inflammatory and neuroimaging correlation findings (Molecular Psychiatry)

Eyes & Ears

• SARS-CoV-2 detection in the middle ear effusion of patients with Otitis media with effusion after omicron infection (American Journal of Otolaryngology)

• COVID-19-related retinal microvasculopathy and systemic implications in patients with severe disease (Frontiers in Medicine)

• Evaluation of the retina, choroid and optic disc vascular structures in individuals with a history of COVID-19 (Journal Français d'Ophtalmologie)

Heart, Lungs, & Cardiovascular Health

From “Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden”

• “…the risk of incident cardiovascular disease extends well beyond the acute phase of COVID-19.” (Nature Medicine)

• “From reports of ‘sticky blood’ raising the risk of deep vein thrombosis, heart attack or stroke, to neurological effects, many complications seemed to be affecting the blood vessels.” (British Heart Foundation)

• COVID-19 and the Blood (NIH National Heart, Lung, and Blood Institute)

• COVID's Long Haul: Virus Lingers in Blood Years After Infection (Neuroscience News)

• “…patients with COVID-19 have been shown to be at increased risk of cardiovascular complications, including myocardial infarction and stroke.” (Nature Cardiovascular Research)

• Tissue Factor and COVID-19 Associated Thrombosis (Arteriosclerosis, Thrombosis, and Vascular Biology)

• Lung abnormalities on computed tomography of Vietnamese patients with COVID-19 and the association with medical variables (IJID Regions)

• “…mild COVID-19 infection affects lung function at the time of infection with limited recovery 2 years after infection.” (Journal of Infectious Diseases)

• Cardiovascular effects of the post-COVID-19 condition (Nature Cardiovascular Research)

• ”…hyperinflammatory response orchestrated by SARS-CoV-2-infected plaque macrophages and foam cells as a mechanistic link between infection of atherosclerotic coronary vessels and acute cardiovascular complications of COVID-19” (Nature Cardiovascular Research)

Immune System & Cancer

• SARS-CoV-2 infection as a potential risk factor for the development of cancer (Frontiers in Molecular Biosciences)

• “Cancer-related effects of SARS-CoV-2 may take several years to manifest themselves.” (Biochimie)

• Autoimmunity in Long Covid and POTS (Oxford Open Immunology)

• Sex differences in symptomatology and immune profiles of Long COVID (medRxiv)

• SARS-CoV-2 Related Antibody-Dependent Enhancement Phenomena In Vitro and In Vivo (Microorganisms)

• Accelerated immune ageing is associated with COVID-19 disease severity (BMC Immunity & Aging)

• Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19 (Annals of Internal Medicine)

• Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection (Nature Cell & Molecular Immunology)

• Activation of tuberculosis in recovered COVID-19 patients: a case report (Annals of Medicine & Surgery)

• From “Immunity Debt” to “Immunity Theft”—How COVID-19 Might Be Tied to Recent Respiratory Disease Surges (JAMA Medical News)

• Evolution of enhanced innate immune suppression by SARS-CoV-2 Omicron subvariants (Nature Microbiology)

• Immune response pattern across the asymptomatic, symptomatic and convalescent periods of COVID-19 (Proteins and Proteomics)

• Cell entry mechanisms of SARS-CoV-2 (PNAS)

• Long COVID manifests with T cell dysregulation, inflammation and an uncoordinated adaptive immune response to SARS-CoV-2 (Nature Immunology)

• Persistent complement dysregulation with signs of thromboinflammation in active Long Covid (Science)

• Rapid Emergence and Evolution of SARS-CoV-2 Variants in Advanced HIV Infection (bioRxiv)

• ACE2-independent infection of T lymphocytes by SARS-CoV-2 (Signal Transduction & Targeted Therapy)

• Longitudinal Analysis of COVID-19 Patients Shows Age-Associated T Cell Changes Independent of Ongoing Ill-Health (Frontiers in Immunology)

• Spontaneous, persistent, T cell–dependent IFN-γ release in patients who progress to Long Covid (Science Advances)

Livers, Kidney, and the Gut

• Depicting SARS-CoV-2 faecal viral activity in association with gut microbiota composition in patients with COVID-19 (Gut, BMJ Journals)

• Risks of digestive diseases in long COVID: evidence from a population-based cohort study (BMC Medicine)

• Post COVID-19 condition imposes significant burden in patients with advanced chronic kidney disease (International Journal of Infectious Diseases)

• Acute Kidney Injury in Severe COVID-19 Has Similarities to Sepsis-Associated Kidney Injury: A Multi-Omics Study (Mayo Clinic Proceedings)

Long COVID & Disability

• “Long COVID is a multisystemic illness encompassing ME/CFS, dysautonomia, impacts on multiple organ systems, and vascular and clotting abnormalities.” (Nature Reviews Microbiology)

• Children and young people with long COVID: overlooked and neglected (Child & Adolescent Health, The Lancet)

• ‘Alarming’ rise in Americans with long Covid symptoms (The Guardian)

• Long COVID Has Caused Thousands of US Deaths: New CDC Data (Medscape)

• Solving the puzzle of Long Covid (Science)

• Increasing Prevalence of Voice Disorders in the USA (Wiley Online Library)

• “Long COVID affects 8% of those with COVID-19, is more common in women” (European Society of Clinical Microbiology & Infectious Diseases)

• Kidney Outcomes in Long COVID (American Society of Nephrology)

• “Of the 312 [cancer] patients, 188 (60%) reported long COVID-19 symptoms with a median duration of 7 months and up to 14 months after COVID-19 diagnosis.” (eLife Sciences)

• “…an individual with [joint hypermobility] was approximately 30% more likely not to have recovered after initial COVID-19 infection.” (BMJ Public Health)

• “The most common post-COVID-19 symptoms were joint pain (34%), muscle pain (31%), lumbago (30%), dyspnoea (30%), paresthesias (29%), anxiety (29%), trouble sleeping (29%), fatigue (27%) and weight gain (24%).” (BMJ Journals Thorax)

• “Preventing infections and reinfections is the best way to prevent Long Covid and should remain the foundation of public health policy.” (Science)

• “Hospitalized COVID-19 patients presented, 7 months after discharge, with a reduction in functional capacity" (Frontiers Medicine)

• In a survey of 350 Iranian healthcare workers, “results showed that 75.7% of HCWs experienced symptoms of long COVID-19.” (BMC Nursing)

• Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies (Trends in Molecular Medicine)

• What is the impact of long-term COVID-19 on workers in healthcare settings? A rapid systematic review of current evidence (PLOS One)

• Muscle abnormalities worsen after post-exertional malaise in long COVID (Nature Communications)

• Long COVID and Chronic Conditions in the US Workforce: Prevalence, Productivity Loss, and Disability (Occupational and Environmental Medicine)

• Systems analysis of innate and adaptive immunity in Long COVID (Seminars in Immunology)

• An ER doctor’s experience with long COVID – “My symptoms seemed endless” (Hospital News)

• Nearly 25% of Iowans with COVID had “long-haul” symptoms (Iowa Department of Health & Human Services)

• Long COVID linked to persistently high levels of inflammatory protein: a potential biomarker and target for treatments (University of Cambridge)

• Adults aged 25-39 had the highest rates of long COVID symptoms, followed by adults aged 40-54 (CDC)

• 1-in-7 Coloradans who tested positive for COVID-19 developed Long COVID (Colorado Health Institute)

• Long covid: Damage to multiple organs presents in young, low risk patients (BMJ)

• Persistent complement dysregulation with signs of thromboinflammation in active Long Covid (Science)

• How long is the long COVID? a retrospective analysis of football players in two major European Championships (medRxiv)

• “…pronounced cognitive slowing in people with [Long COVID]” (eClinicalMedicine)

• Long-term symptoms after SARS-CoV-2 infection in a cohort of hospital employees: duration and predictive factors (BMC Infectious Diseases)

• Long-COVID cognitive impairments and reproductive hormone deficits in men may stem from GnRH neuronal death (eBioMedicine)

Overall Mortality

• “Organ impairment persisted in 59% of 331 individuals followed up at 1 year post COVID-19” (Journal of the Royal Society of Medicine)

• SARS-CoV-2 infection increases the risk of worse outcomes in cancer patients, including those with breast cancer. (Frontiers Oncology)

• "In the absence of the COVID-19 pandemic, we forecast that over 2.1 million (0.63%) more people would be alive in the U.S. in 2025" (Nature Communications)

• “…many excess deaths reported to non-COVID-19 natural causes during the first 30 mo of the pandemic in the United States were unrecognized COVID-19 deaths.” (PNAS)

• Accelerated biological aging in COVID-19 patients (Nature Communications)

• Core mitochondrial genes are down-regulated during SARS-CoV-2 infection of rodent and human hosts (Science Translational Medicine)

Pregnancy

• Research shows 1 in 10 infected pregnant women develop long COVID (CIDRAP)

• Babies Exposed to COVID in the Womb Are More Likely to Suffer Breathing Problems (Scientific American)

• Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (Nature Communications)

• Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy (JAMA Pediatrics)

• Maternal SARS-CoV-2 impacts fetal placental macrophage programs and placenta-derived microglial models of neurodevelopment (mdRxiv)

Reinfections of COVID-19

• Every COVID Infection Increases Your Risk of Long COVID (Uni. of Nebraska)

• How does the SARS-CoV-2 reinfection rate change over time? The global evidence from systematic review and meta-analysis (BMC Infectious Diseases)

• “infection-induced immunity contributes to short-term population protection…but wanes considerably with time” (IJID Regions)

Reproductive Health

From “COVID-19 and male reproductive function: a prospective, longitudinal cohort study” (Reproduction)

• Rescuing fertility during COVID-19 infection: exploring potential pharmacological & natural therapeutic approaches for comorbidity, by focusing on NLRP3 inflammasome mechanism (Journal of Assisted Reproduction & Genetics)

• Men experience a long-term drop in semen quality after COVID infection – even if the infection was mild (European Society of Human Reproduction & Embryology)

• “COVID-19 infection is associated with impaired sexual function in cisgender women…women with long COVID experienced incrementally more impaired sexual function” (Journal of Sexual Medicine)

Skin

• The Pandemic and Your Skin—Direct and Indirect Impact of COVID-19 (Cosmetics)

Viral Persistence

From “Restrained memory CD8⁺ T cell responses favors viral persistence and elevated IgG responses in patients with severe Long COVID”

• Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to 2 Years Following COVID-19 (medRxiv)

• Persistence of S1 Spike Protein in CD16+ Monocytes up to 245 Days in SARS-CoV-2 Negative Post COVID-19 Vaccination Individuals with Post-Acute Sequalae of COVID-19 (PASC)-Like Symptoms (medRxiv)

• Prevalence of persistent SARS-CoV-2 in a large community surveillance study (Nature)

• Restrained memory CD8⁺ T cell responses favors viral persistence and elevated IgG responses in patients with severe Long COVID (medRxiv)

• Viral persistence in children infected with SARS-CoV-2: current evidence and future research strategies (Microbe, The Lancet)

COVID-19 Prevention

Illustrated Current News, 1918. Amazing how far we’ve fallen since.

• Beyond the new normal: Assessing the feasibility of vaccine-based suppression of SARS-CoV-2 (PLOS One)

• An intranasal live-attenuated SARS-CoV-2 vaccine limits virus transmission (Nature Communications)

• Ventilation Can Reduce Exposure to Respiratory Viruses in Indoor Spaces (CDC)

• The durability of vaccine-induced protection (Expert Review of Vaccines)

• An intranasal combination vaccine induces systemic and mucosal immunity against COVID-19 and influenza (Nature NPJ Vaccines)

• Vaccine disinformation from medical professionals—a case for action from regulatory bodies? (Journal of Evaluation in Clinical Practice)

• Children's experiences of mask-wearing: a systemic review and narrative synthesis (Journal of Evaluation in Clinical Practice)

• Comparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States (Nature Communications)

• Estimating The Impact of Public Health Interventions on COVID Mortality in The United States Using Reductions in Influenza Mortality as an Indicator Of Non-Pharmaceutical Infection Control (medRxiv)

• Impact of community mask mandates on SARS-CoV-2 transmission in Ontario after adjustment for differential testing by age and sex (PNAS Nexus)

• The impact of COVID-19 vaccination prior to SARS-CoV-2 infection on prevalence of long COVID among a population-based probability sample of Michiganders, 2020-2022 (Annals of Epidemiology)

• Missed Vaccine Doses Tied to Worse COVID-19 Outcomes (JAMA Network)

2024 will continue to be a significant year in developing our understanding of COVID-19, and the importance of preventing SARS-CoV-2 transmission. While better vaccines are still being developed, our full understanding of how repeated COVID-19 infections harm our health, child development, and reduce life expectancy is still relatively new. It’s important to do everything you can to protect yourself, your family, and especially your children from this virus that has already killed and disabled millions across the globe.

We at the Pandemic Accountability Index will continue to compile this research and document the bad actors who have chosen a path of misleading the public about this worldwide biohazard, in our fifth year of the ongoing COVID-19 pandemic. With your support, the Pandemic Accountability Index will grow and evolve throughout 2024 to better deliver coverage of COVID-19, and future pandemics.