Dr. Patrick: Well, I think in addition to hospitalization, there's also the risk of people who have mild symptoms who don't have to go to the hospital, they stay at home during the duration of their illness, are coming down with post-acute COVID syndrome, which is popularly known as the long-haul COVID. The symptoms range from brain fog to racing heart problems to lethargy. And there's been a variety of studies that have come out that have looked at what long-haul COVID is and what population it seems to be affecting. And interestingly, you'd think, well, people having these long-term effects would be the ones that were, you know, on the ventilator. Well, of course, people on ventilators do have long-term effects. But you'd think people that are hospitalized would be the ones mostly having these long-haul COVID effects, and it turns out younger people, people under the age of 50, teenagers even, people in their 20s are the ones that are really, you know, coming down with this long-haul COVID syndrome.

There's a pre-print that has not been peer-reviewed yet, and it's a big study that was done out of the U.K. It's part of this ongoing study called the Biobank Study. They get large population sample sizes. In this case, it was close to 800 people. It was 780 or something like that people before the pandemic came in and had MRI brain scans. Researchers have all this data on individuals', you know, brain structure and volume. And so once the pandemic hit, many people came down with COVID-19, some mild cases, some more severe, some were hospitalized. And a few months, you know, into the pandemic, researchers doing this Biobank study thought, "Hey, we should bring these people back in and get a brain scan and see if there's any changes." And so that's what they did. Just, you know, months after their first scan, they brought them back in for another scan. And what the preliminary findings, again, that are not peer-reviewed yet, showed is that there are major differences in gray matter regions of the brain. Gray matter atrophy is occurring in several different regions of the brain, very prominently in the olfactory region, which makes sense because, you know, one of the telltale symptoms of COVID-19 at least pre-Delta was loss of smell, loss of taste. And also there's atrophy in other brain regions involved in memory and learning. People that had severe COVID do have worse atrophy compared to the people that only had mild cases, did not need to be hospitalized, but they themselves were also experiencing brain atrophy. These are people that did not have to go to the hospital. And, of course, people were matched for the same age, the same gender, the same ethnicity, and the same time in between scans, so trying to keep everything, you know, as comparable as possible to compare apples to apples. To me, that was quite frightening because it really suggests that there are complications, and there are, you know, long-term effects of this virus that we don't quite understand and that are affecting, you know, hundreds of thousands of people. I personally know quite a few.

Kyle: Dr. Seheult, anything to add on the long COVID front because I know...that's a concern that I have. At my age, if I got COVID-19, would I have lingering symptoms? What are you seeing on your end clinically with regards to that?

Dr. Seheult: Oh, yeah. So, in addition to me working in the intensive care unit, I also have an outpatient pulmonary clinic. I've diagnosed at least three or four, just off the top of my head, blood clots in patients who went to the hospital, had COVID-19, survived, got better, so they weren't part of the 1%, but then they had persistent shortness of breath, leg swelling. We immediately made the diagnosis and put them on blood thinners. And so that's just a small slice of what we're seeing in terms of comorbidity. So the 1% is death, but there's a lot worse that can happen up to that point than death. There's a lot of bad things that can occur. So, totally agree. Absolutely.

Dr. Patrick: To add on to the blood clots and strokes, there was this study...multiple studies, one out of Israel, and a couple out of the United States, showing that people under the age of 50 were coming in to the emergency room for strokes. And one of the studies out of Israel found, because they test everyone for COVID-19, a high percentage of the people that were coming in for these strokes, these young people under 50, had COVID-19 and didn't even know they had had it. So, I mean, we're talking obviously mild, mild cases, potentially, even asymptomatic if they didn't even know they had COVID-19 and they're coming in with strokes.

Dr. Seheult: Yeah, absolutely. And so this is the thing is that COVID-19 has many different ways of affecting the body. The one that we all know about is the lungs, of course, because it can cause inflammation in the lungs. But as Dr. Patrick points out, there are blood clot issues. So blood clots to the lungs can also occur, but also blood clots to the brain, which manifest the strokes.