Health care workers (HCW) who have been on the front-line of the pandemic, highly exposed to SARS-CoV-2 and frequently infected, are now the focus of research on the longer-term evolution of COVID-19. This is important as HCWs are generally young, previously healthy adults and are representative of the active “workforce” in countries worldwide. An infection with SARS-CoV-2 can be seen as a twin-edged sword: on one hand, having had the infection will confer some immunity or protection against re-infection whilst on the other hand, infection sequelae may result in subtle or significant health consequences. How long will the infection -conferred, antibody reactivity to the receptor-binding domain of SARS-CoV-2, the neutralising activity and the specific memory B cells last post infection? Mounting evidence suggests that this protection may last for 12 months or longer . What is the price of this COVID armour? The cost is steep!
SARS-CoV-2 infected individuals may experience debilitating sequelae that persist for months and longer. A systematic review on long-term sequelae in previously healthy, young people aged < 50 years old found a broad spectrum of symptoms . These included persistent fatigue, breathlessness, diminished quality of life, impaired pulmonary function, myocarditis, neurological and psychiatric diagnoses, slow and stagnant recovery of olfactory and gustatory function. Due to the global proliferation of COVID-19 infection, the burden of sequelae is thus projected to be immense.