We tend to make sense of sickness by ascribing levels to it, like medals in Olympic boxing: There’s featherweight “I’m under the weather,” a welterweight “ghastly ill.” And then there’s the super heavyweight, an opponent that actually scares you. Few people have to face off with this kind of illness. I have. Which may be why, as I scan through the daily news about the coronavirus, I tend to skip the stats on how many have died, the ventilators we don’t have, the politics, the quarantines, the jobs lost, even the bread-baking. Instead, I find myself drifting into the minds of those souls strapped to gurneys in the hallway, encased in a macramé of tubes and wires, fighting for each breath. These are the ones facing the super heavyweight. Some of them will die. But the ones I think about are the ones who will survive. Because I’ve been there. I know that getting off the ventilator won’t be the end of the story. And I know that not being sick doesn’t mean you’re well.

There is a common misconception that people who come down with COVID-19 experience one of two disease courses: They have minimal or no symptoms that clear up in a week, or they get extremely ill and either die or recover after receiving intensive care treatment.
But now that the coronavirus has been under sharp focus for more than six months, physicians are noting that this binary belief is inaccurate. Some patients in both categories experience lingering symptoms and are at risk for long-term damage to organ systems weeks and months later.

Patients will survive coronavirus—but that survival will likely come at a cost for some. Research on similar populations suggests that at least 50% of people who survive admission to an intensive care unit (ICU) can be left with what researchers now call “post-intensive care syndrome,” a constellation of emotional, cognitive, and physical symptoms that limit their functioning. Survivors of critical illness can often return to the world with memory problems and difficulty planning and processing that is similar to those with moderate traumatic brain injury or mild dementia. Other survivors experience post-traumatic stress disorder (PTSD), at an incidence ranging from 10% to 50%. Their caregivers, too, will often experience a cluster of adverse outcomes, including anxiety, PTSD, and depression.