There are a variety of symptoms and signs that can persist or develop long after the SARS-COV-2 virus has left the body. When symptoms or complications are present more than 4 weeks after the onset of symptoms of COVID 19 this is revered to as “Post-acute COVID 19 syndrome.” Many people who have such long lasting symptoms after COVID 19 refer to themselves as “long haulers.” Other names such as “long COVID” and post-acute COVID syndrome (PACS) have been applied to this situation as well.
It is common to have symptoms in the weeks and months after being diagnosed with COVID 19. Carfi and colleagues showed in their publication in JAMA that most people still have one or more symptoms at day 60 of recovery. specifically, the authors of this study showed that 87.4 % of patients had at least one symptom and fatigue and shortness of breath were the top symptoms.
Patients with post-acute COVID 19 syndrome can experience a wide array of persisting symptoms. These include fatigue, chest pain, shortness of breath, heart rhythm problems, brain fog, headaches, poor sleep, loss of smell, anxiety, depression, joint pains. Quality of life is reduced in many people even after the infection has cleared the body. Patients with post-acute COVID 19 syndrome may have lung issues, kidney issues, hematologic issues, blood clotting issues, cardiovascular issues, endocrine, psychiatric and neurological issues and therefore may be referred to a variety of different medical specialists.
Hair Loss in COVID Survivors
Hair loss is one of the most common dermatologic issues that develops in patients who recover from COVID 19. It has been estimated that about 1 in 5 patients (20 %) of hospitalized who survive COVID 19 will have hair loss. We don’t know exactly what the numbers are patients with milder forms but it could be slightly less. Hair loss typically happens 8-12 weeks after infection and can even happen in those without any symptoms of COVID 19 at all. Let’s take a look at some of the important studies.
The Huang Study, 2021
Huang and colleagues studied patients with confirmed COVID-19 who had been discharged from a hospital in China between Jan 7, 2020, and May 29, 2020. In total, 1733 patients completed questionnaires about their health status after leaving the hospital. Hair loss was reported in approximately 22 % of patients. Interestingly, the incidence of hair loss did not seem to differ in patients with greater degrees of illness compared to patients with less degrees of illness. For example, 22- 24 % of patients who required oxygen or mechanical ventilation during their hospital stay had hair loss compared to 22 % of patients that did not require oxygen.
The Garrigues Study, 2020
Garrigues and colleagues from Paris France examined health status of patients with COVID 19 after being discharged from hospital. They included 120 patients in their study, of which 96 were admitted to a hospital ward and 24 were more ill and needed to be admitted to the intensive care unit. Hair loss was reported in 20 % of patients overall. Further analysis showed that hair loss occurred in 25 % of ICU patients and 18.8 % of hospital ward patients. In this small study, these differences did not meet statistical significance indicating that hair loss is not seem to matter much according to how ill the patient was.
The Akama-Garren Study, 2021
Akama-Garren and colleagues used the electronic health records from Mayo Clinic to examine whether certain terms were more common in patients before they were diagnosed with COVID 19 or more common after they were diagnosed with COVID 19. The authors showed that the term “hair loss” was much more commonly found in charts in patients after diagnosis with COVID 19 than before COVID 19 (OR 2.44, 95% CI 2.15-2.76, p=8.45×10-3). Other terms that also appeared more frequently were those related to kidney disease and coagulopathies. Hair loss seemed to be much more of a concern unique to females in this study rather than males. In addition, concerned about hair loss spiked dramatically at around day 100 after a diagnosis of COVID 19 which is what we would expect in a telogen effluvium.
The Miyazato Study, 2020
Miyazato and colleagues from Japan interviewed patients following discharge from hospital. 58 patients were asked about hair loss. Fourteen (24.1%) of 58 patients reported hair loss. . Of the 14 patients, 5 were women and 9 were men. Hair loss developed approximately 58.6 days ( 8 weeks) on average after symptoms of COVID 19 firsts began. Of the 14 patients, there were only 5 patients who had been studied long enough to get a good sense of how long hair loss lasted. Nevertheless, of these 5 patients, hair loss lasted on average 76.4 days ( 10 weeks).
The Morenes-Arrones Study, 2020
I’ve talked about the Morenes-Arrones study before This was a study of 214 patients with proven SarsCOV2 infection. 13. 6% were asymptomatic, 77% needed medical treatment and 21 % needed hospitalization. Hair shedding occurred after an average of 57.1 days ( 8 weeks) similar to the results from the Miyazato study reviewed above.
Conclusion and Summary
Thanks again for the great question. If you were hospitalized for your COVID 19 infection, we can say that there is approximately a 20 % chance you’ll get hair loss. we don’t know with great confidence that chances of hair loss in patients with more mild symptoms of COVID19 but there is a chance that the chances of hair loss are under 20 %. The only good data we have so far is in patients who were released hospitalized.
Overall, the data together indicate that there is a much better chance that you won’t get hair loss than you will get hair loss. But if you do get hair loss, it will occur most likely around week 8 to week 12 after your COVID symptoms first started. Shedding will last about 10 weeks before the stopping. Complete hair regrowth would be expected in a large proportion of patients. .