Coronavirus symptoms: 22% of patients have long-term hair loss

Fatigue, loss of smell and chest pains are all some of the better known long-term effects that persist months after coronavirus infection.

But according to a new scientific paper, almost a quarter of Covid-19 survivors may have to adjust to hair loss too.  

The study, published in The Lancet, reveals that 359 out of 1,655 patients hospitalised in Wuhan, China – 22 per cent – had experienced hair loss six months after being discharged. 

Dermatologists say hair loss is a normal physiological response to a stressful event like an infectious illness and is only temporary – but Covid could be linked to conditions like alopecia, which can lead to irreversible hair loss. 

The Chinese authors wanted to investigate the long-term health consequences of Covid-19 – dubbed ‘long Covid’. 

These symptoms, they say, ‘remain largely unclear’ – although the NHS lists 14 symptoms including fatigue, shortness of breath, insomnia, dizziness, joint pain and depression and anxiety.

‘Hair loss’ is absent from the NHS’s list, however.  

‘The aim of this study was to describe the long-term health consequences of patients with Covid-19 who have been discharged from hospital,’ say the authors, from the Chinese Academy of Medical Sciences. 

‘To our knowledge, this is the largest cohort study with the longest follow-up duration assessing the health consequences of adult patients discharged from hospital recovering from Covid-19.’ 

Covid-19 patients looked at for this study had been discharged from Jin Yin-tan Hospital in Wuhan between January 7 and May 29, 2020.  

Six months later, patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a six-minute walking test, and received blood tests 

Researchers found that the survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression – but hair loss was also one of the primary outcomes. 

In all, 63 per cent had experienced fatigue or muscle weakness, 26 per cent had had sleeping difficulties and 23 per cent had had anxiety or depression, as well as 22 per cent with hair loss. 

The findings follow an investigation into ‘long hauler’ Covid symptoms, published last summer by Dr Natalie Lambert from Indiana University School of Medicine.

Dr Lambert collected 1,567 responses in an online survey from people with long Covid symptoms. 

She found 423 of this total had experienced hair loss – the 21st most commonly cited symptom on a list of the 50 (which was topped by fatigue). 

Long haulers’ Covid-19 symptoms are ‘far more numerous’ than the 11 currently listed on the website of the Centers for Disease Control and Prevention, she pointed out.  

‘While the impact of Covid-19 on the lungs and vascular system have received some media and medical attention, the results of this survey suggest that brain, whole body, eye, and skin symptoms are also frequent-occurring health problems for people recovering,’ Dr Lambert said. 

According to the American Academy of Dermatology (AAD), Covid-induced hair loss is due to telogen effluvium (TE) – a shedding condition caused by a disturbance in the hair growth cycle. 

TE results in a high percentage of anagen follicles (follicles which are actively growing hair), going into their resting phase prematurely across the scalp 

TE lasts somewhere between six to nine months before hair returns to its normal thickness and appearance, it says. 

‘It happens when more hairs than normal enter the shedding (telogen) phase of the hair growth lifecycle at the same time,’ AAD says. 

‘A fever or illness can force more hairs into the shedding phase. Most people see noticeable hair shedding two to three months after having a fever or illness.’  

Specialists at the Belgravia Centre in London have also reported an uplift in cases of telogen effluvium since the start of the pandemic.

Nearly two thirds (64 per cent) of male patients and over a third of women (38 per cent) diagnosed with TE at the Belgravia Centre reported having experienced Covid-19 related symptoms, they found last year. 

‘It’s quite common for TE-related hair loss to present around three months after a period of severe trauma, illness or stress, which fits with our findings,’ said Rali Bozhinova, superintdent trichologist at the Belgravia Centre.

‘The spike in diagnoses shows the extent of stress that the virus places on the body, not only causing temporary TE, but also potentially exacerbating other hair loss conditions which can have long lasting effects if left untreated.’ 

Another expert suggested Covid-19 could be linked to alopecia areata, which leads to coin-sized bald patches on the scalp.  

Alopecia areata can result in total hair loss, called alopecia universalis, and it can prevent hair from growing back. 

In these cases, Covid-19 may trigger an auto-immune response, where the body attacks its own hair follicles, switching them off, according to trichologist Iain Sallis, who wasn’t involved in the Chinese study. 

‘Covid, as many other febrile illnesses, have the ability to confuse our auto-immune system,’ Sallis told MailOnline. 

‘Any type of shock be it, physical, emotional or psychological can cause alopecia, so it can most certainly be classed as a possible trigger.’

There is currently a joint effort by dermatologists called SECURE-DERM to look at the effects of Covid on hair loss on a global scale.