There is no doubt that the COVID-19 pandemic changed the lives of everyone- especially as many had to deal with a constantly changing environment that led to many of us adopting a new remote or hybrid lifestyle. While COVID-19 continues to significantly impact our lives today, some people who have had the virus have also noticed its lingering effects. While evidence and research are still emerging, we will further discuss in this article what we know about long COVID so far.
What is Long COVID?
Many people often recover from COVID within a few days or 2 weeks. However, some people may experience lingering symptoms and health issues that can last for weeks, months or even years after initial diagnosis. Symptoms and emerging/worsening health conditions will vary from individual to individual.
According to the CDC, long COVID (also known as post-COVID) has many other names. These include long-haul COVID, post-acute COVID-19, post-acute sequelae of SARS CoV-2 infection (PASC), long-term effects of COVID, and chronic COVID.
What Causes Long COVID?
There is not enough research to determine the direct cause of long COVID. Many experts have noted that people with serious health conditions (such as high blood pressure, diabetes, hypertension, etc.) have a higher risk of developing more severe symptoms. However, there is no clear explanation why this may be the case.
According to the NIH, some theories that experts are researching include:
- The possibility of COVID-19 particles becoming active again- which can restart symptoms.
- COVID-19 leads to an overactive immune system which can cause the release of inflammatory substances within the body (which can further damage a person’s organs and tissues).
- COVID-19 triggers the release of antibodies in specific individuals- which can also attack a person’s organs and tissues.
As more research, studies, and data emerge, health professionals will come to understand more of possible causes or reasons for why long COVID occurs.
What Are the Symptoms?
Symptoms will vary from individual to individual. Symptoms can last from four weeks to a couple of months- or potentially a couple of years. Some symptoms can linger longer, and others can come and go as time passes. The CDC acknowledges that symptoms will vary amongst individuals and that people with long COVID symptoms may experience health problems resulting from different types and combinations of symptoms.
The symptoms that most people commonly report include (but are not limited to):
- General Symptoms
- Tiredness or fatigue that interferes with daily life
- Symptoms that get worse after physical or mental effort ( “post-exertional malaise”)
- Fever and chills
- Restless leg syndrome
- Overall feelings of weakness
- Loss/distorted taste or smell
- Joint or muscle pain
- Reduced mobility
- Respiratory and Heart Symptoms
- Difficulty breathing or shortness of breath
- Chest pain
- Rapid or Irregular Heartbeat
- Neurological Symptoms
- Difficulty thinking or concentrating (also known as “brain fog”)
- Sleep problems (such as insomnia)
- Lightheadedness (dizziness when you stand up)
- Feelings of pins-and-needles
- Change in smell or taste
- Worsening of depression, anxiety, or mood changes
- Digestive Symptoms
- Stomach pain
- Changes in appetite
- Changes in stool color
- Other Symptoms
- Hearing loss
- Changes in vision
- Red eyes or yellow eyes
- Changes in menstrual cycles
- Increased thirst (a symptom of diabetes triggered by COVID-19)
- Changes in urination
- Pain on the side of the body (a sign of kidney issues)
- Shaking of hands
- Swelling in legs and feet
- Hair loss
- Yellow skin
- Erectile dysfunction
What Causes Symptoms in Long COVID?
It is known that COVID-19 affects the body in various ways. Some of which can lead to damage to the lungs, heart, kidney, liver, nervous system, etc. If someone already has a pre-existing medical condition, COVID-19 can lead to a worsening of symptoms. However, it is also important to note that even perfectly healthy individuals (who got sick from COVID) are also reporting symptoms of long COVID. While more research is needed to understand why this is the case, some researchers theorize that this may have to do with the fact that those who don’t experience severe symptoms of COVID-19 are less likely to seek medical attention. As a result, they may be unaware of the internal effects the virus is having on the body.
It is also important to note that it is still unknown how the new variants can affect long COVID symptoms.
How Can I Tell if I Have Long COVID?
There are no definitive laboratory or screening tests to help medical professionals diagnose long COVID at the moment. On top of that, it may be difficult for some people to tell if they have long COVID. Some people may only experience minor symptoms that they may not notice until later. It is also difficult to diagnose long COVID, given that everyone’s symptoms vary in severity and length. Also, many sources report that more than 200 symptoms can be linked to long COVID. The best thing you can do is to stay aware of how you feel afterward. Symptoms can linger for about 2-3 weeks after being cleared of infection. However, if more weeks or months pass and you are still experiencing symptoms- we highly encourage you to schedule an appointment with your doctor. While there are no definitive screening tests to help form a diagnosis- you can still work with your doctor to explore various treatment possibilities.
Who Can Get Long COVID?
As mentioned above, experts have noted that people with existing health conditions may be more susceptible to having severe COVID-19 and then experiencing long COVID. However, it is also important to note that even those who only experienced mild symptoms (or even no symptoms whatsoever) can still get long COVID. The CDC reports that for those who have had COVID-19, those who go on to experience long COVID include:
- 3% at one month or longer after infection
- 5% at three months or longer, based on self-reporting
- More than 30% at 6 months among patients who were hospitalized
It is also important to note that risk factors will vary from individual to individual. Some may be more susceptible than others. Some factors to keep in mind include:
- Older Age
- The severity of the initial COVID-19 illness
- Whether or not you are fully vaccinated
- Which COVID-19 variant caused the initial illness
- If you have pre-existing conditions such as heart disease, diabetes, lung problems, autoimmune diseases, or obesity.
- You had a condition affecting your organs and tissues (multisystem inflammatory syndrome) while sick with COVID-19 or afterward.
- Health Inequities
Children and teenagers are also at risk of getting long COVID. There is also the risk of children (generally ages 5-11) developing multisystem inflammatory syndrome (Misc-C). Those with Mis-C experience inflammation of various body parts (I.e., the heart, lungs, kidney, brain, skin, eyes, and gastrointestinal organs).
As new studies emerge, researchers and medical experts will begin to learn more about this area of research.
What are the Treatment Options?
There are currently no specific treatments for long COVID. However, you can rely on your healthcare provider to help you manage some symptoms. Many long COVID symptoms intercross with those that are common in other health conditions. Therefore, it will be helpful if you work with your doctor to rule out any other possible underlying causes of symptoms. Other treatments to consider may include physical therapy or medications. Overall, we encourage you to meet with your doctor to come up with the best medical management plan that will best suit your needs. Keep an eye on your overall symptoms, and if you or a loved one are experiencing any severe symptoms, don’t hesitate to seek immediate medical attention.
You may also want to consider implementing self-management techniques into your routine until more data comes out on long COVID. You could:
- Take small breaks throughout your day if you are experiencing extreme fatigue.
- Slowly incorporate exercise into your routine to help lift your mood and boost endorphins in your brain. You may want to work closely with your doctor or an exercise specialist (especially if you are experiencing symptoms such as shortness of breath, dizziness, etc.).
- If experiencing joint/muscle pain, consider looking into physical therapy or exercise that involves stretching (such as yoga or strength-building exercises).
- To help with respiratory issues, consider implementing meditation and breathing techniques into your routine (either early in the morning or before bedtime).
- Try leaving yourself little notes, to-do lists, or setting up reminders (on your phone) if you find yourself forgetting often.
- Try to stick to a daily routine to help you get through the day.
- Reach out to loved ones for support!
Is Long COVID Preventable?
As of right now, the best way you can prevent long COVID is by getting vaccinated and staying up-to-date with vaccines. Some studies show that even those who get breakthrough COVID are less likely to report long COVID symptoms than those who are not vaccinated.
Sources: Long COVID | NIH COVID-19 Research, Long COVID: Long-Term Effects of COVID-19 | Johns Hopkins Medicine, Long COVID or Post-COVID Conditions | CDC, What is long COVID? | American Medical Association (ama-assn.org)