What You Need to Know About Long COVID

While you may be ready to be done with COVID, there’s a chance that COVID isn’t done with you.

According to the Centers for Disease Control and Prevention, 1 in 5 U.S. adults who contract COVID also develop symptoms of ‘Long COVID.’ This includes individuals who had a mild or moderate case of the disease not requiring hospitalization. 

Sometimes referred to as Post-Covid Conditions, Long COVID presents with a variable constellation of symptoms that develop after an episode of COVID-19 and without an alternative explanation. Not everyone with Long COVID develops all the related health problems and how long they last vary by individual. But for some people, the severity of symptoms can be debilitating and truly life-altering.

Common symptoms include:

General symptoms

• Tiredness or fatigue that interferes with daily life
• Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”)

Respiratory and heart symptoms

• Difficulty breathing or shortness of breath
• Cough
• Chest pain
• Fast-beating or pounding heart (also known as heart palpitations)

Neurological symptoms

• Headache
• Dizziness when you stand up (lightheadedness)
• Pins-and-needles feelings
• Change in smell or taste

Neuropsychiatric symptoms

• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Sleep problems
• Depression or anxiety

Digestive symptoms

• Diarrhea
• Stomach pain

Other symptoms

• Joint or muscle pain
• Rash
• Changes in menstrual cycles

The challenge with diagnosing long COVID is that there currently isn’t a test for it or even a set of criteria doctors can refer to for diagnosing it. Adding to the challenge is the fact that a patient’s routine blood tests, chest x-rays, and special tests of heart and lung function are usually normal. 

One fact that’s proving helpful in recognizing Long COVID is that certain people or groups appear to be at greater risk of developing it. These include people who:

• did not get a COVID-19 vaccine
• experienced multisystem inflammatory syndrome (MIS) during or after COVID-19 illness
• are a woman; according to one analysis, women are 1.5 times more likely to develop Long COVID than men.
• are over the age of 40
• are obese
• have diabetes
• have a prior history of anxiety and/or depression

Not surprisingly, the best way to avoid getting Long COVID is to not get COVID in the first place.

Studies have found that patients who received two doses of a COVID-19 vaccine were 40% less likely to develop Long COVID than those who were unvaccinated. Further studies suggest vaccination could reduce the risk of long-term COVID-19 symptoms even in individuals with other recognized risk factors.

Additional good news is found in the fact that most people with Long COVID see their symptoms improve over time; for some that means weeks while for others it means years. 

If you’ve had COVID and are experiencing lingering or unusual symptoms that can’t be explained, contact your provider to discuss the possibility that you may have Long COVID.

Dr. Jeffrey Parsonnet, MD is an infectious disease at international health expert at Dartmouth Hitchcock Medical Center.