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There can’t be a person in the world today who doesn’t know that COVID-19, caused by the SARS-CoV-2 virus, is a pandemic of historical proportions. Chinese authorities first confirmed identification of the novel coronavirus on January 7, 2020. By January 30 of that year, cases had been reported in at least 21 countries, plunging many into lockdown. Far more has been discovered about this fast-spreading disease since it emerged. However, information on the lingering condition called long COVID-19 remains largely a mystery.
Most people who develop COVID-19 have symptoms that resolve within a few weeks, or sometimes no symptoms at all. But for a small number, COVID-19 leaves them with symptoms that are still present even months after the initial infection.
Long COVID-19 is also called “long-haul COVID” and is referred to by the World Health Organization (WHO) as “post COVID-19 condition.” Symptoms of long COVID-19 can be similar to that of an acute COVID-19 illness with fatigue, shortness of breath, and cognitive dysfunction. They can also include rapid or pounding heartbeat, skin rashes, depression and anxiety, muscle pain, dizziness, headaches, and other symptoms. These long-term symptoms can seriously impact a person’s everyday functioning.
So far, research on long COVID-19 has not yet answered the question of why some people who contract the coronavirus develop the long-term illness. Reports collected by the WHO indicate that between 10 percent and 20 percent of people who are diagnosed with COVID-19 go on to develop some form of long COVID-19.
According to the WHO, long COVID-19 usually begins within three months after the first COVID-19 infection and lasts for two months or more. The U.S. Centers for Disease Control and Prevention (CDC) defines post-COVID conditions as ongoing health problems four or more weeks after the initial COVID-19 diagnosis.
Anyone who at some point has had COVID-19, whether mild or severe, in or out of hospital, is at risk of having long COVID-19. Even those with no COVID-19 symptoms after a diagnosis can later experience long-term effects. Research from COVID Symptom Study app does show that the risk for developing long COVID-19 may be higher among:
The simple answer is that no one really knows yet what causes long COVID-19. This illness can happen to people who only experience mild COVID-19 symptoms at first, and who have no history of other illnesses.
Scientists theorize that the new or ongoing symptoms some people experience after contracting COVID-19 could be related to fragments of viral protein remaining after infection and disrupting bodily systems. This would be particularly relevant for people whose lungs, heart, brain, or other organs were injured by the virus.
Another area of thought is that long COVID-19 could be the result of damage caused by the body’s own immune response to the virus. But researchers agree that, at this stage, they don’t fully understand the reason certain people develop long COVID-19.
The prevalence of long COVID-19 is still in the early stages of research.
The WHO estimates that between 10 percent and 20 percent of people who get acute COVID-19 go on to develop some form of long COVID-19. However, the pandemic is still changing as coronavirus variants emerge and as vaccination becomes more common worldwide. Therefore COVID-19 prevalence — and long COVID-19 prevalence — will continue to evolve. The rates of long COVID-19 may vary from country to country, and more research is needed to accurately predict its behavior.
While COVID-19 symptoms are clearly defined, the same can’t be said for long COVID-19. Many people with long COVID-19 will test negative for COVID-19 after a few weeks, even though they have lasting symptoms.
A long COVID-19 diagnosis should only be made by a doctor or a nurse who has ruled out other illnesses and tested for COVID-19 reinfection. Many long COVID-19 symptoms, such as mood changes, muscle pain, fever, or joint pain, may be caused by other conditions.
According to the Cleveland Clinic, the most common symptom of long COVID-19 is fatigue. The CDC reports common symptoms of long COVID-19 as:
Read more about diagnosing long COVID-19.
While there is ongoing research in this field, researchers are attempting to describe different types of long COVID-19. A review of 50 studies found that people with long COVID-19 have reported more than 100 different long-term symptoms. These may involve the lungs, brain, heart, kidneys, or skin — as well as general energy levels and mental health. Symptoms may be present from the start of the initial COVID-19 infection, or they may emerge weeks or months later.
Long COVID-19 may affect many systems in the body, which results in a wide range of symptoms. These health issues may be the direct result of the virus, or they can be an effect of the body’s immune system fighting the coronavirus. Multiorgan changes can affect:
Multisystem inflammatory syndrome (MIS) is a very rare condition that involves the inflammation of many parts of the body, including the gastrointestinal tract, eyes, heart, brain, lungs, and kidneys. Some people, mostly children, have developed MIS during or just after recovering from a COVID-19 infection. MIS can evolve into multiorgan long COVID-19 over time.
Treatment will largely depend upon a doctor’s diagnosis of the particular symptoms of a person’s long COVID-19. No two people are the same, so treatment will vary depending on symptoms and disease severity, and a person’s age and overall health.
Some symptoms of long COVID-19, such as severe tiredness, may last longer than other symptoms. Some symptoms may disappear completely. Tracking your symptoms over time in a notebook or on your smartphone may help you better communicate about your condition with your health care team.
Many symptoms of long COVID-19 will benefit from getting plenty of rest, staying hydrated, and eating a healthy, balanced diet. Depending on the symptoms, treatment may include over-the-counter medication for pain or prescription treatments from your doctor.
At this point, there are no drugs specifically approved to treat long COVID-19. However, there are many medications and therapies available to treat the different symptoms of the condition. Ask your doctor to examine your breathing, cardiovascular function, mental health, and any neurological symptoms. After your doctor has a clear idea of how your body is being affected, they can recommend the best treatment plan for you.
Stress can aggravate COVID-19 symptoms, so it is important to treat any mental health issues, particularly if you have a history of such illness. Ask your doctor about stress management techniques or therapy that can help.
Depending on your long COVID-19 symptoms, you may need a team of health care workers to help you. Your team might include:
Ask your primary care doctor about other specialists you may benefit from seeing.
On myCOVIDteam, the social support network for those recovering from the effects of COVID-19, you can connect with others. Members come together to ask questions, give advice, and share their stories with others who understand living with the effects of COVID-19.
Are you living with long COVID-19? Share your insights in the comments below, or start a conversation by posting on myCOVIDteam.
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Robert Hurd, M.D.
is a professor of endocrinology and health care ethics at Xavier University. Review provided by VeriMed Healthcare Network.
Learn more about him here.
Marion Scher
has been one of South Africa's top freelance journalists and media consultants for the last 33 years.
Learn more about her here.
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