Exploring the Reality of COVID Long Haulers and Long COVID

Although we’re pretty familiar with the short-term symptoms of COVID-19, we’re still finding out more about COVID long-term effects. The coronavirus pandemic has only been largely affecting lives for a little over a year, so we're learning more each day about long-term symptoms and effects.

What are COVID long haulers and what is long COVID?

Also called acute COVID-19 and COVID-19 syndrome, long COVID is a series of long-term symptoms present in some who have caught COVID-19. There are tens of thousands of people in the US suffering from lasting symptoms from the COVID-19 pandemic. One study, found that only 65% of people had returned to their previous level of health 14-21 days after a positive test.

Any COVID-19 patients can present symptoms of long COVID, whether they initially showed symptoms or not. According to the Centers for Disease Control (CDC), Long COVID can persist weeks or months from the first infection. Long-haul COVID patients experience persistent symptoms and health issues, even if their original case of COVID-19 was mild. Whether your infection landed you in the ICU or you never had symptoms in the first place, anyone who was infected should follow up with a healthcare provider if symptoms persist.

Why do some people go on to have long-term effects of COVID-19?

It’s not currently known why some people are more prone to long COVID and why some people’s recovery is prolonged.

There are a few theories as to why long haulers exist. One is that their immune system may still be continuing to respond even after the initial illness (which may have been mild) is gone. But it’s important to note that people with long COVID are not thought to be infectious, unless they have caught the virus again. Most of them test negative for COVID.

Another theory is that once infected, the virus somehow alters the autonomic nervous system, which is responsible for maintaining heart rate, blood pressure, temperature, and digestive health, among other things. More research is being done and needed, to determine exactly how this can happen--contributing to prolonged symptoms.

While children can be affected, it’s more common in adults, especially those with certain risk factors. There’s some evidence to suggest that some people may be at greater risk of developing long COVID, in particular:

• older adults
• women
• people with pre-existing asthma or similar medical conditions
• people with a greater number of initial symptoms in the first week of their initial illness

What are the common symptoms of long COVID?

The number of post-COVID-19 long-haul symptoms you can experience is long and not necessarily consistent between cases. Medical centers are doing their best to catalog the numerous side effects of long COVID, though symptoms can vary from person to person and are wide-ranging. They can affect different parts of the body, can fluctuate and change in nature over time.

The most commonly reported long-term COVID symptoms include:

Neurological (brain and nerve) symptoms such as:

• ‘Brain fog’ (problems concentrating or slowed thinking)
• Memory loss
• Headaches
• Insomnia (problems sleeping)
• Pins and needles or numbness in the body’s extremities such as the hands, feet or arms
• Dizziness
• Delirium (sudden confusion), in older people

Symptoms related to the ears, nose and throat such as:

• Tinnitus (the sensation of ringing or buzzing in the ears)
• Earache
• Sore throat
• Vertigo (spinning sensation)
• Loss of, or change in sense of taste or smell

Cardiovascular (heart) symptoms such as:

• Chest tightness
• Chest pain
• Palpitations (heartbeats that suddenly become more noticeable)
• Blood clots

Pulmonary (lung) symptoms such as:

• Shortness of breath
• Cough, which can be both dry or with mucus

Gastrointestinal (gut and digestive) symptoms such as:

• Abdominal pain (stomach ache)
• Nausea
• Diarrhea
• Weight loss and reduced appetite, in older people

Symptoms related to the muscles and joints such as:

• Joint pain, for example back, rib or neck pain
• Muscle pain

Symptoms related to the skin such as:

• Rashes, which may look like hives, prickly heat or chilblains

Other symptoms such as:

• Fatigue (feeling tired), which can range from mild fatigue to extreme exhaustion and chronic fatigue
• Temperature changes
• Mental health problems such as depression or anxiety
• Loss of smell or taste

How long can it take to recover from long COVID?

Recovery time is different for everyone but for most people, symptoms will resolve by 12 weeks. Most people with long COVID will be able to continue life as normal, but for a small number, their mental and physical health may be severely affected to the point where their symptoms limit their ability to engage in work and family activities at their previous level. Research is ongoing about why this happens, and how to best help these patients.

Speaking to a healthcare professional about your symptoms

If you’re worried about new, ongoing or worsening symptoms, especially if you’ve had them for more than 4 weeks after the start of suspected or confirmed COVID-19, speak to a clinician. Health systems are currently working to address the new public health concerns of long COVID.

If you’re experiencing symptoms such as worsening breathlessness, unexplained chest pain, new confusion, or new weakness in the face, arms or legs, seek urgent medical attention as this could be a sign of a serious condition.

Clinical tests are not always needed to diagnose long COVID, but they may be used to rule out other causes of your symptoms. Blood tests, chest x-rays, blood pressure and heart rate are some of the tests that may be requested. Your doctor will give you tips to help you monitor and manage your physical symptoms at home, and offer you mental health support if needed. Other therapies may be offered depending on your symptoms. Referral to specialist rehabilitation services are not needed for most people, but depending on where you live and your symptoms, this may be an option to help you recover.

If you are experiencing COVID long-haul symptoms, speak to your health care provider before receiving a COVID-19 vaccine. The current effects of vaccination while experiencing symptoms of long COVID are unknown. Your healthcare provider can help discuss the risks versus benefits and explain what is known, and what is unknown about this.

Sources

• Post-COVID Conditions - CDC
• Long haulers: Why some people experience long-term coronavirus symptoms - UC Davis Health
• The tragedy of long COVID - Harvard Health Publishing
• COVID-19 (coronavirus): Long-term effects - Mayo Clinic
• What It Means to Be a Coronavirus “Long-Hauler” - Cleveland Clinic