Strategic COVID-19 Pandemic Committee

What is Long COVID?

COVID-19 Questions & Myths

There is a widespread perception that people either die, get admitted to hospital or recover after two weeks. However, it is now clear that some people, even those with mild initial infections, continue to suffer from ongoing symptoms for weeks or months.  Studies have shown that while the majority of people with mild infections fully recover within two weeks, between 10% and 20% of people continue to have symptoms that are often disabling for weeks or months.  This is now called “Long COVID” and is defined by persistent symptoms lasting longer than 4 weeks.  Those suffering from it have called themselves “Long-haulers”. 

The frequency and severity of Long COVID is even higher in people who have had more severe disease requiring admission to hospital or to the ICU.  A study from Italy found that only 12.6% of patients who had required admission to hospital had fully recovered at two months.  People who have required ICU admission and treatment on mechanical ventilators for COVID have been found to have the most severe long-term effects with many being disabled by Long COVID symptoms for months.

Common Long COVID symptoms include:
-extreme tiredness (fatigue)
-shortness of breath
-cough, sore throat
-chest pain or tightness
-problems with memory and concentration ("brain fog")
-difficulty sleeping (insomnia)
-heart palpitations
-dizziness
-pins and needles
-joint pain
-depression and anxiety
-tinnitus, earaches
-nausea, diarrhea, stomach aches, loss of appetite
-headaches, changes to sense of smell or taste
-skin rashes

These symptoms often arise in one part of the body, then ease, only for new symptoms to arise in a different system.  Many say this prolonged illness severely impacts their lives, often leaving them unable to cope with work or enjoy activities.  Extreme fatigue, muscle aches, and brain fog appear to be among the most the common symptoms in long haulers.  People who have required hospitalization or ICU care for severe COVID pneumonia often have respiratory difficulties and mental health problems such as anxiety, depression, adjustment disorder, and post-traumatic stress disorder.

Brain fog is among the most confusing symptoms for long-haulers. Patients report being unusually forgetful, confused or unable to concentrate even enough to watch TV. This can happen to people who were in an intensive care unit for a while, but it is relatively rare. However, it is happening to a variety of patients, including those who were not hospitalized. Some people have reported feeling better for days or even weeks then relapsing.

There is not much information on long-haulers, who only recently received attention from experts because it is new. The vast majority of long haulers test negative for COVID-19 and many are investigated for rare organ specific complications of COVID including blood clots to the lung, inflammation of the heart muscle (myocarditis), and abnormal blood pressure responses to standing up.

One common theory about patients with long-term COVID-19 symptoms is that the virus possibly remains in their bodies in some small form. Another theory is their immune systems continue to overreact even though the infection has passed.

However, because Long COVID has such a wide range of symptoms, and scientists and medical professionals are unsure what this phenomenon is or how to treat it, it means many people are unable to access appropriate support.  Post COVID clinics have been set up in some hospitals to treat people with the most severe forms of Long COVID.  The World Health Organization has developed guidance for self-rehabilitation for people with milder forms of the condition. 

Interestingly, there are some media reports that people with Long COVID sometimes feel significantly better following COVID vaccination. 

It is hoped that ongoing research into this increasingly common phenomenon will provide information on how it is caused and options for treatment.

References:
i. Post-COVID Conditions, Centers for Disease Control and Prevention
ii. Support for Rehabilitation: Self-Management after COVID-19 Related Illness, World Health Organization
iii. Anecdotal evidence suggests vaccine relieves long COVID, Healthline