Understanding Long COVID: Symptoms, Treatment, & Risks

Long COVID, also known as Post-COVID Conditions, has affected nearly 23 million Americans, leaving them with persistent, recurring, or new symptoms long after the initial SARS-CoV-2 infection. 

These symptoms can range from mild to severe, lasting for weeks, months, or even years, affecting various organs or systems within the body. The National Institutes of Health (NIH) estimate that approximately 1 million American workers are unable to work due to the debilitating effects of Long COVID.

 

What Is Long COVID?

Post-COVID conditions, also known as Long COVID, are defined as a wide range of health problems affecting nearly any organ or system in the body. If symptoms last for four or more weeks after the initial SARS-CoV-2 infection, a person is then said to be suffering from Long COVID.

The CDC suggests that roughly 1.5 in 10 patients with COVID-19 infections caused by the omicron variant will end up developing Long COVID symptoms.

Currently there is no way to tell which patients will develop Long COVID. Though, the prevalence of certain risk factors can exponentially increase a person’s chances of developing the condition.

 

Risk Factors for Long COVID

Most people that develop Long COVID can vividly recall when they first fell ill with the coronavirus. However, those with mild or asymptomatic cases can develop Long COVID without ever being aware of their initial COVID-19 infection.

People infected with certain strains of SARS-CoV-2, that suffer from severe COVID infections, have underlying medical conditions, or belong to certain groups are at an increased risk for Long COVID. Some of these risk factors include:

Strain Type: Research suggests that people infected with newer variants of the SAR-CoV-2 virus (i.e. Omicron) are less likely to develop Long COVID.

The Severity of Infection: More severe cases of COVID-19, especially those resulting in hospitalization, increase the risk of developing lingering symptoms.

Amount & Timing of infections: Repeated exposure to or infection by the virus can increase the chances of developing recurrent symptoms. Those infected before the 2021 Omicron strain emerged are also at increased risk.

Vaccination Status: Long COVID appears to be more prevalent in the unvaccinated population.

Underlying Medical Conditions: Any medical conditions that can increase your risk of developing severe COVID-19 also increases your chances of developing Long COVID. Some of these conditions include kidney disease, lung disease, diabetes, heart conditions, obesity, and immunodeficiencies.

Sex: On average, research shows that Long COVID affects more women than men.

Age: Older people are more likely to experience more severe COVID infections and have an increased risk of developing Long COVID

Race: Black and Hispanic adults are more likely to experience Long COVID symptoms.

Note: Not everyone with any of these risk factors will end up being diagnosed with Long COVID or will experience lingering symptoms of the coronavirus. However, the more risk factors a person has, the more likely they are to develop the condition. Because of this, it is essential to understand your personal risk factors and remain vigilant in the weeks and months after any case of COVID-19.

 

Common Problems & Symptoms Associated With Long COVID

For every patient suffering from Long COVID, their symptoms are as unique as they are. NIH’S Researching COVID to Enhance Recovery (RECOVER) initiative has identified the 12 most common symptoms in Long COVID patients.

• Post-exertional malaise – symptoms worsen after any physical or mental activity
• Fatigue
• Brain fog
• Dizziness/ Lightheadedness
• Parosmia – new loss of taste/smell
• Gastrointestinal symptoms – nausea, vomiting, diarrhea, loss of appetite, unexplained weight loss
• Heart palpitations
• Decreased sex drive
• Excessive Thirst
• Chronic cough
• Chest pain
• Abnormal movements

But these are not the only symptoms that are associated with Long COVID. Those that suffer from Long COVID have also reported experiencing:

Respiratory Symptoms:

• Shortness of breath
• Chest tightness
• Wheezing
• Hypoxia – low oxygen levels
• Difficulty breathing during physical activity

 

Cardiovascular Symptoms:

• Chest pain or pressure
• Tachycardia – high heart rate
• Hyper- or Hypotension – abnormal high or low blood pressure
• Presyncope & Syncope – episodes of near or complete fainting
• Blood clots

 

Neurological Symptoms:

• Headaches & Migraines
• Restless legs
• Vision Changes – blurry vision, double vision, loss of depth perception
• Temporary Paresthesia – feeling of pins & needles
• Dysphagia – difficulty swallowing

 

Psychological Symptoms:

• Mood swings
• Sleep Disturbances & Insomnia
• Difficulty coping with stress or emotional challenges
• Anxiety
• Depression
• PTSD  – Post Traumatic Stress Disorder

 

Pain & Weakness:

• Muscle weakness
• Muscle aches
• Chronic pain – can happen all over the body or be confined to the abdomen, stomach, joints, and/or nerves

 

Other Symptoms:

• Skin rashes or unusual skin sensations
• Hair loss or changes in hair texture
• Recurrent Fever
• Light & Noise sensitivity
• Numbness
• Tremors
• New allergies
• Menstrual changes
• Decreased sex drive

Treatments for Long COVID

Long COVID is a syndrome — meaning that it comprises different symptoms that occur at the same time — and no two patients present with the condition in the same way. People’s symptoms can also change the longer they live with Long COVID or based on their day-to-day activities. Because of this, doctors are having a hard time spotting the condition and offering successful treatments to patients.

Because of the nuances of this condition, patients must keep track of their symptoms on their own, and advocate for themselves.. Sometimes, they even have to act as a mediator between all the different doctors and specialists that must collaborate to design their best plan of care. Below are a list of possible ways patients can manage their Long COVID.

• Symptomatic Relief: Medications may be prescribed to address specific symptoms such as pain relievers for muscle aches (e.g., acetaminophen), antihistamines for allergies or nasal symptoms, or cough suppressants.

• Physical Therapy and Rehabilitation: For individuals experiencing muscle weakness, fatigue, or difficulty with mobility, physical therapy can help in regaining strength, flexibility, and stamina.

• Respiratory Therapy: Patients with persistent shortness of breath may benefit from respiratory therapy techniques to improve lung function and breathing exercises.
• Cognitive Behavioral Therapy (CBT): CBT can assist in managing anxiety, depression, or coping with the mental health challenges that often accompany long COVID.
• Cardiac Rehabilitation: For those with cardiovascular symptoms or complications, supervised exercise programs tailored to individual needs can be beneficial.
• Pacing and Energy Management: Learning to pace activities and manage energy levels to prevent symptom exacerbation is important. Patients are often advised to avoid overexertion and to take frequent breaks.
• Nutritional Support: A balanced diet is recommended to support overall health and recovery. Some individuals may benefit from nutritional counseling if gastrointestinal symptoms affect eating habits.
• Support Groups and Counseling: Engaging in support groups or seeking counseling can provide emotional support and help in coping with the challenges of living with long-term symptoms.
• Medication Adjustments: In some cases, if symptoms persist or worsen, healthcare providers may adjust medications or try different approaches to alleviate specific symptoms.
• Multidisciplinary Care: A team-based approach involving various specialists (such as pulmonologists, neurologists, cardiologists, physiotherapists, mental health professionals, etc.) may be employed to address the diverse and complex nature of long COVID symptoms.

 

Risks of Untreated Long COVID

• Persistent Symptoms Worsening: Symptoms such as fatigue, shortness of breath, cognitive issues, and muscle pain can persist and potentially worsen over time without appropriate management or treatment.
• Increased Risk of Long-Term Health Problems: Some individuals with Long COVID might be at risk of developing chronic health issues, such as chronic fatigue syndrome, ongoing respiratory problems, cardiac issues, neurological complications, or mental health disorders like depression or anxiety.
• Reduced Functional Capacity: Without proper management, persistent symptoms can limit a person’s ability to perform daily activities, work, or engage in physical and social activities, leading to a reduced functional capacity and impact on overall well-being.
• Psychological Impact: Prolonged illness and persistent symptoms can lead to psychological distress, including anxiety, depression, or stress due to uncertainty, ongoing health issues, and the impact on daily life.
• Complications with Organ Systems: Long COVID can affect multiple organ systems, potentially leading to complications involving the respiratory system, cardiovascular system, neurological function, and more. Without appropriate care, these complications may persist or worsen.
• Long-Term Disability: In severe cases or when symptoms significantly limit a person’s abilities, there might be a risk of long-term disability, affecting employment, social interactions, and overall independence.
• Increased Healthcare Utilization: Untreated long COVID might lead to increased visits to healthcare providers, emergency department visits, and hospitalizations due to exacerbation of symptoms or complications.

 

——-

Note: The information provided in this article is for educational purposes only. Always consult with healthcare professionals for personalized advice and treatment plans tailored to your individual health needs.

 

Sources: CDC, NIH, NHS, WHO, American Medical Association, John Hopkins Medicine, Yale Medicine, RECOVER, Health Affairs