What we know about long-term COVID-19 right now

At least 1 in 10 people who get COVID-19 still have frustrating symptoms – like fatigue and brain fog – weeks or months later. Here’s what scientists have learned so far about the most common lingering effects and how to manage them.

COVID-19 affects everyone differently. Some people who test positive never have symptoms. For others, their health quickly gets worse, and they end up in the hospital. And some get better from the first infection but still have symptoms weeks or months later. 

Officially, this is called “post-acute COVID syndrome.” But you’ve probably heard it referred to as long-haul COVID. “It’s not something we have a complete handle on,” says Kathryn Boling, MD, a family doctor with Mercy Medical Center in Baltimore. “The hallmark of this virus is that it hits different people in different ways. That’s what happens with the long-haul syndrome, too. I’ve seen post-COVID patients with many different health problems, from a pulse that randomly speeds up and slows down to deep fatigue to extreme shortness of breath. They may have a tough time just walking up a flight of stairs.”

The exact number of people with these symptoms isn’t known yet. One report published in JAMA Network in February 2021 found that a third of the patients were coping with fatigue, loss of taste or smell, or brain fog as long as nine months after their initial infection. Another study reviewed the records of more than 1,400 people in California who had mild or moderate cases of COVID (no one required hospitalization). After 60 days, 27% still had ongoing symptoms. 

Any virus can have symptoms that hang on after the first infection is over. But the effect seems to be worse with COVID-19. “Post-viral syndrome is nothing new,” Dr. Boling says. “Lots of people with a bad virus, like the flu, have symptoms after they get better. But with COVID, it’s more severe. It lasts longer and the effects can be vicious.”

Doctors are still figuring out what this syndrome is and how to take care of it. “Even 10 months out, some people just aren’t functioning properly,” says Christian Sandrock, MD. He’s an infectious disease specialist at the UC Davis Health Post-COVID-19 Clinic. “COVID is a new disease, and this is all a work in progress. There’s so much we don’t know yet.”

But scientists are learning more every day. Here’s what we know so far.
 

Almost anyone can develop post-acute COVID syndrome

Anybody who’s had COVID-19 can have lingering symptoms long after they’re “officially” better. “Some people have post-acute syndrome after being severely ill in the ICU,” says Dr. Sandrock. “But I’ve seen patients who were never seriously ill, or who never went to the hospital.”

For reasons we don’t yet fully understand, women are more likely to develop it than men. Age can play a part, too. Last spring, the Centers for Disease Control and Prevention (CDC) contacted 292 people who had tested positive for COVID. Those older than 50 were nearly twice as likely to report lingering symptoms as those between the ages of 18 and 34.

One of the best ways to reduce your chance of developing post-acute COVID syndrome is to get vaccinated. Learn more about COVID-19, including the vaccines, testing and getting care, through our member site.
 

There’s a constellation of symptoms

Some of the most common symptoms of post-acute COVID syndrome are:

• Fatigue
• Muscle weakness
• Cough
• Shortness of breath
• Chest pain
• Headache
• Loss of smell or taste
• Difficulty concentrating
• Insomnia

More unusual symptoms, such as rashes, hair loss, and kidney injury, can happen, too. “We’ve seen so many different kinds of post-acute COVID patients,” says Dr. Sandrock. “Some are really sick and knocked down. Others have symptoms like low-grade fever or fatigue that gets a little better, then gets a little worse.”

Brain fog is common

Many people report trouble concentrating or thinking clearly after they’ve had COVID-19. You may have mental health challenges, too, such as depression or anxiety. “If you feel lethargic or depressed or have brain fog, you’re not crazy,” says Dr. Sandrock. “It may be caused by limited blood flow to the frontal lobe of your brain.”
 

Having another health condition makes you more likely to get post-acute COVID 

Even healthy young adults can have post-acute COVID syndrome. But people who already have other medical conditions are more likely to suffer. The CDC poll found that 48% of patients with high blood pressure – and 55% of obese patients – had the syndrome.
 

Special post-acute COVID clinics are opening around the country*

As more people deal with these ongoing symptoms, hospitals are creating dedicated centers to help them. You may need to go for testing in person. “Expect blood work, a test to see how well your lungs are working, and perhaps an echocardiogram or magnetic resonance imaging (MRI) scan,” says Dr. Sandrock.

Treatment will depend on what the doctors find. “I’ll usually do an EKG in the office. Then if I’m concerned, I’ll send the patient for a follow-up with a cardiologist,” says Dr. Boling. “That’s because post-COVID inflammation can put you in danger of heart problems. Or I may order a CT scan of the lungs to look for underlying damage. That might be treated with inhalers.”

The most important advice: Don’t wait for problems. If you’re not feeling right in a week or two, call your provider. Make an appointment for a telehealth visit. Or book an in-person visit as soon as you’re no longer contagious.

“There is hope,” says Dr. Boling. “You will most likely get better. It may just take some time.”

*Not all post-acute COVID clinics may be available to all members. Out of pocket expenses may also vary by plan. Read more about Getting COVID-19 Care. Check your Summary of Benefits or plan documents for information about standard out-of-pocket costs for your plan. You can also log in to your online account to see what benefits your plan covers. If you need more guidance, please call the customer care number on your member ID card.

The information in this story is accurate as of press time and posting. Getting vaccinated is one of the best ways to limit the spread of the coronavirus. It’s also important to continue practicing social distancing (keeping at least 6 feet away from people outside your household) and washing your hands frequently. You should also be appropriately masked any time you’ll be in public. According to the CDC’s latest guidance, this means layering a disposable mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDC, WHO, their local public health department and our COVID-19 member site.