FeverCoughingDifficulty breathing, or shortness of breathFatigueBrain fog (difficulty thinking or concentrating)Joint or muscle painHeadacheDiarrheaSkin rashesLoss of taste or smell
In other cases, new symptoms that were not part of the initial bout of COVID may develop for the first time in the weeks or months after the initial infection. According to the CDC, these can include:
Mood changesChest painHeart palpitationsStomach painSleep problemsDizziness or lightheadedness upon standingA feeling of pins-and-needles in the bodyExhaustion or other symptoms after physical or mental activities (known as post-exertional malaise)Changes in menstrual cycles
Other experts have pointed to the immune system, which perhaps mistakenly continues its attack against SARS-CoV-2 even when the virus is gone, damaging normal cells in a reaction called a cytokine storm. Researchers are investigating other possibilities, too. Experts aren’t sure what might make a person prone to long COVID. Early research has pointed to several potential risk factors that seem to be associated with developing the condition, but this research is preliminary and ongoing.
The level of coronavirus RNA in the blood early in the infection (which can indicate how much virus is in the body)The presence of certain autoantibodies that might mistakenly attack body tissuesThe reactivation of a prior bout of the Epstein-Barr virusHaving type 2 diabetes
Most doctors use existing tests and tools to evaluate specific symptoms. For example, if a person with long COVID is regularly short of breath, their doctor would likely perform a variety of pulmonary function tests to assess their lung health. If the person is experiencing heart palpitations, their physician might instruct them to wear a heart monitor. Physicians have no way to evaluate symptoms like extreme fatigue or brain fog. If you believe you are experiencing long COVID, experts suggest you keep a detailed log of your symptoms and bring it to your doctor to help them make a diagnosis.
Prognosis for People With Long COVID
Scientists studying long COVID say that many if not most people do eventually return to (or close to) their pre-disease state. But much is not yet known about patients whose long COVID persists. Since the condition is new, experts can’t say that everyone with symptoms of long COVID will eventually get better. But that’s not true of everyone. There are some members of the Body Politic group who have had the condition since contracting COVID soon after the disease was first discovered more than two years ago. For example, someone who experiences brain fog may be referred by their doctor for cognitive rehabilitation, akin to physical therapy for the brain. During the rehab they might be taught ways to improve concentration or memory, or they may learn strategies to compensate for problems thinking, such as by consciously marking their place in a work task when the phone rings. People with long COVID can be treated by their general practice physician or by individual specialists for the body parts affected by their condition, such as a cardiologist for heart issues. Another option is to visit a clinic dedicated to long COVID care. These long COVID clinics are opening around the country, and many are affiliated with large community or academic hospitals; the website of the patient support group Survivor Corps offers a list of long COVID clinics across the United States. Still, the ratio of clinics to people grappling with symptoms is low, so many clinics have patient wait lists. Experts agree that much more research is needed on long COVID in order to enable better care. To that end, President Biden signed an executive order in April 2022 directing a coordinated research and treatment effort by the federal government. Among other things, the order builds on a long COVID research study, called RECOVER, that is underway at the National Institutes of Health. Other ways of protecting yourself from COVID-19, and therefore long COVID, include wearing a well-fitting, high-protection respiratory mask, avoiding crowds in poorly ventilated spaces, washing your hands frequently, and regularly using rapid tests on yourself and those with whom you will be spending time indoors, to detect who might have the virus. Some experts distinguish these conditions from long COVID, because they can appear in people who don’t have any of the common symptoms that currently define long COVID. Long COVID can also harm emotional health. Whether that’s a function of the condition itself or other people’s response to it remains unclear. A major research effort called the CLoCk study is underway in the United Kingdom to better understand long COVID in children. In this research, conducted by the National Institute for Health and Care Research, thousands of kids ages 11 to 17 who have previously been diagnosed with COVID-19 are being compared with children who have not tested positive. Black Americans and Latinos as a group are also more prone to contracting COVID-19, in many cases because they work in jobs and live in housing that puts them in more contact with other people, in contrast to people from communities that have not been actively disadvantaged over the years. These groups provide information, guidance, emotional support, and the knowledge that no one with long COVID has to face it alone. Some of the largest groups include:
Body PoliticSurvivor CorpsLong COVID AllianceLong COVID Kids