Three years after the global outbreak of the COVID virus, some survivors are still living with its long-term effects. The condition is known as long COVID, post-COVID, long-tail COVID, or long-haul COVID. In most cases, a few days or weeks after getting COVID-19, you are likely to notice a significant improvement in your symptoms and, in some cases, no signs.
This isn't the case for people with long COVID. Up to 24 million Americans may be living with long COVID. In a study by the Centers for Disease Control and Prevention (CDC), researchers found that one in five people under the age of 65 may get long COVID¹ after being infected with the COVID-19 virus. This number is one in four for people over the age of 65.
According to the Centers for Disease Control and Prevention (CDC), over 30% of people hospitalized with COVID-19 for six months may develop long COVID. Researchers are unsure what to make of this novel condition. While long COVID is more likely to occur in people who had severe symptoms when they initially contracted the virus, it can also occur in people who had mild symptoms. Long-term COVID could also happen in children, although it's much rarer than in adults.
What distinguishes long COVID from COVID-19 is how long you continue to have symptoms after your initial infection. The World Health Organization (WHO) describes long COVID or post-COVID-19 as persistent or recurring symptoms of the coronavirus three months after you first became ill.² Unlike COVID-19, long COVID isn't contagious. Long COVID may manifest in three ways:
Not recovering completely from an initial COVID-19 infection
Exhibiting symptoms as a result of an extended stay in the ICU
Exhibiting symptoms after already making a recovery from the initial infection
It may be challenging to make a definitive list of the symptoms of long COVID. People with the condition exhibit a wide range of symptoms. These symptoms can last for months, and what some fear may even be years. It doesn't help that, in some cases, the symptoms may dissipate and reemerge.
Symptoms of long COVID are similar to the COVID-19 virus. The most recurring long COVID symptoms³ that people with the condition have reported include:
Shortness of breath
Difficulty concentrating, also known as brain fog
Altered sense of smell and taste
Joint or muscle pain
Research is still ongoing into the various symptoms people with long COVID exhibit. Of all the above symptoms, the most commonly reported are fatigue, loss of smell and taste, shortness of breath, and muscle and joint pain.
People with Long COVID are prone to medical complications from experiencing the virus's long-term effects. Unfortunately, little is indeed known about the long-term effects long COVID is likely to cause in people living with the condition. The following medical complications have been linked to the aftereffects of being infected with the COVID-19 virus.
People who had a severe case of COVID-19 may experience a condition known as post-intensive care syndrome (PICS)⁴. PICS occurs due to extended periods in the intensive care unit (ICU). Symptoms include difficulty concentrating and thinking, weak muscles, anxiety, and stress. PICS also increases a person's risk of developing mental health conditions such as depression⁵.
People with PICS may also experience cognitive problems and find it challenging to recover from their illness physically. Research shows that spending a prolonged time in the ICU can cause delirium⁵. They might experience hallucinations and delusions due to being isolated in strange surroundings and put through several courses of medication their bodies are unused to.
Researchers have already begun noticing a pattern of mental health conditions such as depression and post-traumatic stress disorder⁶ in people living with long COVID or severe symptoms of COVID-19. However, this phenomenon isn't unique to people who have had COVID. It can also be observed in people who have lived with critical conditions such as cancer.
One of the most common complications of COVID-19 is scarring and damage to the lungs, which can also be observed in people with long COVID. In some instances, COVID-19 survivors have been found to have scarring on their lungs, which has been linked to lung infections and breathing issues⁷.
One of the symptoms some people with long COVID experience is shortness of breath, which is thought to be caused by the scarring on their lungs. In a 2022 study, researchers observed that 44.9% of COVID-19 survivors with severe symptoms often show signs of pulmonary fibrosis⁸. Pulmonary fibrosis is a condition that causes damage to your lungs and can cause long-term breathing difficulties.
At the start of the pandemic, diabetes was identified as a risk factor for experiencing severe symptoms of the infection. For some reason, a small percentage of people with long COVID are developing type 2 diabetes, and researchers can't seem to figure out why.
Another health complication that might occur is heart problems. In a 2020 study, researchers observed that up to 60% of participants who had been infected with COVID-19 and recovered showed signs of heart inflammation⁹. Heart inflammation ranges in severity. However, it could cause symptoms such as heart palpitations, coughing, difficulty breathing, and weakness.
The virus which causes the COVID-19 infection has been shown to cause kidney damage¹⁰ in some people, even if they showed no signs of kidney disease before being infected with the coronavirus. Researchers are unsure why this occurs and are unable to predict who is likely to develop this. However, damage to the kidney can increase your risk of developing long-term kidney disease.
One of the most immediately telling symptoms of long COVID is a persistent loss of a person's sense of taste and smell¹¹. These symptoms have also been observed in people initially diagnosed with COVID-19. However, for people without long COVID, these symptoms resolved in a couple of weeks.
For some people with long COVID, these symptoms persist, disrupting their daily functioning. Eating certain foods they might have enjoyed before having COVID-19 may now be unpleasant.
Symptoms such as difficulty concentrating and headaches are brought on by cognitive aftereffects of being infected with COVID-19¹². Researchers have observed that some people with long COVID experience a significant shift in the way they think, concentrate, and even their ability to remember things.
These symptoms can severely disrupt a person's daily functioning in severe cases. Activities like work, school, and socializing become more challenging.
It's not entirely understood what causes long COVID because the condition is relatively new. Scientists and researchers are working tirelessly to understand what causes the disease. It's established that it might occur in people with severe symptoms at the point of initial infection¹³, but some people with mild symptoms have also gone on to develop long COVID.
With COVID-19, certain underlying conditions such as hypertension and diabetes increase the risk of developing severe symptoms when infected with the virus. On the other hand, these factors seem to play no role in determining whether a person will develop long COVID.
The virus responsible for COVID-19 is capable of causing damage multiple organs in your body¹⁴. It has been shown to affect the lungs, heart, brain, liver, and other organs. It's suspected that long COVID occurs due to this multi organs assault. Its wide-reaching effects on your body are also why people with this condition experience a wide range of varying symptoms.
Not everyone with COVID-19 will go on to develop long COVID. Some people are at a higher risk of developing post-COVID symptoms than others. There is no exact science to determine who will likely develop long COVID. Primarily because, in some scenarios, people who had mild symptoms when they initially got the virus may develop long-term symptoms¹⁵.
Researchers are considering several factors by studying people diagnosed with long COVID. They've identified that healthcare inequalities brought on by either geography or race might play a factor¹⁶. For instance, poorer countries have less access to quality healthcare and, as a result, are less likely to get adequate treatment for their symptoms. This could lead to long-term complications.
The following groups of people have also been identified as being at a higher risk of developing the condition:
People who haven't been vaccinated for COVID-19
People who experienced severe symptoms of COVID-19
People who had underlying medical conditions before they got COVID-19
Unfortunately, there's currently no test to diagnose long COVID as there was with COVID-19. Many people with long COVID are likely to test negative for the virus that caused COVID-19¹⁷. If you test positive for COVID-19, it's more likely that you've been reinfected with the virus. People with this condition also experience varying symptoms, making an initial diagnosis difficult, especially for people who might not have been diagnosed when they initially contracted the virus.
To make a diagnosis, your healthcare provider will consider your medical history. If you have been diagnosed with COVID-19 or exhibited symptoms of the virus, long COVID will be considered.
There's no blanket treatment for long COVID. This is partly because it manifests such a wide range of symptoms. It's also a relatively new condition, and scientists and researchers are looking for the best treatment approach.
Your healthcare provider will focus on managing your symptoms and helping you recover from them. Some clinics have begun to develop specialized units focused on supporting people living with long COVID. It's unclear how long it will take a person to recover from long COVID fully.
The good news is that some research shows that experiencing long-term symptoms after a viral illness isn't uncommon. They observed that symptoms could last up to twelve months in certain people before recovery.
Living with long COVID can be demanding, especially when your symptoms come in the way of your daily functioning. If you haven't been vaccinated, doing so is highly advisable. Research shows that people vaccinated for COVID-19 are less likely to experience post-COVID symptoms¹⁸ than those who haven't been vaccinated. While you can be infected with COVID-19 even after being fully vaccinated, you are less likely to experience severe or debilitating symptoms.
Suppose your long COVID symptoms are so severe that they disrupt your daily functioning. In that case, your doctor may ask you to consider a rehabilitation service with more expertise in managing your unique symptoms. Other tips to help you cope with the condition include:
Slow down: While your recovery might be taking longer than most, you are still in recovery from COVID-19, and it's important to pace yourself, especially when carrying out physically exerting tasks.
Exercise regularly: You might have to train specific muscles, such as muscles in your lungs, to help them function correctly again. Exercise, in this case, includes breathing exercises that may help you strengthen your lungs.
Take care of your mental health: Do things that spark joy and speak to someone about any difficulties you might have. Living with long COVID can be an isolating experience, especially when witnessing people around you seemingly making a full recovery from the virus.
Get enough sleep: While some people report difficulty sleeping as a symptom of long COVID, the importance of getting enough sleep can't be overemphasized, especially if you are also experiencing brain fog. Establish a bedtime routine to help you sleep through the night. Stay away from blue light-emitting screens at least an hour before bedtime, and avoid caffeine or other stimulating substances hours before sleep.
Stimulate your brain: If you have brain fog or any other cognitive challenges resulting from long COVID, engaging in activities stimulating your brain can help you work through it. Read, meditate, socialize and try to learn something new now and then.
If you are still experiencing symptoms of COVID-19 up to four weeks after your initial infection, you should contact your healthcare provider. Many of its symptoms can be new and confusing. If you know no one else with long COVID, it can feel isolating to cope with the condition on your own. The good news is that there are support groups you can join with other people living with the condition and healthcare providers who can provide you with valuable information and resources.
Working to prevent the spread of COVID-19 goes a long way in helping to protect you and others from developing long COVID. If you've been vaccinated once, you might want to consider getting booster shots. The COVID-19 virus continues to mutate, and new variants have been discovered. Long COVID is still being researched, and we expect scientists to learn much more about its cause, treatment, and prevention in the coming years. It's essential to report any potential symptom of long COVID to your healthcare provider so that they can help you stay on top of it.
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Nearly one in five American adults who have had COVID-19 still have “long COVID” | Centers for Disease Control and Prevention (CDC)
A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 | World Health Organization
Signs and symptoms of long COVID | NHS Inform
Post-intensive care syndrome (PICS) | Cleveland Clinic
The impact of long COVID-19 on mental health: Observational 6-month follow-up study (2022)
COVID-19 lung damage | Johns Hopkins Medicine
Post COVID-19 pulmonary fibrosis; a meta-analysis study (2022)
Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19) (2020)
Coronavirus: Kidney damage caused by COVID-19 | Johns Hopkins Medicine
Long COVID: Loss of smell or taste | NHS Inform
COVCOG 2: Cognitive and memory deficits in long COVID: A second publication from the COVID and cognition study (2022)
Long COVID or Post-COVID conditions | Centers for Disease Control and Prevention (CDC)
Long COVID: Long-term effects of COVID-19 | Johns Hopkins Medicine
Long COVID and health inequities: The role of primary care (2021)
Long COVID: Some COVID-19 symptoms last for months | UCDavis Health
Do vaccines protect against long COVID? What the data say | Nature
Toketemu Ohwovoriole is a healthcare writer who has spent the last six years creating content for companies and publications around the globe. She has been featured in The Huffington Post, Insider, Verywell, and other major publications. Her previous work delves into the mental and physical health effects of birth control, overall wellness, and sensitive women's healthcare issues.
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