Long COVID
Post-COVID; Post-COVID conditions; PCC; Long-haul COVID; Post-acute COVID-19; Post-acute sequelae of SARS CoV-2 infection; PASC; Long-term effects of COVID-19; Chronic COVIDMost people who have COVID-19 recover completely. Some people continue to have health problems after having COVID-19. This is called long COVID.
COVID-19
Coronavirus disease 2019 (COVID-19) is a respiratory illness that causes fever, coughing, and shortness of breath, but many other symptoms can occur....
Read Article Now Book Mark ArticleLong COVID can happen in people who had mild to severe disease or no symptoms at all during an active COVID-19 infection. Long COVID most often affects adults. It can also occur in children, although less often.
Other names for long COVID include: long-haul COVID, chronic COVID, post-COVID conditions (PCC), and post-acute sequelae of SARS CoV-2 infection (PASC).
Causes
Health experts are not sure exactly what causes long COVID. Some theories include:
- SARS-CoV-2 virus particles become active again in the body after the initial illness or one or more of the person’s organs is taking longer to recover than the rest
- The immune system becomes overactive, causing inflammation in the body
Immune system
The immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....
Read Article Now Book Mark Article - The overactive immune system makes antibodies that attack organs and tissues
Long COVID health problems may be due to more than one of these factors. Research is ongoing to find out what causes long COVID, and who is most at risk.
Your risk of developing long COVID may be higher if you:
- Had severe illness with COVID-19
- Required hospitalization or intensive care during COVID-19 infection
- Had other health conditions before COVID-19 infection
- Had inflammation in the heart, lungs, kidneys, brain, or other areas if the body following COVID-19 infection (multisystem inflammatory syndrome)
- Are not vaccinated
- Are an older adult
- Are female
People at high risk for COVID-19 infection because of where they live and work and members of communities who don't have good access to health care may also be at risk for long COVID.
People with mild COVID-19 can also develop long COVID. Some people have developed long COVID and never knew they had a COVID-19 infection.
Symptoms
A person who has symptoms that persist for 4 or more weeks after a case of COVID-19 is said to have long COVID. Long COVID does not affect every person the same way. The symptoms may:
- Continue after your initial illness
- Begin later after you recover
- Go away and then come back
- Improve or get worse with time
- Be some of the same symptoms you had when you had COVID-19
Symptoms
COVID-19 is a highly infectious respiratory illness caused by a virus called SARS-CoV-2. COVID-19 symptoms can range from mild to severe. Symptoms m...
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Symptoms of long COVID may last for weeks, months, or longer. Although many people have mild symptoms, long COVID can be disabling for some people.
Common symptoms of long COVID include:
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Fatigue or tiredness that makes it hard to do daily activities
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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Difficulty breathing or shortness of breath
Difficulty breathing or shortness of br...
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Cough
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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- Worsening symptoms after vigorous physical or mental activity
Long COVID can affect different body systems and include other symptoms:
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Brain and nerves -- headache, difficulty thinking or concentrating (sometimes called "brain fog"), sleep problems, dizziness, tingling, numbness
Difficulty thinking or concentrating
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
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Mental health -- mood changes, depression, anxiety, post-traumatic stress disorder (PTSD)
Depression
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...
Read Article Now Book Mark Article - Bones and joints -- joint pain, muscle pain
- Digestive -- stomach pain, diarrhea, constipation, appetite changes
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Heart and blood -- Blood clots, chest pain, palpitations (fast or irregular heartbeat)
Blood clots
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
Read Article Now Book Mark ArticlePalpitations
Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck. You may:Have an unpl...
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Long COVID may affect multiple organs in the body, such as the lungs, kidneys, heart, brain, and skin. People who had severe COVID-19 are more at risk for multi-organ effects. This increases the risk for a person to develop diabetes, heart conditions, or neurological problems compared to people who did not have COVID-19.
Some long COVID symptoms, such as muscle weakness and PTSD may result from having spent a long time in the hospital. These effects can occur from any illness that leads to being in bed for a long time and being on a breathing machine (intubated).
PTSD
Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that invol...
Read Article Now Book Mark ArticleLong COVID symptoms vary a lot and can be hard to figure out and manage. Because of this, people with long COVID can have a hard time getting a proper diagnosis.
Exams and Tests
There are no specific tests for long COVID. Your health care provider may diagnose you with long COVID based on:
- Your symptoms
- A physical exam
- Your health history, including whether you had COVID-19 before
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Complete blood count (CBC)
Complete blood count (CBC)
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Complete metabolic panel
Complete metabolic panel
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
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Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Liver function tests
Liver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
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C-reactive protein
C-reactive protein
C-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation in the body. It is one of a group of proteins,...
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Erythrocyte sedimentation rate (ESR)
Erythrocyte sedimentation rate (ESR)
ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...
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TSH
TSH
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
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Free T4
Free T4
T4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood. Fre...
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Electrocardiogram or cardiac MRI
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark ArticleCardiac MRI
Heart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...
Read Article Now Book Mark Article - Tests for vitamin deficiencies vitamin D and B12
Vitamin D
The 25-hydroxy vitamin D test is the most accurate way to measure how much vitamin D is in your body. Vitamin D helps regulate calcium and phosphate ...
Read Article Now Book Mark ArticleB12
The vitamin B12 level is a blood test that measures how much vitamin B12 is in your blood.
Read Article Now Book Mark Article - Test for antibodies to COVID-19 to document your initial infection
Antibodies to COVID-19
This blood test shows if you have antibodies against the virus that causes COVID-19. Antibodies are proteins produced by the body in response to ha...
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Medical tests may be normal despite the presence of symptoms, and this does not rule out a long COVID diagnosis.
Treatment
There is no specific cure for long COVID. Treatment will depend on your symptoms and may include:
- A progressive exercise program
- Physical therapy
- Occupational therapy
- Speech and language therapy
- Neurological rehabilitation (for cognitive symptoms)
- Pulmonary rehabilitation
- Mental health care
- Medicines to help manage symptoms
You may want to consider joining a clinical trial for long COVID. A clinical trial is a study using people who agree to participate in new tests or treatments. Clinical trials help researchers know whether a new treatment works well and is safe. The National Institutes of Health has created RECOVER: Researching COVID to Enhance Recovery where you can learn more about long COVID clinical trials near you.
For the most up-to-date information on long COVID, visit these websites:
Centers for Disease Control and Prevention: Long COVID basics -- www.cdc.gov/covid/long-term-effects/
Centers for Disease Control and Prevention: CDC science and the public health approach to long COVID -- www.cdc.gov/covid/php/long-covid/
US Department of Health and Human Services: COVID-19 treatment information for patients -- aspr.hhs.gov/COVID-19/treatments/Pages/default.aspx
Support Groups
More information and support for people with long COVID and their families can be found at:
- Long COVID Kids -- www.longcovidkids.org/support-services
Outlook (Prognosis)
COVID-19 is a new disease, so no one knows exactly what the outlook will be for people with post-COVID symptoms. Most people who have symptoms at 4 weeks after a COVID-19 infection will gradually improve. Research is ongoing into how to help people with long COVID overcome the condition.
When to Contact a Medical Professional
You should contact your provider if you had COVID-19 and you have ongoing symptoms for 4 weeks or more, or the same or new symptoms return 4 or more weeks after your illness.
Call 911 or the local emergency number if you have:
- Trouble breathing
- Chest pain or pressure
- Confusion or inability to wake up
- Blue or gray lips or face
- Any other symptoms that are severe or concern you
Prevention
The only way to prevent long COVID is to protect yourself from COVID-19 infection.
Protect yourself from COVID-19 infectio
Coronavirus disease 2019 (COVID-19) is a serious disease, mainly of the respiratory system, affecting many people around the globe. It can cause mil...
Read Article Now Book Mark Article- Get an updated COVID-19 vaccine.
Updated COVID-19 vaccine
COVID-19 vaccines are used to prepare the body's immune system to protect against COVID-19. Everyone ages 6 months and older should get a 2024-2025 C...
Read Article Now Book Mark Article - Avoid contact with people who are suspected or confirmed to have COVID-19.
- Get yourself tested if you develop COVID-19 symptoms or come in contact with someone with COVID-19.
Tested
Testing for the virus that causes COVID-19 involves taking a mucus sample from your upper respiratory tract. This test is used to diagnose COVID-19....
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References
Berger Z, Altiery DE Jesus V, Assoumou SA, Greenhalgh T. Long COVID and health inequities: the role of primary care. Milbank Q. 2021;99(2):519-541. Epub 2021 Mar 30. PMID: 33783907; PMCID: PMC8241274. pubmed.ncbi.nlm.nih.gov/33783907/.
Centers for Disease Control and Prevention website. Clinical overview of long COVID. www.cdc.gov/covid/hcp/clinical-overview/index.html. Updated July 12, 2024. Accessed July 25, 2024.
Centers for Disease Control and Prevention website. Long COVID basics. www.cdc.gov/covid/long-term-effects/. Updated July 11, 2024. Accessed July 25, 2024.
Crook H, Raza S, Nowell J, Young M, Edison P. Long COVID - mechanisms, risk factors, and management. BMJ. 2021; 374:n1648. Erratum in: BMJ. 2021;3;374:n1944. PMID: 34312178 pubmed.ncbi.nlm.nih.gov/34312178/.
Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021;38:101019. PMID: 34308300 pubmed.ncbi.nlm.nih.gov/34308300/.
National Institutes of Health website. Long COVID. covid19.nih.gov/covid-19-topics/long-covid. Updated September 28, 2023. Accessed March 13, 2024.
Ramadan MS, Bertolino L, Zampino R, Durante-Mangoni E; Monaldi Hospital Cardiovascular Infection Study Group. Cardiac sequelae after coronavirus disease 2019 recovery: a systematic review. Clin Microbiol Infect. 2021;27(9):1250-1261. PMID: 34171458 pubmed.ncbi.nlm.nih.gov/34171458/.
Recover: researching COVID to enhance recovery website. What is long COVID? recovercovid.org/long-covid. Accessed March 6, 2024.
Sierpina VS, Seashore J, Kamprath S, Xie C. Post-acute COVID syndrome. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier 2024:681-688.
World Health Organization website. Coronavirus Disease (COVID-19). Post COVID-19 condition. www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(COVID-19)-post-COVID-19-condition. Updated March 28, 2023. Accessed March 6, 2024.
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How long COVID affects the body - illustration
Some people who had COVID-19 experience symptoms that recur or persist 4 or more weeks after the initial infection. This is called long COVID or post-COVID conditions. Long COVID has a wide range of symptoms that can affect one or more body systems. Common symptoms of long COVID include whole-body symptoms, such as fatigue, fever, and worsening symptoms after physical or mental effort. Long COVID can also affect the muscles and joints, digestion, kidneys and reproductive organs, heart and blood vessels, lungs, nervous system, and mental health. COVID-19 is a new disease, so no one knows exactly what the outlook will be for people with post-COVID symptoms. Research is ongoing into how to help people with long COVID overcome the condition.
How long COVID affects the body
illustration
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Long-term effects of COVID - illustration
Cardiovascular Blood clots, stroke, chest pain, palpitations (strong, fast, or irregular heartbeat), other heart problems Systemic Fatigue, worsening symptoms after mental or physical activity, fever, chills, flushing, sweats, pain Eye, Ear, Nose, and Throat Sore throat, tinnitus, visual symptoms, hearing loss Musculoskeletal Joint pain, muscle pain and aches Genitourinary Kidney problems, menstruation changes Neuropsychiatric Difficulty thinking or concentrating (“brain fog”), headache, sleep problems, dizziness, pins-and-needles feelings, changes in smell or taste, depression or anxiety Gastrointestinal Abdominal pain, nausea, reflux, diarrhea, constipation, loss of appetite Respiratory Cough, difficulty breathing, shortness of breath Dermatological Hair loss, COVID toe, skin rashes
Long-term effects of COVID
illustration
-
How long COVID affects the body - illustration
Some people who had COVID-19 experience symptoms that recur or persist 4 or more weeks after the initial infection. This is called long COVID or post-COVID conditions. Long COVID has a wide range of symptoms that can affect one or more body systems. Common symptoms of long COVID include whole-body symptoms, such as fatigue, fever, and worsening symptoms after physical or mental effort. Long COVID can also affect the muscles and joints, digestion, kidneys and reproductive organs, heart and blood vessels, lungs, nervous system, and mental health. COVID-19 is a new disease, so no one knows exactly what the outlook will be for people with post-COVID symptoms. Research is ongoing into how to help people with long COVID overcome the condition.
How long COVID affects the body
illustration
-
Long-term effects of COVID - illustration
Cardiovascular Blood clots, stroke, chest pain, palpitations (strong, fast, or irregular heartbeat), other heart problems Systemic Fatigue, worsening symptoms after mental or physical activity, fever, chills, flushing, sweats, pain Eye, Ear, Nose, and Throat Sore throat, tinnitus, visual symptoms, hearing loss Musculoskeletal Joint pain, muscle pain and aches Genitourinary Kidney problems, menstruation changes Neuropsychiatric Difficulty thinking or concentrating (“brain fog”), headache, sleep problems, dizziness, pins-and-needles feelings, changes in smell or taste, depression or anxiety Gastrointestinal Abdominal pain, nausea, reflux, diarrhea, constipation, loss of appetite Respiratory Cough, difficulty breathing, shortness of breath Dermatological Hair loss, COVID toe, skin rashes
Long-term effects of COVID
illustration
Review Date: 2/22/2023
Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 07/03/2024.