Long-Term COVID-19 Effects

senior man sitting in chair and coughing

Most people who develop COVID-19 recover completely within 2 to 3 weeks. However, approximately 10% of patients who’ve been infected with SARS-CoV-2 (the virus that causes COVID-19) remain unwell beyond 3 weeks; some are still sick months after infection. Continued health problems after COVID-19 have been called “long-haul COVID,” “post-acute COVID,” “chronic COVID,” and “long COVID-19 syndrome.”

Long-term COVID-19 symptoms

Like COVID-19, long-haul COVID can affect nearly every part of the body, and symptoms can vary greatly from one individual to the next. A citizen-led survey led to a definition of long COVID syndrome as a collection of symptoms lasting more than 28 days.

According to University of California Davis Health, the most common symptoms of long-term COVID include:

  • Coughing. Approximately 19% of long-haulers report persistent coughing.
  • Fatigue. More than half (58%) of long-haulers experience significant fatigue. Some people are unable to work due to overwhelming fatigue.
  • Body aches, joint pain, and headaches. According to one study, about one-quarter of long-haulers report pain. About 3% experience continued sore throat, nearly 20% have joint pain, and 44% of long-haulers deal with headaches.
  • Loss of taste and smell. About 1 in 5 patients with long COVID report loss of taste or smell. Others report alterations in smell; they may “smell” scents that are not present.
  • “Brain fog.” Lingering confusion and difficulty with thinking and memory is common after time in an intensive care unit (ICU), particularly in elderly patients. But, many long-haul COVID patients reporting alterations in thinking were never hospitalized.

Other long-haul COVID symptoms include:

  • Shortness of breath. Nearly 25% of long-haulers report breathlessness or shortness of breath—sometimes, even at rest. Many become short of breath with minimal activity.
  • Heart palpitations. Approximately 11% of people with long-haul COVID have periodic heart palpitations. Some have developed heart arrhythmias, or irregular heart rhythms.
  • Fever. Though fever is most common in the acute stage of infection, some long-haulers report intermittent spikes in body temperature.
  • Nausea, vomiting, diarrhea and constipation. Digestive symptoms bother 12 to 16% of long haulers.

Long-term effects of COVID-19 can also include:

  • Kidney failure. Approximately 1% of long-haulers develop kidney failure. Some have pre-existing conditions (such as diabetes and high blood pressure) that increase the risk of kidney failure; others do not.
  • Diabetes. New-onset diabetes has been reported in patients with long-haul COVID.
  • Heart failure. COVID-19 can damage the heart and trigger heart failure. Some long-haulers need pacemakers to maintain heart function.
  • Mental disorders, including paranoia, mood disorders (including depression and anxiety), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

Long-haul COVID-19 treatment

At present, treatment is focused on symptom relief. Scientists and doctors are still looking for effective treatments for long-term COVID.

Olfactory training, or smell training, may help patients regain their sense of taste and smell; the process involves sniffing familiar scents (often, rose eucalyptus, lemon, and clove essential oils) twice a day while remembering what that scent smells like. Olfactory training helps build connections in the brain and should continue for at least six months. Patients with persistent alterations in taste and smell should see an otolaryngologist—ear, nose and throat doctor (ENT)—as soon as possible. An ENT can provide instruction and support for olfactory training and may prescribe medicine that may hasten sensory recovery.

If your shortness of breath or cough wakes you up at night, your symptoms might be due to inflammation of the vagus nerve. Physicians can treat that problem with respiratory retraining (special breathing exercises). Eating a low-acid diet—one that limits or eliminates acidic foods, including soda, citrus, wine and tomatoes—may also help.

Patients with heart damage should work with cardiologists. Patients who develop diabetes may need oral medicine or insulin treatment. In a few cases, patients who experienced significant lung damage after COVID-19 recovery were treated with lung transplant.

Researchers are testing a variety of drugs to see if they can effectively treat long COVID.

If you or a loved one has long-haul COVID symptoms, consult your healthcare provider for help managing your symptoms.

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