Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC), describes new, returning, or ongoing health issues that some individuals experience after an initial COVID-19 illness. Symptoms typically begin four or more weeks following the initial infection with SARS-CoV-2. While some definitions extend this timeline to three months, the presence of symptoms for at least four weeks is commonly recognized.
This condition can affect anyone who has had COVID-19, irrespective of whether their initial illness was mild or severe. Symptoms can persist for weeks, months, or even years, and may be debilitating. Long COVID is not contagious.
Systemic and General Symptoms
Many individuals with Long COVID report pervasive symptoms, often experiencing profound and debilitating fatigue. This fatigue differs from ordinary tiredness, as it is not alleviated by rest and can significantly impair daily activities.
A defining characteristic for many is post-exertional malaise (PEM), where physical or mental exertion triggers a significant worsening of symptoms. This “crash” can occur hours or even days after activity, leading to a profound sense of exhaustion and a flare-up of other symptoms. Managing PEM often requires careful pacing of activities to avoid exacerbations.
Beyond fatigue and PEM, other general symptoms can manifest or persist. These include recurring low-grade fevers, a general feeling of unwellness, or flu-like sensations that may come and go. Such widespread symptoms underscore the multi-systemic nature of Long COVID.
Respiratory and Cardiovascular Symptoms
Long COVID can significantly affect the respiratory and cardiovascular systems. Many individuals report persistent shortness of breath or difficulty breathing, even with minimal exertion. A chronic cough, sometimes dry and persistent, is also a common complaint.
Chest pain or tightness, often described as a pressure or ache, can also be a recurring issue, distinct from acute cardiac events. Cardiovascular symptoms frequently include heart palpitations, where an individual feels a fast-beating, pounding, or fluttering sensation in their chest.
Postural Orthostatic Tachycardia Syndrome (POTS) is another condition sometimes associated with Long COVID. POTS can cause a significant increase in heart rate upon standing, leading to symptoms such as dizziness, lightheadedness, weakness, and fainting.
Neurological and Cognitive Symptoms
Neurological and cognitive issues are among the most frequently reported and distressing symptoms of Long COVID, significantly impacting daily function. A prominent symptom is “brain fog,” characterized by a pervasive difficulty with thinking clearly or concentrating. This cognitive impairment can manifest as problems with memory, such as forgetting recent events or struggling to recall words, and a general slowing of mental processing speed.
Individuals may also experience persistent headaches, which can range in intensity and type, sometimes resembling tension headaches or migraines. Sleep disturbances are also common, including insomnia, difficulty falling or staying asleep, and unrefreshing sleep that leaves individuals feeling tired despite adequate hours.
Other neurological manifestations include dizziness or lightheadedness, which can occur independently of standing or in conjunction with POTS. Changes to smell or taste are frequently reported, ranging from a complete loss (anosmia, ageusia) to distortions where familiar scents or flavors are perceived as unpleasant (parosmia, dysgeusia). Additionally, some individuals describe pins-and-needles sensations, numbness, or tingling in their extremities. Mood changes, such as new onset depression or anxiety, are also recognized.
Other Common Symptom Clusters
Long COVID’s widespread impact extends to various other bodily systems. Musculoskeletal pain is frequently reported, encompassing joint pain or muscle aches that can be generalized or localized. These pains often fluctuate in intensity and location.
Gastrointestinal issues are also common among individuals with Long COVID. These can include persistent diarrhea, abdominal pain, and nausea, reflecting a potential disruption to digestive function. Such symptoms can affect appetite and nutrient absorption, contributing to overall malaise.
Dermatological symptoms may also arise, such as new rashes or unusual skin sensations. Hair loss is another reported symptom. Additionally, ear, nose, and throat (ENT) symptoms like tinnitus, a persistent ringing or buzzing in the ears, and a chronic sore throat can occur.
Navigating Diagnosis and Symptom Management
Diagnosing Long COVID involves a careful evaluation by a healthcare provider, as there is currently no single definitive test for the condition. The diagnostic process typically relies on a thorough review of the patient’s health history, including their COVID-19 infection, and ruling out other potential causes for their persistent symptoms. This approach ensures that other treatable conditions are not overlooked.
Tracking symptoms is a practical step that can significantly aid discussions with a doctor. Patients can note down what symptoms they are experiencing, when they occur, how long they last, and what factors seem to worsen or improve them. This detailed information provides valuable insights for healthcare providers to understand the symptom patterns and develop a tailored management plan.
A primary care physician often serves as the initial point of contact for individuals experiencing Long COVID symptoms. These doctors can provide initial assessments, coordinate care, and make referrals to specialists as needed. For more complex cases, specialized post-COVID care clinics have emerged, offering multidisciplinary approaches.