Following an infection with the virus that causes COVID-19, some individuals experience a continuation of health issues. This condition is clinically referred to as Post-COVID Conditions (PCC), but is more commonly known as long haul COVID. It encompasses a variety of new, returning, or persistent health problems that linger for more than four weeks after the initial infection. The condition can develop in anyone who has had COVID-19, regardless of whether the illness was mild or severe, and can significantly impact quality of life.
Recognizing the Symptoms
The symptoms of long COVID are numerous and varied, often fluctuating over time. An individual may have a single symptom or a combination, and the presentation is unique to each person. One of the most common symptoms is severe fatigue that is not relieved by rest. Many also experience post-exertional malaise (PEM), where physical or mental exertion worsens symptoms, making a return to daily routines challenging.
Neurological symptoms are also common. Cognitive dysfunction, or “brain fog,” includes difficulty with thinking, concentration, and memory. Headaches, dizziness, an altered sense of taste and smell, pins-and-needles sensations, and sleep problems are also widely reported.
Cardiopulmonary issues can persist long after the initial infection has cleared, with shortness of breath, chest pain, and heart palpitations being frequently noted. Other possible symptoms include joint or muscle pain, hair loss, rashes, and digestive problems like diarrhea. The diverse nature of these symptoms underscores the systemic impact the condition can have.
Theories on Underlying Causes
The exact reasons why some individuals develop long COVID remain under scientific investigation. Researchers are exploring several leading hypotheses to explain the prolonged and varied symptoms.
- Viral persistence: The SARS-CoV-2 virus, or fragments of it, may remain in the body’s tissues after the acute infection has resolved. This lingering presence could trigger ongoing inflammation and immune system activity.
- Autoimmunity: The initial viral infection might cause the immune system to become dysregulated. This could lead it to mistakenly produce antibodies that attack the body’s own healthy tissues and organs.
- Microclots: The virus may induce the formation of tiny, persistent blood clots that can obstruct blood flow in the smallest blood vessels. This blockage could deprive tissues of oxygen, leading to symptoms like fatigue and brain fog.
- Dysautonomia: The virus may disrupt the autonomic nervous system, which controls involuntary functions like heart rate and breathing. This can result in symptoms such as palpitations and dizziness upon standing.
How Long COVID is Diagnosed
Diagnosing long COVID is not straightforward, as there is no single definitive test. Healthcare providers make a diagnosis based on a patient’s health history, including a confirmed or suspected case of COVID-19. A diagnosis is considered when symptoms persist for an extended period, often defined as three months or longer.
Because the symptoms can overlap with many other health conditions, an important step is to rule out other potential causes. A doctor will conduct a physical examination and may order tests to investigate other possibilities. These can include blood tests, imaging studies, or functional assessments of the heart or lungs to exclude other medical explanations for the ongoing health problems.
Managing Long COVID Symptoms
There is no single cure for long COVID, so management focuses on addressing specific symptoms to improve a person’s quality of life. Treatment plans are individualized and often involve a multidisciplinary team of specialists. A primary strategy for managing severe fatigue and post-exertional malaise (PEM) is pacing. This involves balancing activity and rest to avoid overexertion, which can worsen symptoms.
Healthcare providers may recommend medications to manage specific issues, such as to control pain, regulate heart rate, or address anxiety. For those with persistent loss of smell, olfactory retraining might be considered. Rehabilitative therapies also play a part in the management plan for many.
Physical therapy can help with muscle weakness, while pulmonary rehabilitation may assist those with ongoing breathing difficulties. For individuals struggling with brain fog, cognitive rehabilitation can provide strategies to cope with and improve memory and focus. These combined approaches aim to support the body’s recovery and help individuals regain function.