As our knowledge and interventions improve against COVID-19 infections, long haul symptoms are the most concerning. According to recent reports, 10-30% experience long haul complaints. While there is no official definition for long COVID, healthcare providers across the country diagnose patients based on a wide variety of symptoms. Long COVID has become so prevalent and in some cases, debilitating, that in July 2021 the CDC officially included long COVID as a disability protected under the Americans with Disabilities Act. Today we’ll share information on symptoms.
Symptoms
Long COVID—or post-COVID conditions—is a wide range of new, returning or ongoing health problems people may experience more than four weeks after being first infected with SARS-CoV-2. According to one large scale study that included over 5,000 people, the most common symptoms of long COVID include:
- chest pain (up to 89%)
- fatigue (up to 65%)
- dyspnea (difficulty breathing) (up to 61%)
- cough and sputum production (up to 59%)
Additional studies reinforce the findings. One published in June 2022 utilized artificial intelligence to classify tens of thousands of U.S. patients with long COVID using electronic medical records. The main symptom sets the study found include patients who primarily suffer from:
- Blood and circulatory system issues like heart failure, arrhythmias, and chest pain.
- Respiratory system issues like throat and chest pain, upper respiratory infections, asthma, and lower respiratory disease.
- Musculoskeletal and nervous system issues like connective tissue disorders, osteoarthritis, and musculoskeletal pain.
- Digestive system issues like abdominal and pelvic pain, nausea, vomiting, and disorders of the urinary system.
Dr. Alexandra Brugler Yonts, an infectious disease specialist at Children’s National Hospital in Washington, D.C., recently shared her list of possible buckets with Fortune. They include patients who:
- Have sustained long-term organ injury from COVID, such as lung damage.
- Are suffering from inflammation resulting from COVID.
- Have developed dysautonomia, which leads to changes in blood pressure and heart rate upon changes in position, like sitting or standing.
- Have ongoing COVID viral activity.
- Have immune systems that over-corrected in response to COVID and now under-respond to pathogens.
A study out of Britain, published in The Lancet found that symptoms have been found to impact 10 of the 11 organs, exposing just how destructive the COVID-19 is proving to be on the human body, even well beyond the scope of the initial infection. That same study found that for the majority of people (>91%) that experienced long COVID, the time to recovery exceeded 35 weeks.
Additionally, the study published in The Lancet shared 100 long COVID symptoms (not meant to be an exhaustive list, but rather an insight into how extensive the symptoms can be):
| Emotion and mood | Anxiety Irritability Depression Tearfulness Apathy Sense of doom Depersonalization Anger Impulsivity Suicidality Euphoria Delusions |
| Memory | Short-term memory loss Long-term memory loss Forgetting how to do routine tasks Inability to make new memories |
| Headaches | Behind the eyes All over Temples only Base of skull After mental exhaustion Migraines |
| Sleep | Insomnia Awakened by feeling of inability to breathe Vivid dreams Nightmares Restless leg syndrome Sleep apnea |
| Cognitive functioning | Brain fog Poor attention span Difficulty thinking Sudden confusion Racing thoughts |
| Speech and language | Difficulty finding the right words Difficulty reading Difficulty understanding speech Difficulty speaking Difficulty writing Slurred speech Speaking unrecognizable words |
| Taste and smell | Loss of taste Loss of smell Altered taste Altered smell Heightened taste Heightened smell Phantom smells Phantom taste |
| Hallucinations | Visual Auditory Tactile |
| Systemic | Chills, sweats Elevated temperature Fatigue Low temperature |
| Pulmonary, respiratory | Breathing difficulties but normal oxygen saturation Cough with mucus Coughing up blood Dry cough Sinus issues Rattling of breath Shortness of breathe Sneezing |
| Reproductive, genitourinary, endocrine | Menstrual issues Bladder control issues |
| Cardiovascular | Fainting Heart palpitations Burning in the chest Bulging veins |
| Dermatologic | “COVID toe” Peeling skin Rashes |
| Gastrointestinal | Abdominal pain Constipation Diarrhea Loss of appetite Reflux Nausea Vomiting |
Immunological, autoimmune | New allergies New anaphylaxis reactions |
| Head, ear, eye, nose, throat | Hearing loss Runny nose Sore throat Vision symptoms |
| Sensorimotor | Dizziness Pins and needles feeling Tremors Numbness Noise sensitivity Ringing in the ears Feeling of brain pressure Nerve pain Sensation of brain “on fire” Inability to yawn |
| Musculoskeletal | Bone aches Joint pain Muscle aches Muscle spasms Chest tightness |
It is clear that COVID-19 has the potential to significantly impact an individual’s health beyond the damage that can occur within the initial period of infection. It now appears SARS-CoV-2 will never be fully eradicated and adapting to life with COVID -19 is essential. Accepting there will be times we can dial down precautions when transmission levels are low and dial them back up when they are higher is the only way to prevent infections, death and long haul consequences.
We are far better off today than we were two years ago. The data is clear -vaccinations, treatments and something as simple as wearing a mask can minimize risk and lower transmission rates. Vaccines can decrease the risk of suffering from long COVID effects, in that they prevent infection in the first place. But it is still possible to experience long COVID symptoms should an individual experience a breakthrough infection.
As not all health concerns related to COVID are yet understood, stay vigilant about your health. If after four to six weeks of a COVID infection you feel symptoms, speak to your provider to determine the underlying cause and the potentially increased risk associated with COVID (such as that of a cardiovascular event). Stay informed- information about how COVID impacts the human body is still evolving. Don’t underestimate the importance of seemingly mild symptoms, as when they are reviewed holistically they may reveal a more serious concern.
-https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
-https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-long-covid
-https://www.thelancet.com/action/showPdf?pii=S2589-5370%2821%2900299-6
-https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v3
-https://www.researchsquare.com/article/rs-798316/v1
-https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/heart-problems-after-covid19
-https://www.heart.org/en/news/2022/03/31/after-covid-19-experts-say-watch-for-these-potential-heart-and-brain-problems
-https://www.politico.com/news/2022/06/03/can-long-covid-lead-to-death-a-new-analysis-suggests-it-could-00036845
-https://www.medrxiv.org/content/10.1101/2022.05.21.22275412v1
-https://fortune.com/2022/06/04/100-most-common-long-covid-symptoms/
-https://pubmed.ncbi.nlm.nih.gov/33977626/