COVID Long Haulers – What Symptoms do COVID-19 Long Haulers Experience?

Within a few weeks, most people completely recover from coronavirus disease 2019 (COVID-19). However, some continue to have symptoms after initially recovering even if they had mild versions of the virus. These people are sometimes referred to as “long haulers”, and the condition is called long COVID-19 or post-COVID-19 syndrome.

Common COVID-19 Long Hauler Symptoms

There is a long, inconsistent list of COVID-19 long hauler symptoms and just like acute COVID-19, they can impact every part of the body. For some, the residual COVID-19 symptoms are unlike the symptoms when they were infected with the virus originally. Included amongst the most frequent long hauler symptoms are:

  • Coughing
  • Ongoing fatigue
  • Body aches
  • Headaches
  • Joint stiffness or pain
  • Chest pain
  • Rapid heartbeat
  • Hair loss or rash
  • Shortness of breath
  • Loss of smell and taste
  • Trouble sleeping
  • Brain fog – trouble concentrating or focusing

Fatigue is one of the more significant symptoms experienced across the board with COVID long haulers. According to survey data from COVID-19 Survivor Corps, of the 1500 long haulers who participated, fatigue was the most common symptom. Often, these patients report feeling tired and run down with simple tasks, such as walking to their mailbox, leaving them exhausted. Not only is chronic fatigue frustrating, but it can also have debilitating effects physically and mentally.

One of the more confusing long hauler symptoms is brain fog that leaves patients feeling other than themselves. An inability to focus or being unusually confused or forgetful are commonly reported in those experiencing post-COVID brain fog. While this has occurred in those in intensive care, it has also been reported in those that were not hospitalized. And even more confusing is the fact the condition may reoccur after a period of days or weeks of feeling better.

In severe cases of COVID-19, hospitalization and breathing assistance (a ventilator) may be required. By going through this ordeal, patients are more likely to suffer post-traumatic stress syndrome, anxiety, and depression. When combined with chronic fatigue, mood issues can further worsen physical and mental wellbeing.

Pulmonary issues like shortness of breath and a persistent cough are also commonly reported by COVID long haulers. These issues occur with patients regardless of if they were hospitalized and, in some cases, pulmonary issues persist for four or five months. As with any lengthy illness, deconditioning could contribute to shortness of breath but infection-specific conditions, like viral myocarditis or lung fibrosis also could play a factor.

Why do COVID Long Haulers Continue Having Symptoms?

Coronavirus disease 2019 only first appeared in December 2019. As such, much remains to learn about the virus and little information is available as to why some suffer symptoms longer than others. It is known that an inflammatory response starts in the body as a response to COVID-19 infection. This sets off a chain of events with several various symptoms and outcomes.

One theory as to why COVID-19 symptoms persist long-term is that a small amount of the virus may remain in the patient’s body. However, most long haulers test negative for the virus and there is not a test for lasting COVID symptoms.

Another theory is that after the infection has passed, the immune system continues to overreact. Because the immune system fails to return to normal, ongoing symptoms and ill-health may persist despite no presence of the virus.

It is also possible that the virus could alter how a person’s organs function leading to long-term symptoms or complications. One obvious example is lung scarring which has been seen previously with other types of coronavirus like MERS or SARS. As a result of COVID, metabolic changes have also been noted with cases of diabetes developing following infection.

Will Long Haulers Fully Recover?

While it appears the cases of long-COVID are falling, the emergence of the virus in 2019 makes long-term data unavailable. The concern remains that even if COVID patients recover, they could still face long-term risks. For example, patients that developed chronic fatigue syndrome from the virus, have a higher risk of it happening again and there is concern that flare-ups could occur from future infections.

What to do About Long COVID

Anyone that suspects they were infected or were positively diagnosed with COVID that still experiences symptoms at least 28 days following infection should consult a doctor. Health care providers are addressing the needs of these patients through pulmonary, respiratory, cardiovascular, behavioral, and neurological testing. Based on these results, a treatment plan is formulated, and the patient’s status will be monitored.

It will be important for the patient to stay hydrated and rest while recovering from long COVID. To conserve energy, it is recommended that patients:

  • Not over-exert themselves or push themselves too hard.
  • Plan their days so that tiring activities are evenly spread throughout the week.
  • Prioritize activities – consider what needs to be done and what can be delayed.

Long-Term Effects of COVID-19

While less common, serious long-term complications from COVID-19 have been reported that affect different organ systems. These systems include:

  • Cardiovascular (Heart): Heart muscle damage has appeared on imaging tests months after recovering from COVID-19 even in those who only had mild symptoms of the virus. This could cause the patient to be at higher risk of future heart failure or complications.
  • Respiratory (Lungs): The lungs have small air sacs (alveoli) that can suffer long-term damage as a result of the pneumonia commonly associated with coronavirus. Long-lasting breathing problems can result from the scar tissue that forms in the lungs.
  • Neurological (Brain): Regardless of age, COVID-19 can cause seizures, strokes, and Guillain-Barre syndrome (a condition causing temporary paralysis). The risk of Alzheimer’s disease and Parkinson’s disease may also be increased as a result of COVID-19 infection.
  • Renal (Kidneys): As many as 30% of COVID-19 patients develop moderate or severe kidney injuries. In some cases, kidney damage is significant enough to require dialysis.
  • Circulatory (Blood Vessels): Blood cells are more prone to clumping up and forming clots with COVID-19. Although large clots can lead to strokes and heart attacks, the majority of heart damage COVID-19 causes is thought to come from small clots blocking the capillaries.

COVID Long Haulers & Mental Health