Long COVID, also known as post-COVID conditions, long-haul COVID-19, or post-acute sequelae of SARS-CoV-2 infection (PASC), is a term used to describe a range of ongoing health problems experienced by individuals after being infected with the virus causing COVID-19. While most people recover from the illness within a few days to a few weeks, some individuals continue to experience symptoms that persist for several months, significantly impacting their daily lives and requiring further medical attention.
Researchers are still trying to understand Long COVID’s various causes and effects. Still, it is known that these post-COVID conditions can affect anyone, regardless of the severity of their initial illness. Various treatments, such as medications, physical therapy, and breathing exercises, have been shown to aid in addressing the wide array of symptoms experienced by those dealing with these lingering health issues. In response to the growing need for specialized care, many hospitals have established multidisciplinary clinics, like the Johns Hopkins Post-Acute COVID-19 Team (JH PACT), focused on supporting the recovery of patients affected by Long COVID.
Symptoms And Health Problems
Physical Symptoms
Long COVID, also known as post-COVID syndrome, affects individuals for weeks, months, or even years after their initial COVID-19 illness. People with Long COVID can experience various physical symptoms, such as:
- Fatigue: A common and persistent issue for many individuals, making daily activities more difficult.
- Shortness of breath: Difficulty breathing, especially during physical activities.
- Muscle pain: Aching or discomfort in muscles throughout the body.
- Digestive symptoms: Nausea, changes in appetite, and gastrointestinal issues.
- Heart palpitations: Irregular or rapid heartbeat can sometimes indicate underlying heart problems.
- Loss of taste and smell: A common symptom during the acute phase of the infection, which can persist long after recovery.
- Blood clots: An increased risk of clotting that can lead to more severe complications.
Neurological Symptoms
In addition to physical symptoms, Long COVID can also present neurological symptoms, such as:
- Brain fog: Difficulty concentrating, remembering information, or experiencing confusion.
- Cognitive impairment: More severe issues with memory, problem-solving, or understanding complex concepts.
- Dizziness when standing: Feeling lightheaded or unsteady when transitioning from a sitting or lying to standing.
Mental Health Conditions
Individuals coping with Long COVID might also experience mental health conditions. The uncertainty and stress of dealing with persistent symptoms can exacerbate mental health issues. Common mental health conditions associated with Long COVID include:
- Anxiety: Increased worry, nervousness, or unease.
- Depression: Sadness, hopelessness, or loss of interest in activities once enjoyed.
People with Long COVID need to consult their healthcare providers to address their symptoms and rule out other underlying health problems. A supportive network of medical professionals, family, and friends can be crucial in managing the physical, neurological, and mental health aspects of Long COVID.
Risk Factors and Vulnerable Groups
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), affects many individuals after their initial recovery from COVID-19. Identifying the risk factors and vulnerable groups is important to understand better the necessary preventative measures and support required.
Several risk factors are associated with an increased likelihood of developing long COVID. These include:
- Increasing age: Older individuals are more susceptible to prolonged symptoms.
- Gender: Females have a higher risk of developing long COVID than males.
- Pre-existing health conditions: Poor general and mental health, asthma, and obesity have been linked to a higher risk of long COVID.
- Immunosuppressive conditions: These conditions can lead to a greater increased risk of long COVID.
- Chronic diseases: People with chronic obstructive pulmonary disease (COPD) and type 2 diabetes are at a higher risk.
Additionally, certain populations are more vulnerable to long COVID due to various socioeconomic factors. These groups include:
- Racial or ethnic minority groups: These communities have been disproportionately affected by COVID-19 and are likelier to suffer from long COVID.
- Adults: Although children can experience long COVID, adults generally face a higher risk of developing prolonged symptoms.
- Individuals with limited access to healthcare: Poor access to healthcare services can exacerbate long COVID symptoms and impede recovery.
Understanding the risk factors and vulnerable groups helps healthcare professionals and policymakers make informed decisions about support and prevention strategies for those suffering from long COVID.
Long Covid And Organ Damage
Heart Damage
Long Covid can lead to heart damage in some individuals. Inflammation is a common issue, and it has been reported that the virus can affect the heart muscle, causing myocarditis. Furthermore, patients who had a severe illness with COVID-19 might experience organ damage, which can also involve the heart. The long-term effects of this damage have yet to be completely understood.
Lung Damage
Lung damage is another area of concern for individuals suffering from Long Covid. The virus primarily targets the respiratory system; in severe cases, patients might experience lasting lung damage. While many people recover without lasting issues, some experience prolonged shortness of breath, difficulty breathing, and fatigue. These symptoms indicate potential lung damage that could become a long-term concern.
Neurological Disease
Long Covid can also have neurological implications, potentially impacting brain function. Some individuals report experiencing brain fog, memory loss, and difficulty concentrating after recovering from a COVID-19 infection. It is suspected that ongoing inflammation and immune system problems may contribute to these neurological symptoms. However, researchers are still working to understand the full extent of these effects, and the long-term consequences remain uncertain.
In summary, Long Covid can result in organ damage, affecting the heart, lungs and even the brain. The presence of inflammation and ongoing immune system problems contribute to these issues, and the long-term impact on the affected individuals is not yet fully known.
Diagnosis and Assessment
Long COVID, also called post-acute COVID-19 or post-COVID-19 syndrome, is a condition in which individuals experience symptoms weeks or months after the initial infection. The range of symptoms is broad and may include neurological manifestations, cognitive impairment, fatigue, and respiratory issues.
Diagnosing long COVID can be challenging, as no specific test exists for the condition. Typically, a diagnosis is made based on a patient’s reported symptoms and their history of COVID-19 infection. A key factor in diagnosing long COVID is determining whether a patient’s symptoms are due to a previous SARS-CoV-2 infection or are a manifestation of another underlying condition. Individuals may be diagnosed with long COVID even after receiving a COVID-19 vaccine, provided they had been infected before vaccination.
The assessment of long COVID involves a series of evaluations, which may include:
- Medical history and physical examination: A thorough review of the patient’s medical history, including any past or current illnesses, medications, and lifestyle factors, is essential. A physical examination will also assess the patient’s overall health and identify any specific concerns.
- Symptom tracking: Patients should be encouraged to track their symptoms through a diary or digital tools to help identify patterns and potential triggers.
- Cognitive assessment: Short tests may evaluate memory, language ability, reasoning, and other cognitive skills. This can help to identify any cognitive impairments or “brain fog” often reported by those with long COVID.
- Additional tests and referrals: Further tests or specialist referrals may be necessary depending on the symptoms presented. For example, patients reporting chest pain or shortness of breath might undergo cardiac testing or pulmonary function tests. Referrals to a neurologist can also be considered if neurological symptoms are present.
Primary care providers play a crucial role in assessing and managing long COVID, as they are often the first point of contact for patients and their families. Structured primary care visits, considering the patient’s history and symptoms, are essential in providing appropriate guidance and support. By adhering to up-to-date guidelines and being mindful of the evolving knowledge surrounding this complex condition, healthcare providers can help patients navigate their recovery from long COVID.
Treatment And Management
Exercise and Rehabilitation
According to the Centers for Disease Control and Prevention (CDC), establishing a healthy lifestyle can help manage Long COVID symptoms. Engaging in at least 150 minutes of physical activity per week1 is recommended. However, some individuals with Long COVID may experience post-exertional malaise, where symptoms worsen following physical or mental exertion. In such cases, consulting with healthcare providers to design a gradual and personalized exercise or rehabilitation program is crucial.
Mental Health Support
Mental health is essential to managing Long COVID, as individuals may experience anxiety, depression, or difficulty coping with prolonged symptoms. Support groups can be beneficial for sharing strategies and experiences. Mental health professionals can also provide counseling and therapy better to navigate the challenges and emotions of Long COVID.
Medications and Therapies
While there is no specific treatment for Long COVID, existing medications and therapies can manage symptoms. For example:
- Asthma medications may provide relief for those with breathing difficulties.
- Over-the-counter pain relievers can be taken to alleviate muscle or joint pain.
- Sleep aids can be used under a healthcare provider’s guidance to ensure proper rest.
- Vaccines, including COVID-19, can reduce the risk of reinfection or complications.
It’s important to remember that treatment and management of Long COVID should be tailored to each individual’s needs and symptoms. A healthcare provider can help develop a comprehensive and personalized medical management plan2 to improve the overall quality of life while dealing with Long COVID.
Footnotes
- https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html ↩
- https://www.webmd.com/lung/news/20211027/doctor-checklist-long-covid ↩
Filing For Disability Benefits With Long COVID
People diagnosed with long COVID may be eligible for disability benefits, depending on the severity of their symptoms and how much they have impacted their ability to work. To file a claim, individuals should contact their local Social Security Administration (SSA) office or disability carrier. The application process requires documentation of medical evidence, such as lab results, physician notes, and hospital records.
Documentation for Disability Claims
The SSA will require proof that an applicant has a medically determinable physical or mental impairment that prevents them from engaging in any “substantial gainful activity”. Documentation should include:
- Medical tests and results (e.g. blood tests, imaging studies)
- Primary care provider notes
- Hospital records or other specialist reports
- Mental health evaluations
- Statements from family or friends regarding the individual’s condition
Appealing a Denial of Benefits
If an individual’s disability claim is denied, they may appeal the decision. This process will require a thorough application review and additional evidence to support the claim. An appeal should include:
- Documentation of any new medical information, diagnoses, or treatments since the initial filing
- A letter from your doctor outlining how long COVID has significantly impacted your life
- Any other evidence that may support your claim
Individuals must ensure all evidence and paperwork is complete and accurate before filing a claim. An experienced attorney can guide navigating the appeals process.
Prevention And Precautions
Long COVID, also known as post-COVID conditions, can cause lingering symptoms and health issues even after initial recovery from the infection. Several prevention and precaution measures can be taken to mitigate the risk of experiencing Long COVID.
One vital strategy is to get vaccinated against COVID-19. Vaccines have been proven to significantly reduce the chances of severe illness, hospitalization, and death due to the virus. Additionally, vaccination can lower the likelihood of developing long-lasting symptoms after infection. It is essential to receive a COVID-19 vaccine and stay updated on booster recommendations to maintain optimal protection.
In the event of a breakthrough infection, which occurs when a fully-vaccinated individual contracts COVID-19, maintaining general health and well-being may aid in the prevention of Long COVID symptoms. For example:
- Regular physical activity, such as walking, can support the immune system and alleviate some symptoms of Long COVID, like fatigue and cognitive dysfunction.
- A balanced diet, focusing on essential nutrients, can strengthen the immune system and promote overall health.
Lastly, following the established public health guidelines remains crucial. These measures include:
- Wearing masks in public spaces, especially when social distancing is not possible.
- Practicing good hygiene, such as frequent hand washing and using hand sanitizers.
By taking these precautions, individuals can reduce their likelihood of contracting COVID-19, minimize the severity of the illness if contracted, and lessen the risk of developing Long COVID.
