Condition Center: Long COVID

Photo Illustration by Keila Gonzalez
Photo Illustration by Keila Gonzalez

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

The virus that causes COVID-19 — and our understanding of it — has evolved over the past two-plus years. At this point, we know that most people who contract the current strains of SARS-CoV-2 recover. But nearly one in five Americans who've had the virus continue to have lingering symptoms for four weeks or more after recovering, according to the Center for Disease Control and Prevention. For some, the side effects are debilitating, which can lead to problems at work or school and difficulty carrying out everyday tasks. The official name for these enduring symptoms? Post-acute sequelae of SARS-CoV-2, or, as it's colloquially called, long COVID. And while experts agree the condition is very real — as of July 2021, long-COVID conditions can be considered a disability under the Americans With Disabilities Act (ADA) — we're still learning when and why it happens and how it can be prevented and treated.

Understanding Long COVID

Long COVID, officially known as post-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC), is categorized by a wide range of symptoms that can last for months after an initial diagnosis or infection. There is no test for long COVID (yet — researchers are currently working on a tool to help identify sufferers), so symptoms play a big role in diagnosis.

"Symptoms of long COVID have been reported to range from tolerable to disabling, significantly affecting daily quality of life," Krista Elkins, a paramedic and registered nurse, says. The most common symptoms include insomnia, headaches, changes to taste and/or smell, persistent brain fog, and problems with digestion and respiratory systems, Eugene Chan, MD, cofounder of Abpro, a Massachusetts-based biotechnology company, says. "Unfortunately, some people can experience even more concerning symptoms, such as cognitive damage, extreme fatigue, and the development of autoimmune disorders in individuals who were otherwise healthy pre-COVID," he says, adding, "One of the most challenging issues pertaining to long COVID is that there is no set timeline for recovery."

Below is a list of common long COVID symptoms listed by the World Health Organization.

  • Fatigue
  • Shortness of breath or difficulty breathing
  • Memory, concentration, or sleep problems
  • Persistent cough
  • Chest pain
  • Trouble speaking
  • Muscle aches
  • Loss of smell or taste
  • Depression or anxiety
  • Fever

Causes of Long Covid

Anyone who's been infected with the virus can experience post-COVID, regardless of how severe the initial symptoms are. For the most part, "contracting long COVID is up to chance," Dr. Chan says. So while the CDC notes that the following populations may be more at risk for developing long COVID, many people who fall outside these groups can experience the condition, which is why experts emphasize that more research is needed to determine why some people develop persistent symptoms and others don't.

  • People who were severely ill, particularly those who were hospitalized or in intensive care, during their COVID-19 infection.
  • People with preexisting, underlying health conditions.
  • Those who have not been vaccinated against COVID-19 before contracting the virus.
  • Those who experienced multisystem inflammatory syndrome (MIS) during or after COVID-19 illness. MIS is a rare but severe inflammatory condition shown to accompany COVID-19 and is categorized by stomach pain, bloodshot eyes, diarrhea, dizziness, skin rash, and vomiting.

Most Effective Long COVID Treatments

According to the WHO, there currently isn't specific medication therapy for people with post COVID-19 condition. But with research by the National Institutes of Health and others, a better understanding of long COVID could lead to improved diagnoses and new therapeutic approaches. "As the pandemic persists, scientists have offered some measures of relief for more vulnerable populations," Dr. Chan says.

Most recently, that includes looking into the diabetes drug metformin to curb the effects of COVID altogether. A study published on June 8 in The Lancet found that when given early on to those diagnosed with COVID-19, metformin could reduce the risk of developing long COVID later on by 41 percent. It's important to note that the study was tested on a specific population — those who struggle with weight and obesity — so that's not to say the results with be the same for everyone. Still, "The results of this study are important because long COVID can have a significant impact on people's lives," said lead researcher in the study, Carolyn Bramante, in a press release. "Metformin is an inexpensive, safe and widely available drug, and its use as a preventive measure could have significant public health implications." Ultimately, more research needs to be done in order to confirm the efficacy of metformin as a preventative long COVID method.

Until more developments are made, if you think you might have long COVID, contact your healthcare provider to discuss your symptoms and possible treatment options. Mount Sinai, for instance, suggests that holistic care or rehabilitation can help treat symptoms. This may involve physical therapy, occupational therapy, or other types of support whether in groups or one on one.

But the safest way to avoid long COVID is through prevention methods, such as:

  • Getting vaccinated. "The best way to protect ourselves from long COVID is to get vaccinated," Sandra Bonat, MD, pediatric physician director at VIP StarNetwork, says. "We have a new bivalent booster, which is targeting not only the original COVID strain but also the predominant omicron strains that are currently in the US."
  • Following COVID-19 best practices. Basically, do everything you can to avoid getting infected with COVID-19 in the first place. "Continue to avoid crowded indoor spaces and poorly ventilated spaces," Dr. Bonat says. "If you have to be in those spaces, wear a mask. Hand hygiene is really important for any kind of illness prevention, and it's one of our best defenses we have. Also, people should be responsible and stay home when they're sick."
  • Asking your doctor about antivirals if you do get COVID-19. Antivirals work to "target specific parts of the virus to stop it from multiplying in the body, helping to prevent severe illness and death," per the CDC. One that's become popular for COVID treatment is Paxlovid. Antivirals have "saved many lives and reduced COVID's more drastic symptoms," Dr. Chan says. "But these drugs are not the end-all solution for the virus." Treatment must begin within five days after symptoms begin, according to the FDA. And still, COVID rebound symptoms are possible after treatment.

As experts continue to learn more about long COVID, it's important to stay safe and continue taking precautionary measures against infection.