What Is Long COVID? Symptoms, Causes, Diagnosis, Treatment, and Prevention

For most people who get sick with COVID-19, the illness comes and goes in a week or two. But some individuals develop lingering, sometimes debilitating symptoms, commonly referred to as long COVID. Other names for the condition are long-haul COVID, post-acute COVID-19, chronic COVID, or post-acute sequelae of COVID-19 (PASC).

Many of the symptoms that have been documented in people with long COVID are similar to those that occur during the initial bout of illness.

• Fever
• Coughing
• Difficulty breathing, or shortness of breath
• Fatigue
• Brain fog (difficulty thinking or concentrating)
• Joint or muscle pain
• Headache
• Diarrhea
• Skin rashes
• Loss of taste or smell

In other cases, new symptoms that were not part of the initial bout of COVID may develop for the first time in the weeks or months after the initial infection.

According to the CDC, these can include:

• Mood changes
• Chest pain
• Heart palpitations
• Stomach pain
• Sleep problems
• Dizziness or lightheadedness upon standing
• A feeling of pins-and-needles in the body
• Exhaustion or other symptoms after physical or mental activities (known as post-exertional malaise)
• Changes in menstrual cycles

Like COVID-19, the culprit behind long COVID is a coronavirus (a type of virus) called SARS-CoV-2. Once the virus enters the respiratory system via the nose and mouth, it can multiply and infect many parts of the body. In most people, the immune system clears the virus and the person fully recovers. In a subset of people, however, symptoms continue and/or expand.

Other experts have pointed to the immune system, which perhaps mistakenly continues its attack against SARS-CoV-2 even when the virus is gone, damaging normal cells in a reaction called a cytokine storm. Researchers are investigating other possibilities, too.

Experts aren’t sure what might make a person prone to long COVID. Early research has pointed to several potential risk factors that seem to be associated with developing the condition, but this research is preliminary and ongoing.

• The level of coronavirus RNA in the blood early in the infection (which can indicate how much virus is in the body)
• The presence of certain autoantibodies that might mistakenly attack body tissues
• The reactivation of a prior bout of the Epstein-Barr virus
• Having type 2 diabetes

There is currently no diagnostic test that can confirm whether someone has long COVID. This is part of the reason that some people with the condition say their doctors have not taken their complaints seriously.

Most doctors use existing tests and tools to evaluate specific symptoms. For example, if a person with long COVID is regularly short of breath, their doctor would likely perform a variety of pulmonary function tests to assess their lung health. If the person is experiencing heart palpitations, their physician might instruct them to wear a heart monitor.

Physicians have no way to evaluate symptoms like extreme fatigue or brain fog. If you believe you are experiencing long COVID, experts suggest you keep a detailed log of your symptoms and bring it to your doctor to help them make a diagnosis.

Prognosis for People With Long COVID

Scientists studying long COVID say that many if not most people do eventually return to (or close to) their pre-disease state.

But much is not yet known about patients whose long COVID persists. Since the condition is new, experts can’t say that everyone with symptoms of long COVID will eventually get better.

How long the symptoms of long COVID last varies by person. Some recover within the first month or two, while others get better over a longer period of time.

But that’s not true of everyone. There are some members of the Body Politic group who have had the condition since contracting COVID soon after the disease was first discovered more than two years ago.

There is no specific treatment for long COVID. Instead, the current approach is to deal with each symptom individually.

For example, someone who experiences brain fog may be referred by their doctor for cognitive rehabilitation, akin to physical therapy for the brain. During the rehab they might be taught ways to improve concentration or memory, or they may learn strategies to compensate for problems thinking, such as by consciously marking their place in a work task when the phone rings.

People with long COVID can be treated by their general practice physician or by individual specialists for the body parts affected by their condition, such as a cardiologist for heart issues.

Another option is to visit a clinic dedicated to long COVID care. These long COVID clinics are opening around the country, and many are affiliated with large community or academic hospitals; the website of the patient support group Survivor Corps offers a list of long COVID clinics across the United States. Still, the ratio of clinics to people grappling with symptoms is low, so many clinics have patient wait lists.

Experts agree that much more research is needed on long COVID in order to enable better care. To that end, President Biden signed an executive order in April 2022 directing a coordinated research and treatment effort by the federal government. Among other things, the order builds on a long COVID research study, called RECOVER, that is underway at the National Institutes of Health.

The best way to prevent a post-COVID condition is to avoid getting COVID-19 in the first place. While that may not always be possible, there are things you can do to protect yourself.

Other ways of protecting yourself from COVID-19, and therefore long COVID, include wearing a well-fitting, high-protection respiratory mask, avoiding crowds in poorly ventilated spaces, washing your hands frequently, and regularly using rapid tests on yourself and those with whom you will be spending time indoors, to detect who might have the virus.

Several serious medical conditions have been documented as occurring after a person recovers from an acute bout of COVID.

Some experts distinguish these conditions from long COVID, because they can appear in people who don’t have any of the common symptoms that currently define long COVID.

Long COVID can also harm emotional health. Whether that’s a function of the condition itself or other people’s response to it remains unclear.

Women Are More Likely to Get Long COVID Than Men

Children Can Get Long COVID, Too

Long COVID doesn’t just affect adults. Children, especially older kids and teens, are at risk.

A major research effort called the CLoCk study is underway in the United Kingdom to better understand long COVID in children. In this research, conducted by the National Institute for Health and Care Research, thousands of kids ages 11 to 17 who have previously been diagnosed with COVID-19 are being compared with children who have not tested positive.

Little research has so far teased out whether people of color have any inherent factors that make them more prone to long COVID.

Black Americans and Latinos as a group are also more prone to contracting COVID-19, in many cases because they work in jobs and live in housing that puts them in more contact with other people, in contrast to people from communities that have not been actively disadvantaged over the years.

Some people include another condition as part of long COVID, known as multisystem inflammatory syndrome (MIS-A, or MIS-C when it affects children), but most experts consider this to be a separate disease.

People with long COVID and those who have recovered from the condition have launched a number of online support groups, sometimes working alongside scientists on research investigations.

These groups provide information, guidance, emotional support, and the knowledge that no one with long COVID has to face it alone.

Some of the largest groups include:

• Body Politic
• Survivor Corps
• Long COVID Alliance
• Long COVID Kids