This resource Reviews long COVID symptoms to assist readers in understanding what long COVID looks like. It describes the more common and less common symptoms of long COVID, including fatigue, brain fog, breathing problems, rash, and hair loss – their duration, severity, and risk factors are also noted. Helpful information from experts is provided on how to diagnose, monitor, manage, and treat long COVID including lifestyle modification, rehabilitation, and mental health and wellbeing. Intended for patients, caregivers, and practitioners, this resource will increase awareness, support recovery, and provide suggestions for coping with post- COVID syndrome.
Introduction to Symptoms of Long COVID
What is Long COVID?
Long COVID, sometimes called post-COVID syndrome and post-acute COVID-19, is the term for when individuals experience symptoms weeks or months later after a person has overcome their initial COVID-19 infection. Unlike a straightforward illness, the long-term symptoms of COVID can affect multiple organ systems, involving the respiratory, cardiovascular, neurological, and the digestive systems of the body. Symptoms may include fatigue, brain fog, persistent cough, chest pain, and muscle or joint aches. Symptoms can vary widely from person to person and some people with mild illness or have started with asymptomatic infections have gone on to develop long COVID. Recognition and management of early symptoms are key to improving recovery.
Who is at Risk?
Long COVID can occur in anyone following an episode of COVID-19. Some people are at increased risk including older adults or women who report having persistent symptoms more often. Risk also rises in individuals who have pre-existing conditions like diabetes, obesity, any type of cardiovascular disease, and respiratory illnesses. Additionally, those with severe initial COVID infections are more likely to develop persistent complications. It is worth noting that some young individuals, and people who are otherwise healthy, can also have persistent effects. Knowing the risk factors associated with long COVID can help identify those who will be at risk for post-COVID symptoms so that it may be monitored and managed effectively.
Common Symptoms of Long COVID
The symptoms of long COVID vary widely and can affect multiple organ systems. Here is a detailed breakdown of the most common long COVID manifestations:
Fatigue and Weakness
A common long-COVID symptom is fatigue and exhaustion that persists over time. Patients often describe fatigue that resolves with rest, they can have lower levels of endurance and work will take more time with greater difficulty in most activities of daily living. Patients’ post-viral fatigue may be similar to chronic fatigue syndrome (CFS) and manifest for weeks to months. Some activities, like walking or climbing a flight of stairs, can be tiring. Treating fatigue entails pacing, proper rest, good nutrition, and a slow increase in physical rehabilitation in order to recover and rehabilitate.
Respiratory Symptoms
Many people suffering with long COVID continue to have respiratory symptoms whether the acute illness has settled or not. Symptoms may include breathlessness, an ongoing cough, wheeze, and/or tightness or pain in the chest. Symptoms may result from inflammation in the lung tissue, damage from the viral illness (after effects), or due to reduced lung capacity. In some cases, the respiratory symptoms can interfere with daily activities and exercise tolerance. Management may involve pulmonary rehabilitation and breathing programs along with health professionals monitoring for lung function and provide support to set the individual up for longer term recovery.
Neurological Symptoms
Long COVID can present frequently with neurological manifestations that affect mental processing and functioning in everyday life. Patients describe cognitive fog, memory issues, difficulty concentrating with cognitive tasks, and headache. Other neurological issues can include dizziness, tingling or numbness in the extremities, and loss of taste or smell (anosmia). Cognitive and other neurological symptoms may last over a span of weeks or months which impact work, study/learning and functional daily living. Management may include cognitive rehabilitation, mental exercises, and supportive therapies, as well as ongoing monitoring and relations with health care professionals to determine progress in recovery process.
Cardiovascular Symptoms
Heart symptoms are often seen in long COVID with chest pain, palpitations, fast or irregular heart rate, and increased clotting factors in the body. These symptoms can come on as a result of inflammation, an injury to the heart muscle, or by affecting circulation physiologically due to the viral process. Patients will note not taking a deep breath with exertion. It is important to recognize these symptoms early and treat them if there is need. Considerations to follow are monitoring the heart as warranted, based on symptoms, implementing new lifestyle choices, finding ways to reduce the stress and anxiety impacts, and referral to cardiology for complications, as each is sustainable the plan of improving continued health of the heart long-term.
Digestive and Gastrointestinal Symptoms
Some individuals with long COVID report chronic gastrointestinal and digestive complaints. Common symptoms/ complaints include diarrhea, constipation, abdominal/ gastrointestinal pain, nausea, and loss of appetite. The digestive symptoms may be derived from post-viral inflammation, potentially due to disturbance and alteration of gut function due to COVID-19 infection. Although common digestive/ sub-gastrointestinal complaints may be considerably less impact full relative to respiratory or neurological symptoms in frequency of occurrence; man effort will be required for nutritional health and emotional and mental well-being. Management pathways include a balanced diet and hydration, probiotics and referral to a gastroenterlgist as needed to support recovery and nutritional health and improved digestive functioning.
Muscle and Joint Pain
Chronic pain in muscles and joints is a frequent complaint of long COVID, often with consequential increased mobility challenges and obstacles to activities of daily life. Patients may experience myalgia (muscle aches) and/or arthralgia (joint pain) and/or generalised stiffness of the body that can extend weeks to months post-COVID recovery. Symptoms may be attributed to immune system activation, prolonged inflammation, and/or post-viral fatigue. Management of symptoms can include gentle stretching, physical therapy, rest, treatment with anti-inflammatories, and re-acquisition of ability through a gradual exercise program to manage comfort levels and restore flexibility while overall promoting strength and recovery.
Sleep Disorders and Fatigue
Sleep issues are common in long COVID illness, and they can contribute to fatigue and low energy. Individuals may have insomnia, disrupted sleep, difficulty falling or staying asleep, as well as excessive daytime sleepiness. Sleep changes may worsen other symptoms, including cognitive impairment, mood changes, and physical fatigue. Options to treat sleep problems include sleep hygiene practices, keeping a regular sleep schedule, using stress management strategies, and working with the healthcare provider when it is indicated. Managing sleep disorders is essential because recovery from fatigue, cognitive function improvement, and overall recovery from long COVID may be directly reliant on effective management of sleep issues.
Mental Health and Emotional Symptoms
Cognitive problems or “brain fog” can also be profoundly impactful or debilitating, and can show up as a severe degradation of overall mental health. Patients may benefit from counselings, therapy, stress reduction and management, mindful based strategies, and/or medications that have been prescribed as symptom management options. Early identification and support of emotional health needs is essential for the emotional and mental health and well being of patients suffering from long COVID.
Less Common or Rare Symptoms
Besides the common signs of long COVID, there are atypical or uncommon symptoms that might involve multiple organs or systems within the body, including rash or dermatitis, hair loss, persistent or low-grade fever, joint pains or swelling, or autoimmune type reactions. Not everyone affected by long COVID would present with unusual symptoms as mentioned, but again, some could significantly influence overall quality of life, and necessitate specialist or multi-disciplinary consultation. Reporting unusual symptoms, in addition to other atypical or prolonged symptoms to your provider will ensure you receive appropriate and needed care. While monitoring and being mindful of unusual or uncommon symptoms, it generates opportunities for total post COVID care, and early intervention.
Duration and Severity of Symptoms
The length and severity of long COVID symptoms can vary considerably among individuals. Some people recover completely in a matter of weeks, while others may have symptoms lasting six months or longer. Key factors affecting severity include: age, gender, underlying health conditions, and severity of the original COVID-19 illness. Symptoms can be mild (fatigue with intermittent brain fog) to more severe respiratory, cardiovascular, or neurological symptoms that affect daily functioning. Knowing the timelines and possible severity of symptoms lets patients and their healthcare providers formulate the best possible monitoring, management, and rehabilitation plan for full recovery.
Diagnosis and Monitoring
A specific, singular test for long COVID does not exist; diagnosis is dependent on having a symptom history, a clinical assessment and investigating and ruling out other causes. Providers will typically assess respiratory, cardiovascular, neurological and gastrointestinal symptoms to gauge the impact of post COVID-19 severity. Suggested monitoring approaches could consist of blood tests for inflammatory markers and organ function, chest imaging, cardiac assessments and neurological assessments. Ongoing assessment can help facilitate the tracking of symptom progress and establishing an individualised treatment plan. Early detection and ongoing evaluation and monitoring are essential to facilitating optimal ongoing care of long COVID and long-term recovery.
Management and Treatment Options
Currently, there is no singular cure for long COVID, but its symptoms can be managed and addressed in multiple ways through lifestyle changes, rehabilitation and medical management. Lifestyle changes may include diet, gradually returning to regular physical activity, stress management, and sleep. Rehabilitation may be pulmonary rehab, physiotherapy or cognitive rehabilitation. Medical management may include a variety of pain medications, anti-inflammatories or mental health supports including counselling and/or medications for anxiety and depression. It is vital to take a multi-disciplinary, individualised approach to assist with ongoing recovery progress, limit persistent symptoms and improve quality of life for individuals with long COVID.
Expert Opinions on Long COVID
Leading health agencies understand that long COVID is a significant post-viral condition that will need follow up care. The World Health Organisation (WHO) promotes long-term observation in a multi-faceted management framework to aid the treatment of long COVID. The Centers for Disease Control and Prevention (CDC) recommends that screening, evaluation and management of long COVID in its early stages can help to mitigate effects associated with the condition. The reviewed literature indicates that rehabilitation, cognitive training and mental health support can eventually improve patients’ function. All consulted experts agree that individuals recovering from long COVID, as well as those with other persistent symptoms, will require individualised treatment which will address medical treatment, health maintenance, and allied therapies and gives a recommendation of a non-judgmental, biopsychosocial perspective to improve symptoms and quality of life.
Prevention and Risk Reduction of Symptoms of Long COVID
While preventing long COVID entirely may be impossible, there are many actions you can take to lower your risk of lingering symptoms. Perhaps the most effective approach to lower risk of moderate to severe disease and complications from long COVID is to become vaccinated. Treatment of acute COVID-19 (when started as soon as feasible, if possible) may help to prevent long COVID symptoms. It is also highly recommended to establish other good health behaviours, such as good nutrition, regular physical activity, and good management of any chronic health conditions, in regards to recovery from long COVID. Infection control measures (masking, good hand hygiene, avoiding crowded venues) could also reduce risk of reinfection. Any degree of incorporation of these strategies will improve recovery, lower the risk of long COVID, and enhance health overall!
Conclusion Symptoms of Long COVID
Symptoms of long COVID may vary such as fatigue, brain fog, and difficulty breathing; onset of cardiovascular concerns; abdominal complaints; and social and psychological concerns. Symptoms may persist for long periods of time, vary in intensity, and all impact a person’s ability to function in their daily work life, and effect all aspects of one’s physical and mental health. Identifying post COVID syndrome in the early stages, doing long-term follow-up of the symptoms, and thinking about a multidisciplinary approach to treatment, which includes lifestyle modifications and includes rehabilitation and mental health treatment is key to recovery. Recognition of the occurrence of caring for other unusual and rare symptoms is also needed for the patient to receive holistic care.
