Long Covid

Millions of people who have had COVID-19 find themselves suffering from a host of debilitating symptoms that can persist for weeks or even months after their initial coronavirus infection fades.

This phenomenon, dubbed long COVID, has puzzled experts since near the start of the pandemic. And while research is starting to shore up some answers, Greg Vanichkachorn with Mayo Clinic says, “we don’t really have [long COVID] nailed down yet.” A big reason is because “it looks like more and more symptoms can be associated with this condition,” says Vanichkachorn, M.D., an occupational and aerospace medicine specialist and medical director of Mayo Clinic’s COVID Activity Rehabilitation Program.

In fact, the list of the most commonly reported long COVID symptoms maintained by the Centers for Disease Control and Prevention (CDC) includes nearly 20, ranging from neurological complications to digestive disorders. Some studies have uncovered more than 50 long-term effects of COVID-19, adding issues such as hair loss and vision loss to the mix. Others estimate that number is much higher — closer to 200.

Still, some of these symptoms seem to be more prevalent.

New research published May 25, 2023 in JAMA identified 12 symptoms that most set apart people with and without long COVID. They are: 

1. Post-exertional malaise, or the worsening of symptoms following physical or mental exertion — even minor effort. 
2. Fatigue 
3. Brain fog
4. Dizziness
5. Gastrointestinal symptoms 
6. Heart palpitations
7. Issues with sexual desire or capacity
8. Loss of smell or taste
9. Thirst
10. Chronic cough
11. Chest pain
12. Abnormal movements

Vanichkachorn says fatigue is the most common complaint that he sees among his long COVID patients. “And that’s often coupled with some breathing problems, either coughing or shortness of breath,” he adds. Almost equal to that are patients coming in with neurological issues — headaches, tingling or numbness in the arms and legs, ringing in the ears, changes in their vision, “as well as a lot of trouble with thinking,” Vanichkachorn says.

For some, this means routine tasks such as getting dressed or taking a shower require assistance. Others have trouble completing everyday errands like grocery shopping or doing the laundry due to their symptoms — “and of course, going to work,” Vanichkachorn adds.

Priya Duggal, a professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, estimates that 3 to 5 percent of people who have had COVID-19 “feel they cannot function normally in everyday life” due to lasting symptoms. “If we think this could even be 1 percent, it would affect 800,000 people, given that 80 million have had a COVID-19 infection in the United States,” she said in a 2022 media briefing. That number is now much higher. As of March, 2023, there have been more than 103 million cases of COVID-19 in the U.S., according to the Johns Hopkins COVID-19 Dashboard.

It’s still not clear who is at greatest risk for these more acute cases of long COVID-19, Duggal said. “Definitely people who already had mobility issues or who are older, and those who are hospitalized are at risk. But we’re also seeing younger people, and those who were healthy before their infections, and those who had mild infections,” she added.

When it comes to long COVID — which is thought to impact up to one-third of people who have had a coronavirus infection — a few folks may be more at risk than others, though Duggal emphasizes that “no one gets a free pass.” People who had underlying health conditions before their infection may be more likely to develop long COVID, the CDC says.

Research also finds that more women report long COVID symptoms than men, and it tends to be more prevalent in middle-aged adults. And according to the CDC, unvaccinated individuals are more likely to get long COVID than people who had the vaccine.

Talk to your doctor early if you experience symptoms