COVID Survivors Experience Long COVID

How long it takes to recover from COVID-19 is different for everybody. Many people feel better in a few days or weeks and most will make a full recovery within 12 weeks. But for some people, COVID-19 can cause symptoms that last weeks or months after the infection has gone.

There are long-term health effects for people recovering from coronavirus infections. This is sometimes called post-COVID-19 syndrome or "long COVID". Previous studies have found different estimates for the proportion of COVID-19 survivors who face long COVID symptoms, ranging from 20% to 50%. 

In a study, researchers identified four early things linked to greater chances that someone with COVID-19 will have long-term effects: type 2 diabetes at the time of diagnosis, the presence of specific autoantibodies, unusual levels of SARS-CoV-2 RNA in the blood, and signs of the Epstein-Barr virus in the blood. The chances of having long-term symptoms does not seem to be linked to how ill you are when you first get COVID-19.

Type 2 diabetes, pre-existing pulmonary disease, and other things could affect how long it takes to recover from long COVID. The vast majority of people with long COVID will get better over time, given enough support and relief of their symptoms. 

Fatigue is the most common symptom of long COVID in research so far, said Bhadelia, who is an associate professor of medicine at Boston University.

Other common symptoms are a hard time thinking quickly -- also known as “brain fog” -- and the feeling that, despite normal oxygen levels, breathing is difficult, as well as having the musculoskeletal pain. Other major symptoms included kidney failure, heart problems, blood clots and vascular issues. In fact, a study found that COVID-19 survivors had twice the risk for developing respiratory conditions and pulmonary embolism. 

Among ages 65 and older, researchers found an “increased risk for neurological conditions” and other mental health issues such as mood disorders and substance abuse.

Headache and persistent loss of smell and taste are also widely reported, said Bell, a professor and chair of the Department of Physical Medicine and Rehabilitation at the University of Texas Southwestern Medical Center in Dallas.

"Pretty prominent things that we're seeing are very high levels of anxiety, depression, and insomnia," Bell said. These "actually seem to be associated independently with the virus as opposed to just being a completely reactive component."

It remains unclear if a hyperinflammatory response is driving persistent post-COVID-19 symptoms. Children and some adults have developed multi-system inflammatory conditions associated with COVID-19, for example.

Spending time in critical care, even without COVID-19, can result in persistent symptoms after a hospital stay, such as acute respiratory distress syndrome. Recovery can take time because being in an ICU is "basically the physiologically equivalent of a car crash," Bhadelia said. "So you're recovering from that, too." 

Bell agreed. "You're not only recovering from the virus itself, you're recovering from intubation, secondary infections, secondary lung conditions, perhaps other organ failure, and prolonged bed rest. There are so many things that go into that, that it is a little bit hard to sort that out from what long COVID is and what the direct effects of the virus are."