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Long COVID General Information

BACKGROUND

An estimated 49 percent of people who become infected with COVID-19 will experience persistent symptoms after recovering from COVID-19, which is known as long COVID, post COVID, or “long-haul COVID.” These persistent symptoms can arise even after a person recovers from an asymptomatic or mild case of COVID-19. Long COVID is characterized by damage to several different vital organs, including the heart, kidneys, lungs, and brain. Some of this organ damage is caused by an overactive autoimmune response to COVID-19, in which the immune system produces autoantibodies that attack the body’s tissues and organs over time, including the joints, skin, and nervous system. This damage can lead to widespread and long-term inflammation. Being vaccinated against COVID-19 reduces the risk of developing long COVID after recovering from a breakthrough COVID-19 infection, but it is still possible to develop long COVID if you are vaccinated. The risk for developing long COVID is much higher for unvaccinated individuals; women are more likely to develop long COVID.

SYMPTOMS

Long COVID symptoms can include fatigue, impaired respiratory function, memory loss, “brain fog,” nausea, and difficulty concentrating. Some patients living with long COVID experience mild symptoms that clear up over the course of weeks or months while others experience severe, debilitating symptoms that do not improve over time or relapse after improving. One systematic study of long COVID patients found that over 85 percent experienced a relapse after symptoms initially improved. The U.S. Centers for Disease Control and Prevention (CDC) provides the following symptoms of long COVID:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue
  • Symptoms that get worse after physical or mental activities (post-exertional malaise)
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Cough
  • Chest or stomach pain
  • Headache
  • Fast-beating or pounding heart (heart palpitations)
  • Joint or muscle pain
  • Pins-and-needles feeling
  • Diarrhea
  • Sleep problems
  • Fever
  • Dizziness on standing (lightheadedness)
  • Rash
  • Mood changes
  • Change in smell or taste
  • Changes in menstrual period cycles

In addition to these symptoms, patients with long COVID are more likely to develop one or more Post-COVID Conditions following their recovery from COVID-19, which can further compromise their health. Review our Post-COVID Conditions page to learn more about the heightened health risks that patients are susceptible to following their recovery from COVID-19.

Some children develop multisystem inflammatory syndrome (MIS-C) after recovering from COVID-19, a condition characterized by widespread inflammation in the body. MIS-C is a different condition than long COVID, but symptoms of MIS-C can develop into long COVID symptoms over time.

DIAGNOSIS

Despite long COVID symptoms resulting from damage to their vital organs, receiving a diagnosis for long COVID can be challenging because the symptoms of the condition can manifest without being quantifiable in lab results or measurable in diagnostic imaging. There is currently no available diagnostic test to confirm that symptoms are wholly attributable to a prior COVID-19 infection. Definitions vary between practitioners, but generally patients who have a confirmed diagnosis of COVID-19 and who have experienced persistent symptoms for at least twelve weeks are considered to have long COVID. Refer to the table below to learn about the diagnostic tests that are commonly used to assess the presence and severity of long COVID symptoms.

Symptoms
Specialist
Diagnostic

Persistent cough

Pulmonologist

Chest X-ray or CT scan to check for lung damage or inflammation

Shortness of breath

Pulmonologist

Pulmonary function test to measure how well the lungs are working

Fatigue

General practitioner or infectious disease specialist

Blood work to check for inflammation or anemia

Joint pain

Rheumatologist

X-rays or MRI to check for joint damage or inflammation

Headache

Neurologist

MRI or CT scan to check for brain abnormalities or inflammation

Loss of sense of smell or taste

Otolaryngologist

CT scan of the sinuses to check for damage or inflammation

Difficulty with memory or concentration

Neurologist

Cognitive assessment or MRI to check for brain abnormalities or inflammation

Heart palpitations or chest pain

Cardiologist

EKG or stress test to check for heart damage or abnormal function

Anxiety or depression

Psychiatrist

Mental health evaluation to assess symptoms and determine appropriate treatment

Persistent fever

General practitioner or infectious disease specialist

Blood work to check for ongoing infection or inflammation

Persistent body aches or muscle pain

General practitioner or infectious disease specialist

Blood work to check for inflammation

Persistent diarrhea or abdominal pain

Gastroenterologist

Stool sample or colonoscopy to check for gastrointestinal issues

Persistent dizziness or lightheadedness

Cardiologist or neurologist

EKG or MRI to check for heart or brain abnormalities

Persistent skin rash or changes in skin color

Dermatologist

Skin biopsy to check for inflammation or other abnormalities

Persistent eye issues, such as redness, swelling, or vision changes

Ophthalmologist

Eye exam and possibly imaging tests to check for eye abnormalities or inflammation

TREATMENT

There are currently no available treatments for long COVID, but many patients report that their symptoms improve over time. However, supportive care can help alleviate some symptoms of long COVID. Patients seeking treatment for long COVID may be referred to specialists, such as neurologists, cardiologists, pulmonologists, and psychologists who can provide treatments to relieve some long COVID symptoms. Counseling may also be offered to provide mental health support.

LONG COVID AND DISABILITY

Long COVID is recognized under federal law as a disability, which protects people with long COVID from discrimination on the basis of their disability. Protection from discrimination in this context means that people are entitled to “full and equal opportunities to participate in and enjoy all aspects of civic and commercial life.” To qualify for these protections, a person’s long COVID symptoms must represent a physical or mental impairment that substantially limits one or more major life activities. A person with long COVID who has a record of such an impairment or is regarded as having such an impairment may also be similarly protected, depending on their individual circumstances. The following examples are situations where a person’s long COVID symptoms satisfy the requirement of substantially limiting one or more major life activities:

  • A person with long COVID who has lung damage that causes shortness of breath, fatigue, and related effects is substantially limited in respiratory function, among other major life activities.
  • A person with long COVID who has symptoms of intestinal pain, vomiting, and nausea that have lingered for months is substantially limited in gastrointestinal function, among other major life activities.
  • A person with long COVID who experiences memory lapses and “brain fog” is substantially limited in brain function, concentrating, and/or thinking.

Please note that these examples are not an exhaustive list. Having long COVID does not always qualify as a disability. Depending on the extent of a person’s physical or mental impairment, they may qualify for disability benefits, such as short-term disability insurance, long-term disability insurance, and Social Security Disability Insurance (SSDI), among others. Review our COVID-19 and Disability Benefits page to learn more.

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