LONG COVID GENERAL INFORMATION

BACKGROUND

An estimated 49 percent of people who become infected with SARS-CoV-2 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 chronic or recurring symptoms are attributable to COVID-19. Definitions vary between practitioners, but generally patients who have a confirmed diagnosis of COVID-19 and who have experienced symptoms for at least twelve weeks are considered to have long COVID.

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.

Pandemic Patients Submits Letter of Support for California’s Proposed Workplace Safety Standards

On July 29, 2022, the California Occupational Safety and Health Standards Board (Cal/OSHA) proposed to implement new workplace safety standards for large employers operating in the state. Referred to as General Industry Safety Orders, the proposed standards would require employers to play a more active role in reducing the spread of COVID-19 in the workplace.

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J.B. Asked: Can I Appeal a Disability Insurer’s Medical Review?

“I have long COVID and I recently filed a claim for disability insurance benefits through my workplace disability policy. The insurance company relied on a clinician’s review of my medical records to deny my claim. The clinician is employed by the insurance company, they never examined me in-person, and they do not specialize in a field of medicine relevant to my long COVID symptoms. Can I appeal the insurance company’s decision?”

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