This picture taken on November 28, 2020 shows Juno Simorangkir, a Long Covid campaigner.
Dr. Kortepeter, an infectious disease and public health physician and biodefense expert discusses common signs and symptoms that some Covid victims have experienced after illness.
A gentleman reached out to me recently for help who said he was previously successful, but was now a broken man, sick, in agonizing pain, broke and out of work. His wife was even worse. He had seen multiple physicians and a psychiatrist, but no one could help him. What struck me was that both his and his wife’s symptoms began after having Covid-19 illness. I thought that if his current complaints are due to his Covid infection, he may have what is called “long Covid.”
Although most people who get a Covid infection recover within a couple weeks, not long after the Covid-19 pandemic began, clinicians started seeing patients who took longer to improve or just didn’t seem to get better at all. These individuals are called “long haulers.” You may have heard about it. Multiple other names have been used to describe this phenomenon, including: post-acute sequelae of SARS-CoV2 (PASC), or post-Covid syndrome.
It has taken some time, but long Covid is now recognized as a real problem. The CDC is tracking this unfortunate phenomenon. The CDC uses “post-COVID conditions” to cover a “wide range of health consequences that are present four or more weeks” after Covid-19 illness.
What are the symptoms of long Covid?
The constellation of long Covid symptoms is broad, can vary widely between individuals and can affect multiple different parts of the body. This makes it a challenge to diagnose, especially since there’s no simple diagnostic test and Covid-19 can affect most of the systems in your body. Similarly, long Covid can affect multiple parts of the body, as the snapshot of the types of symptoms below shows, by major organ system:
- General symptoms: fatigue, difficulty sleeping, altered mood
- Lungs: shortness of breath, cough, chest pain
- Heart: pounding heart, rapid heartbeat, dizziness after standing
- Nervous System: “brain fog” (i.e. difficulty thinking or concentrating), headache, feelings of pins and needles, altered smell or taste
- Gastrointestinal: diarrhea, abdominal pain
Individuals who had severe disease or prolonged hospitalizations can also have post-traumatic stress disorder.
Long Covid is not unique – other infections can have long-lasting impacts
Long Covid is a real phenomenon. From a scientific standpoint, it is a puzzle. We don’t know what causes it or why this specific virus causes it; however, it is not the only virus that can lead to long-term sequelae in a subset of people who get an infection. More recently, we have seen chronic post-infection side effects with the Ebola virus as well. Before the 2014-16 Ebola outbreak in West Africa, cases of Ebola occurred in remote areas in Africa and there weren’t many survivors, so we didn’t recognize the problem. But the West Africa outbreak was so large that there are now thousands of survivors, and many of them suffer from chronic ill effects that share similarities with the aftereffects of Covid, including muscular and joint pain, headaches, difficulty concentrating, skin rashes, and visual disturbances. Some victims have been found to harbor live virus that hides out in certain parts of the body (the brain, the eye, the testes). We don’t understand why some have problems and others don’t.
This post-infection problem is not confined to just viruses. The debate about the cause and appropriate treatment for individuals who suffer from chronic symptoms after Lyme disease (caused by a bacteria) has been ongoing for decades. Multiple other infections can lead to long-term consequences after someone has appeared to recover from the acute illness.
Clearly all of these are real phenomena, but the frustrating thing is that we don’t know the cause. On the positive side, the medical establishment is now aware of this problem. Research efforts have kick-started to study these individuals to try to understand the etiology and how they do over time. If we can figure this one out, maybe we can figure out some of the other post-infection syndromes that have baffled us.
Long Covid is another reason to get vaccinated
With Covid infection, we know that certain underlying factors predispose to more severe illness (hypertension, heart disease, obesity, diabetes, immune problems). But this isn’t the case for long Covid. In fact, even someone with a mild infection can still become a long hauler. It’s a bit like drawing straws. You don’t know who will draw the short straw. As the pandemic launches on a new wave, especially in areas with low vaccination rates, if you didn’t have enough reason to get vaccinated before, perhaps the long-hauler phenomenon will provide additional incentive.
Most people are familiar with the challenge of preventing mosquito bites when outdoors on a warm summer evening. Even if you slather on bug juice, somehow a pesky mosquito will find its window of opportunity in a minute patch of skin that is lacking repellant. Think about Covid in the same way – it seeks out the unvaccinated like that mosquito, only the short and long-term consequences may be greater. It will find you – it’s only a matter of time.
If you or someone you know has already been infected with Covid and is having ongoing symptoms or has not returned to their normal state of well-being, consider that you or they may be experiencing long Covid. Ask your doctor about it. Support groups are forming now. Join one. You could share resources, information about clinical trials, or the challenges you are having with others who are having similar experiences.
