Long COVID

Information about Long COVID

As new research emerges, we are learning more and more about the long-term effects of COVID-19, and the symptoms that continue to affect individuals day to day lives long after their diagnosis. Although many people get better within weeks of being diagnosed with COVID-19, some continue to experience symptoms months after first being infected, or may have new symptoms come up at a later time. This can happen to anyone who has been infected with COVID-19. This condition is commonly known as “Long COVID”

Background

Long COVID, also called post-acute sequelae of COVID-19 (PASC),¹ long-haul COVID², post-acute COVID-19², long-term effects of COVID², or chronic COVID², consists of a range of symptoms that can emerge weeks to months following infection with COVID-19 or symptoms that never fully resolve while infected with COVID-19.^1,2 While some people only report having one symptom (such as chronic fatigue), some report multiple symptoms.² In most cases, long COVID tends to start a few weeks or months after infection with COVID-19, but for others, they continue to experience symptoms from the period when they were first infected with COVID-19.²

In 2021, the World Health Organization (WHO) issued a definition for long COVID to help physicians and individuals know whether they should have a diagnosis of long COVID. The definition is as follows:

“Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months [or 12 weeks] from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others* and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.”³

Symptoms

Symptoms experienced by those with long COVID vary widely and many studies have already been conducted to estimate how common any given symptom might be. The following list includes the symptoms reported by individuals participating in several different research studies conducted around the world. Next to each symptom is the range of people who reported experiencing each symptom.⁴

Neurological disorders:
- Difficulty concentrating (20-26%)
- Memory deficits (17-23%)
- Cognitive impairment (14-31%)
- Loss of smell (8-19%)
- Loss of taste (7-19%)
- Headache (2-14%)
Mental health related disorders:
- Sleep disorders (19-30%)
- Depression (19-22%)
- Anxiety disorder (14-44%)
- Post-traumatic stress disorder [PTSD] (7-25%)
Pulmonary system:
- Pulmonary diffusion abnormalities (22-39%)
- Ground glass opacification (20-43%)
- Shortness of breath (14-37%)
- Restrictive patterns on spirometry (6-24%)
- Cough (5-23%)
- Lung fibrosis (3-18%)
Functional mobility impairments:
- General functioning (23-63%)
- Mobility decline (15-31%)
- Reduced exercise tolerance (11-19%)
Constitutional symptoms:
- Muscle weakness (25-55%)
- General pain (22-38%)
- Joint pain (6-19%)
- Muscle pain (6-21%)
- Flu-like symptoms (5-19%)
Cardiovascular disorders:
- Chest pain (9-18%)
- Palpitations (6-11%)
Other disorders:
- Hair loss (17-23%)
- Gastrointestinal symptoms (6%)
- Sore throat (3-4%)
- Skin rash (2-6%)

Other symptoms of long COVID, not included above, may occur.

Underlying Conditions

Individuals who were diagnosed with certain conditions before being infected with COVID-19 may have a greater risk of developing long COVID. Research on risk factors is less widely reported at this time, yet a few studies have shed some light on certain conditions that could predispose certain individuals.

One study found that female gender, particularly those under the age of 50, were far more likely to experience long COVID symptoms.⁵

The CDC has recently published information regarding long COVID on their website and note that the following persons may have a greater risk of developing long COVID⁶:

People who have experienced more severe COVID-19 illness, especially those who were hospitalized or needed intensive care.
People who had underlying health conditions prior to COVID-19.
People who did not get a COVID-19 vaccine.
People who experience multisystem inflammatory syndrome (MIS) during or after COVID-19 illness.
Some people affected by health inequities including people from racial or ethnic minority groups and people with disabilities.

How long does it last?

The answer to this question remains unknown at this time. Since SARS-CoV-2 remains a novel virus, and long COVID is even newer, research remains limited. Furthermore, because the first cases of long COVID were also first diagnosed in 2020, no one knows how long this condition may persist into the future. Some individuals, particularly those with milder symptoms, may go on to recover from long COVID while others may remain impacted for a longer period of time. The best course of action for persons experiencing long COVID is to seek medical attention and advice from a medical provider.

Does vaccination prevent or reduce the risk of long COVID?

One large study out of the United Kingdom found that there may be 9-13% decreased risk of developing long COVID among persons who were vaccinated and then were infected with COVID-19.⁷Another study out of Israel found that some common post-COVID symptoms are less likely among vaccinated persons, such as fatigue, headache, weakness, and muscle pain.⁸The United Kingdom Health Security Agency compiled several studies that attempt to address this question, and several similar questions, and found that vaccination does appear to reduce the likelihood that one develops long COVID, and among those who do, may reduce the length of persistent symptoms.⁹

Can vaccination after developing long COVID reduce the severity of symptoms?

The answer to this question is unknown, although it is possible for persons to be reinfected with COVID-19. It is unknown at this time whether reinfection increases the risk of developing long COVID; however, because vaccination is likely to reduce the risk of developing long COVID, everyone should be vaccinated for COVID-19 regardless of whether they have been infected previously.

Self-Reporting Long COVID Symptoms

If you believe you may be experiencing symptoms and/or conditions associated with long COVID, please share your experience with us by completing this form. You can also request that a public health staff member follow up with you should you have any questions or concerns.

Resources

Some providers in Colorado and Utah provide care to people experiencing symptoms from long COVID. A list of such providers can be found below:

Survivor Corps (Aurora, Boulder, Denver, Fruita, Johnstown, Westminster, Virtual)
NJH Center for Post COVID Care & Recovery (Denver, Virtual)
Family Health West (Fruita)
Mental Health Colorado (Virtual)
UC Health (Aurora)
Yale Medicine (Virtual)

If you need any support with finding resources, please either fill out the form above in the Self-Reporting Long COVID Symptoms section or email [email protected]