With US deaths from COVID-19 recently surpassing 500,000, there are 111 million confirmed cases worldwide. Fortunately, COVID-19 vaccination is also on the rise, with more than 63 million doses administered in the United States. Cases of COVID-19 were first reported in January 2020, and the virus has been predictably unpredictable. While some people experience seemingly mild cases with few to no symptoms, many others suffer acute COVID-19 cases that are severe or even life-threatening.
The immediate symptoms of COVID-19 are like the flu. Short-term symptoms include fever or chills, cough, shortness of breath, fatigue, muscle aches, sore throat, and congestion. Additionally, COVID-19 can cause loss of smell and taste, nausea, and diarrhea.
Unfortunately, patients are reporting long-term symptoms of COVID-19. In one COVID-19 clinical study, as many as 30% of patients experienced long-term symptoms. A person that has long COVID is called a COVID-19 long hauler.
This study noted that diabetic or hypertensive patients were more likely to experience long hauler symptoms. The older the patient, the more likely they were to have long-term symptoms post COVID-19.
Here are seven of the most common long-term effects of COVID-19.
Fatigue is a symptom that accompanies the COVID-19 patient not only immediately after infection, but as a long hauler symptom. Not only does fatigue cover physical feelings of tiredness and exhaustion, but also psychological fatigue. Psychological fatigue could include problems starting things and difficulty concentrating.
One study indicated that fatigue occurred whether the COVID-19 case was severe or mild. In a press release the study authors noted, “a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness.” Their results highlighted the importance of assessing post-COVID-19 patients for severe fatigue and tailoring interventions specifically to address this symptom.
Shortness of breath
Another one of the persistent symptoms of COVID-19 is shortness of breath. Many patients were physically active before the virus, playing sports or exercising. However, after COVID-19, they have not been able to resume their normal activity level due to shortness of breath.
The severity of shortness of breath varies from patient to patient. Some cases are mild and occur only when trying to exercise strenuously or hurry up a slight hill. Others cause patients to pause for breath when walking quickly, while the worst cases can affect simple tasks like dressing.
One study found 28% post COVID-19 patients were not able to resume physical activities they enjoyed before infection. Others were able to be active, but only at a lower level.
Besides shortness of breath, long hauler COVID-19 patients frequently experience other respiratory complications. While abnormal chest x-rays are not uncommon for COVID-19 patients, post COVID-19 patients often develop pneumonia and require support from a ventilator.
These patients must carefully monitor their symptoms after release from medical care. They are more likely to develop other infections and diseases, so they should work with their healthcare providers to prevent these complications.
Depression and anxiety
While quarantine mandated by the COVID-19 pandemic has led to many feeling depression, anxiety, and loneliness due to isolation, having the virus can increase feelings of depression and anxiety post COVID. One study found that within three months, as many as eight percent of post COVID-19 patients experienced a psychiatric illness.
There was a greater risk for the patients to develop anxiety disorders than mood disorders. Risk of developing insomnia and dementia were also higher after COVID-19 infection.
Another one of the common long-term symptoms of COVID-19 is brain fog, sometimes called COVID brain. The symptom is so common that a brain cancer team collaborated with critical care doctors to research potential causes. Brain fog is a common side effect of patients being treated for blood cancer and is caused by cytokines released to kill cancer cells.
Cytokines can be overproduced however, leading to inflammation. This inflammation can lead to brain fog weeks after infection. For cancer patients, the brain fog is treated with steroids. Doctors are hopeful this treatment will help COVID-19 patients.
Significant hair loss can be one of the long-term symptoms of COVID-19. While this may be distressing, it is not surprising. This is part of the normal hair growth lifecycle. A high fever or other body stressor can cause the hair to enter the shedding phase of the hair life cycle at the same time.
The greatest amount of hair loss is usually two to three months after the high fever, but it can last anywhere from six to nine months. Stress can also contribute to temporary hair loss but should return to a normal cycle when the stress ends.
Pain and fever
While it seems once the virus has run its course, pain and fever would be over. For some, the long-term symptoms of COVID-19 are joint pain, chest pain, muscle pain, and intermittent fever. Joint and muscle pain after COVID-19 can be caused by inactivity. This symptom may also be caused by treatments received during the illness.
Fever may come and go after COVID-19 infection. After any other sickness is ruled out, fever can be treated by normal over the counter medicines.
While healthcare providers don’t yet know what the importance of these long-term symptoms of COVID-19 is, multitudes of researchers are diligently studying the COVID-19 virus, symptoms, and side effects.
Preventing COVID-19 is one of the best ways to avoid the long-term symptoms of COVID-19. To do this, wear a mask in public places, practice social distancing, wash your hands, and avoid crowds.
If you are experiencing a severe long-term symptom of COVID-19, make sure to see your doctor. Even if you are not certain the symptoms are caused by COVID-19, your doctor will be able to fully assess your condition and provide the treatment options best for you.
NHS Choices. https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/musculoskeletal-shoulder-and-back-pain/.
COVID-19: Why is it mild for some, deadly for others? COVID-19: Why is it mild for some, deadly for others? | Weill Cornell Medicine. https://weillcornell.org/news/covid-19-why-is-it-mild-for-some-deadly-for-others.
Can COVID-19 cause hair loss? American Academy of Dermatology. https://www.aad.org/public/diseases/hair-loss/causes/covid-19.
EurekAlert. Study shows high prevalence of fatigue following SARS-CoV-2 infection independent of COVID-19 disease severity. EurekAlert! https://eurekalert.org/pub_releases/2020-09/esoc-ssh091720.php.
Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. Journal of Infection. 2020;81(6). doi:10.1016/j.jinf.2020.08.029
George PM, Barratt SL, Condliffe R, et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax. 2020;75(11):1009-1016. doi:10.1136/thoraxjnl-2020-215314
Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. The BMJ. https://www.bmj.com/content/370/bmj.m3026. Published August 11, 2020.
Hollingsworth H. US tops 500,000 virus deaths, matching the toll of 3 wars. AP NEWS. https://apnews.com/article/us-over-500k-coronavirus-deaths-4ffa86c709f6a843de9cf0711e7215cf. Published February 22, 2021.
Jackson C. Chalder Fatigue Scale (CFQ 11). OUP Academic. https://academic.oup.com/occmed/article/65/1/86/1433061. Published December 29, 2014.
Logue JK, Franko NM, Mcculloch DJ, et al. Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Network Open. 2021;4(2). doi:10.1001/jamanetworkopen.2021.0830
Long-Term Effects of COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html.
Remsik J, Wilcox JA, Babady NE, et al. Inflammatory Leptomeningeal Cytokines Mediate COVID-19 Neurologic Symptoms in Cancer Patients. Cancer Cell. 2021;39(2). doi:10.1016/j.ccell.2021.01.007
Ritchie Rand data: H. Coronavirus (COVID-19) Vaccinations – Statistics and Research. Our World in Data. https://ourworldindata.org/covid-vaccinations.
Symptoms of Coronavirus. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html?CDC_AA_refVal=https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html.
Taquet M, Luciano S, Geddes JR, Harrison PJ. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet Psychiatry. 2021;8(2):130-140. doi:10.1016/s2215-0366(20)30462-4
mMRC (Modified Medical Research Council) Dyspnea Scale. MDCalc. https://www.mdcalc.com/mmrc-modified-medical-research-council-dyspnea-scale#why-use.
Image by Masum Ali from Pixabay