Dr. Mersad Alimoradi 17 May 2021

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Article Updated on 26 July 2021

Have you been infected with COVID-19? Still feeling tired? Have trouble sleeping? Trouble concentrating? In pain? Out of breath?

Post-acute COVID-19 syndrome is a constellation of symptoms that remain after a person recovers from a novel coronavirus infection. Studies show that the majority of people infected with COVID-19 end up with post-acute COVID-19 syndrome. These patients are usually referred to as corona long-haulers or as having long COVID.

Patients with long COVID usually have a wide variety of symptoms that interfere with their quality of life. These symptoms include anxiety, trouble concentrating, insomnia, depression, stress, fatigue, breathlessness, chest pain, among others. Long COVID can be even more severe in some cases, irreversibly damaging some vital organs, and leading to chronic sequelae.

Keep reading to learn more about persistent COVID-19, its symptoms, risk factors, and how you can deal with it.

What is long COVID?

Post-acute COVID-19 syndrome is a group of symptoms that persist beyond 4 weeks after the onset of coronavirus infection. These symptoms can affect nearly any body system, significantly interfering with patients’ quality of life. Many doctors believe that long COVID is somehow related to chronic fatigue syndrome, as it shares many of its characteristics.

It can happen to anyone recovering from COVID-19, regardless of the severity of their illness.

Since the post-COVID 19 syndrome is still being researched, it has not been yet well classified. Different names are being used interchangeably, and there’s no single true classification yet or definition yet. Terms that have been used include:

  • Long COVID syndrome
  • Post-acute COVID-19 syndrome
  • Post-COVID syndrome
  • Long haulers
  • Persistent COVID

Different authors and health authorities have used these names in different contexts. For the sake of simplification, we’ll be using all of these interchangeably to refer to the same syndrome.

Is Long COVID real?

Early on in the pandemic, post-covid syndrome was not well described and there were a lot of speculations questioning whether it’s a real syndrome or not.

Since then, numerous studies done all around the world were able to clearly characterize the long-corona syndrome, its symptoms, causes, and possible treatments. Today, post-acute COVID is a medical diagnosis that warrants medical attention and management.

A similar post-viral syndrome was seen in the 2003 SARS epidemic and the 2012 MERS outbreak, which were both also caused by coronavirus infections. This strongly supported speculations that COVID-19 was no different.

Is Long COVID-19 common?

According to most studies, Long Covid is not uncommon. Since the syndrome is still being heavily investigated, different reports from around the world cite different prevalence rates.

A study done in Italy showed that up to 87.3% of patients had at least one post-COVID symptom 60 days after their infection. The most commonly reported persistent symptoms were fatigue, dyspnea, joint pain, and chest pain.

Another study done in the US found that 32.6% of patients had persistent symptoms 2 months after being infected with the coronavirus. Included were 18.9% who even reported worse symptoms than before. In this study, dyspnea, cough, and loss of taste and smell were the most common post-acute COVID symptoms.

It’s obvious that there’s still some discrepancy between studies. The numbers and reported long corona symptoms differ depending on the criteria and goals of the authors. Nevertheless, combined together, these studies give a more general idea of what post-acute COVID syndrome is as a whole.

What are the long COVID symptoms?

Long-COVID syndrome can affect any and all organ systems. Persistent corona symptoms can range from mild and tolerable to severely debilitating. The most commonly reported symptoms of long-COVID include:

  • Anxiety
  • Depression
  • Sleep disturbance and insomnia
  • Post-traumatic Stress Disorder (PTSD) symptoms
  • Problems with concentration (brain fog)
  • Problems with memory and language
  • Fatigue
  • Headache / Migraine
  • Muscular weakness
  • Joint pain
  • Dyspnea
  • Cough
  • Persistent oxygen need
  • Heart palpitations
  • Chest pain
  • Hair loss

One study done in Wuhan, China, estimated that 76% of patients suffer from at least one post-covid symptom, with fatigue and muscular weakness being the most commonly reported ones (63%). Sleep difficulties and anxiety/depression were seen in 26% and 23% of patients respectively.

The frequency and prevalence of these symptoms are highly variable between studies. But overall, the most common symptoms are fatigue, anxiety, sleeping disorders, dyspnea, and chest pain.

Other complications and conditions can also develop after a coronavirus infection. These are usually called “sequelae” and are also included within the spectrum of the post-acute COVID-19 syndrome. Sequelae of COVID-19 include:

Who is at risk of developing post-COVID?

All COVID-19 patients are at risk of developing post-acute COVID-19 syndrome, regardless of their symptoms, course of diseases, and anything else. If you’ve been infected with the novel coronavirus (or any other coronavirus, for that matter), there’s a chance you will develop a post-viral syndrome.

Numerous studies have already attempted to identify specific risk factors that make you more prone to developing long COVID-19, and they include:

  • Severity of the initial illness
  • Need of ventilation
  • Having a pre-existing respiratory disease
  • Higher body mass index (BMI)
  • Older age
  • Being of Black, Asian, or Minority Ethnicity (BAME)
  • Still having dyspnea 4 weeks after your infection
  • Female sex (specifically for anxiety and depression)
  • Requiring intensive care (ICU) admission

Post-ICU syndrome is already recognized as an independent syndrome that can cause physical, psychiatric, and mental disturbances. Since these overlap with Long COVID, post-ICU syndrome is thought to be an independent cause of long hauling COVID symptoms.

What causes post-COVID syndrome?

The COVID-19 virus has wreaked havoc in the world, causing a devastating pandemic that put the healthcare sector to its knees. The virus is as aggressive when it comes to the human body itself.

The SARS-CoV-2 attacks nearly every body system we have, causing acute and long-term damage, some of which is irreversible.

Doctors are not entirely sure what causes long COVID-19. They believe that it’s probably multifactorial, with different dysfunctions causing it at the same time.

It is thought that a continued state of widespread inflammation could be the cause of post-acute COVID syndrome. The continued inflammation can affect each and all the organ systems in our body, causing a wide range of symptoms. So, long COVID is caused by an interplay of several factors:

  • Continued inflammatory response: Inflammation itself affects our cognition and behavior, causes fatigue, weakness, and can lead to damage to different body parts. One study found that nearly 60% of patients had heart muscle inflammation (myocarditis) more than 2 months after their infection.
  • Sustained damage: The organ damage sustained during acute COVID-19 infection can persist for long, causing a wide variety of symptoms. Lung damage and fibrosis are a cause of dyspnea after COVID.
  • Physiologic disruption: The SARS-CoV-2 virus causes disruption of many physiological processes, which can lead to serious aftermath. One example is the coagulation system. The coronavirus causes a persistent hypercoagulable state, putting patients at higher risk of developing emboli (blood clots).
  • Other factors: Medications and treatments used to combat the acute COVID-19 infection might play a role in later disturbances. One example is the post-Intensive care syndrome.

All of these factors, and more, come together to cause the long COVID syndrome.

Is there a treatment?

Since post-acute COVID-19 syndrome is still very new, there are still no strict guidelines on how it can be treated.

The best way to treat hauling COVID-19 symptoms is by detecting them early. Several health authorities are already implementing screening algorithms in certain patient populations that are at high risk of developing long COVID. Follow-up after 4-6 weeks with these patients can include a wide variety of tests, depending on their risk factors and disease course:

  • Imaging studies
  • Breathing studies (pulmonary function tests)
  • Psychiatric evaluation
  • Kidney tests
  • Cardiac evaluation
  • Evaluation for clotting risk

Based on this, your physician can recommend therapy, rehabilitation, medications, and follow-up testing to lead you safely to a full recovery.

Does The COVID Vaccine Protect From Long COVID? 

The most accurate answer to this is that we still don’t know. We don’t know if vaccines protect against post-COVID syndrome. 

In theory, vaccines decrease the severity of disease and the likelihood of symptoms. This might mean that there would be less damage to the body and less probability of developing long-lasting COVID symptoms. This is, however, just speculation and is not yet based on hard scientific proof. Future studies will be able to compare the frequency of Long COVID in those vaccinated and those who are not. 

Final Word

The best treatment for long COVID is the prevention of COVID-19 altogether. So, to avoid post-COVID-19 syndrome, and even more potentially dangerous outcomes, take your COVID-19 vaccine once you get the chance.

To search for the best healthcare providers that offer either COVID-19 Treatment, or vaccines, please use the Mya Care search engine.

About the Author:
Dr. Mersad is a medical doctor, author, and editor based in Germany. He's managed to publish several research papers early in his career. He is passionate about spreading medical knowledge. Thus, he spends a big portion of his time writing educational articles for everyone to learn.


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