'Long Covid': Are You Feeling the Symptoms?

Fatigue, brain fog, difficulty breathing, chest pain, and other health issues. These are the symptoms 20 million U.S. adults diagnosed with COVID-19 are still having three months after first contracting the virus, according to new federal data.

Overall, 1 in 13 adults in the U.S. (7.5 percent) have symptoms of “long COVID”—as the condition is known—that they didn’t have before their COVID infection, according to a survey conducted by the U.S. Census Bureau. The data was analyzed by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS).

Long COVID symptoms

People with long COVID have a range of new or continuing symptoms that can last weeks or months after they are infected with COVID. The condition typically worsens with physical or mental activity.

Dr. Ravi Ramaswami, a family medicine physician with Lee Health, says long COVID can affect anyone who has COVID — old and young, otherwise healthy people, and those battling other conditions.

“People with long COVID can have a wide range of symptoms which can last more than four weeks or even months after infection,” says Dr. Ramaswami. “In some cases, symptoms can disappear, only to come back again.”

Long COVID doesn’t affect everyone the same way, according to the CDC. People with long COVID symptoms may have various symptoms that could come from other health problems. This can make it difficult for healthcare providers to identify long COVID symptoms.

“Most people with COVID get better within a few days to a few weeks after infection. Anyone who was infected can have long COVID,” notes Dr. Ramaswami, who adds many of his patients are experiencing long COVID symptoms.

“Some people with long COVID recall not noticing any symptoms when they were first infected, while others with long COVID report experiencing symptoms immediately. Then, for some people, long COVID conditions may last months, potentially years, after COVID illness.”

Long COVID symptoms can include:                                                                                          

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes called “brain fog”)
• Shortness of breath or difficulty breathing
• Headache
• Dizziness on standing
• Fast-beating or pounding heart (known as heart palpitations)
• Chest pain
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Loss of taste or smell

Dr. Ramaswami says many of his patients who have had COVID also report experiencing neurological issues like brain fog a month after contracting the virus.

“Everything is cloudy and muddled up in their heads. They may have sleep issues. They may feel drowsy and fatigued,” he says. “Many cases of brain fog can be linked to low serotonin or serotonin imbalance. Researchers are still studying that particular aspect.”

He’s also treated patients who self-report psychological symptoms from long COVID, such as bouts of depression, anxiety, panic attacks, and posttraumatic stress disorder (PTSD). Dr. Ramaswami tries to educate his patients about long COVID symptoms.

For patients with brain fog and long COVID depression, he’s had varying success with prescribing them anti-depressant medications. “Most patients learn to adapt, or the symptoms go away with time, eventually,” he adds.

Researchers continue to study why some people get long COVID. According to the NCHS survey, older adults are less likely to have long COVID than younger adults. Nearly three times as many adults ages 50-59 currently have long COVID than those age 80 and older.

Women are more likely than men to have long COVID (9.4 percent vs. 5.5 percent).

Other survey findings include:

• Nearly 9 percent of Hispanic adults currently have long COVID, higher than non-Hispanic White (7.5 percent) and Black (6.8 percent) adults and over twice the percentage of non-Hispanic Asian adults (3.7 percent).

• Bisexual adults and transgender adults (7.5 percent) were more likely to have current long COVID symptoms than adults of other sexual orientations and gender identities. Twelve percent of bisexual adults have current long COVID symptoms, compared to 7 percent of straight and gay and lesbian adults. An estimated 15 percent of transgender adults have current long COVID symptoms, compared to 5 percent of cisgender male adults and 9 percent of cisgender female adults.

• The prevalence of current long COVID symptoms differed between states. The states with the highest percentage of adults who currently have long COVID symptoms were Kentucky (12.7 percent), Alabama (12.1 percent), and Tennessee and South Dakota (11.6 percent). The states with the lowest percentage of adults who currently have long COVID symptoms were Hawaii (4.5 percent), Maryland (4.7 percent) and Virginia (5.1 percent).

Source: CDC/National Center for Health Statistics

Preventing long COVID

Dr. Ramaswami says the best way to prevent long COVID is to protect yourself and others from becoming infected.

“For eligible people, getting vaccinated and staying up to date with vaccines against COVID-19 can help prevent COVID-19 infection and protect against severe illness,” he says. “Research suggests that people who are vaccinated but experience a breakthrough infection are less likely to report long COVID symptoms, compared to people who are unvaccinated.”

Talk to your doctor if you think you have long COVID.

Federal resources for people with symptoms of long COVID

The Office for Civil Rights of the Department of Health and Human Services (HHS) has this page on civil rights and COVID.

The Civil Rights Division of the Department of Justice has this page on its ADA.gov website that discusses topics related to COVID and the ADA.

CDC’s website has this page on long COVID conditions, which discusses long COVID.

The Administration for Community Living’s document, “How ACL’s Disability and Aging Networks Can Help People with Long COVID,” provides information on resources and programs to assist people with long COVID.  This document is available here.

Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557 is available here.