Patient education: Long COVID (The Basics)

What is long COVID? — This is the term some people use when COVID-19 symptoms last longer than a few months.

COVID-19 stands for "coronavirus disease 2019." It is caused by a virus called SARS-CoV-2. The virus first appeared in late 2019 and quickly spread around the world. People with COVID-19 can have fever, cough, trouble breathing, and other symptoms.

When will I get better after having COVID-19? — For most people who get COVID-19, symptoms get better within a few weeks. But some people continue to have symptoms for longer. These can be mild or more serious.

Doctors are still learning about COVID-19. But they generally describe 2 stages of illness and recovery:

●"Acute COVID-19" – This refers to symptoms lasting up to 4 weeks after a person is infected. Most people with mild COVID-19 do not have symptoms beyond this stage, but some do.

●"Long COVID" – This refers to symptoms that continue beyond 3 months after being infected. This is more common in people who were critically ill. Critically ill means that they needed to stay in the intensive care unit ("ICU"), be put on a ventilator (breathing machine), or have other types of breathing support.

Other terms have also been used when people have persistent symptoms. These include "chronic COVID-19" and "post-COVID syndrome." Doctors also use the terms "post-COVID condition" and "post-acute sequelae of SARS-CoV-2 infection" ("PASC").

Which symptoms are most likely to persist? — This is not the same for everyone. But symptoms that are more likely to last beyond a few weeks include:

●Feeling very tired (fatigue)

●Trouble breathing

●Chest discomfort

●Cough

Other physical symptoms can also continue beyond a few weeks. These include problems with sense of smell or taste, headache, runny nose, joint or muscle pain, trouble sleeping or eating, sweating, and diarrhea.

Some people have ongoing psychological symptoms, too. These might include:

●Trouble thinking clearly, focusing, or remembering

●Depression, anxiety, or a related condition called post-traumatic stress disorder ("PTSD")

It's hard for doctors to predict when symptoms will improve. This is different for different people. Your recovery will depend on your age, your overall health, and how severe your COVID-19 symptoms are. Some symptoms, like fatigue, might continue even while others improve or go away.

When should I call my doctor or nurse? — Some fatigue is common, and can persist for a few weeks into your recovery. But if you had COVID-19 and continue to have bothersome symptoms (such as severe fatigue, or chest discomfort or shortness of breath) after 2 to 3 weeks, call your doctor or nurse. You should also call if you start to feel worse or develop any new symptoms. They will tell you what to do and if you need to be seen.

Depending on your symptoms, you might need tests. This will help your doctor or nurse better understand what is causing your symptoms and whether you need treatment.

How do I know if I have long COVID? — Your doctor can diagnose you with long COVID if:

●You still have symptoms 3 months or longer after getting infected.

●Your symptoms are not caused by other conditions.

How is long COVID treated? — In general, treatment involves addressing the symptoms you have. Often, that means combining a few different treatments.

If you are tired, try to get plenty of rest. You can also try the following things to help with fatigue:

●Plan to do important tasks when you expect to have the most energy, typically in the morning.

●Pace yourself so you do not do too much at once, and take breaks throughout the day if you feel tired.

●Think about what tasks and activities are most important each day, so you don't use more energy than you need to.

If you are not sleeping well, improving your "sleep hygiene" can help. This involves things like going to bed and getting up at the same time each day, avoiding caffeine and alcohol late in the day, and not looking at screens before bed.

Depending on your situation, you might also need:

●Medicines to relieve symptoms like cough or pain

●Cardiac rehabilitation – This involves improving your heart health through things like exercise, dietary changes, and quitting smoking (if you smoke).

●Pulmonary rehabilitation – This includes breathing exercises to help strengthen your lungs.

●Physical and occupational therapy – This involves learning exercises, movements, and ways of doing everyday tasks.

●Treatments for anxiety or depression – This can involve medicine and/or counseling.

●Exercises and strategies to help with memory and focus

There is no evidence that any specific diet or dietary supplements can help you recover from COVID-19 faster.

Is there any way to avoid long COVID? — The only way to avoid this for sure is to avoid getting COVID-19. Most people who are infected will not get very sick. But it's impossible to know who will recover quickly and who will have persistent symptoms.

The best way to prevent COVID-19 is to get vaccinated. Even if you do get infected, being vaccinated will lower your risk of getting very sick, and might also lower your risk of long COVID.

Will getting the COVID-19 vaccine make my symptoms worse? — Some people worry that getting the vaccine will make persistent symptoms worse. But this is not likely to happen. After getting vaccinated, most people's symptoms get better or stay the same. And the vaccine will lower your risk of getting infected again in the future.

More on this topic

Patient education: COVID-19 overview (The Basics)
Patient education: COVID-19 vaccines (The Basics)
Patient education: COVID-19 and pregnancy (The Basics)
Patient education: COVID-19 and children (The Basics)
Patient education: Post-intensive care syndrome (PICS) (The Basics)
Patient education: Pulmonary rehabilitation (The Basics)
Patient education: COVID-19 tests (The Basics)