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Symptoms of Long COVID? Here’s What to Do

Older adults are more likely to experience new or worsening symptoms after an infection

Long COVID symptoms can include fatigue, brain fog, cough and more.
FG Trade / Getty Images

If, like most Americans, you’ve had COVID-19, you may have wondered how long was too long for your cough or fatigue to hang around. On the one hand, it’s not uncommon for symptoms of any illness to linger for a bit. Then again, reports of long COVID — a term used to describe new, returning or ongoing health problems after a bout of COVID-19 — are mounting.

A recent study from the Centers for Disease Control and Prevention (CDC) found that as many as 1 in 5 adults under the age of 65 who had COVID-19 experienced symptoms that could be considered long COVID. The phenomenon is even more common in older adults: 1 in 4 individuals 65 and older developed at least one health condition that may be attributable to a previous coronavirus infection. And research published in the journal The BMJ found that about 32 percent of older adults who survived COVID-19 sought medical attention in the months that followed their infection for new or persistent symptoms.

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Altogether, it’s estimated that long COVID has affected as many as 23 million Americans, according to a March report from the U.S. Government Accountability Office.

As of now, there isn’t a single drug or therapy to treat or cure long COVID, but experts say with rehabilitation and a little time, many patients get better, which is why it’s important to pursue care if you suspect you’re suffering from the condition. Here’s what to look out for and when to seek help.

1. Keep an eye out for symptoms that need immediate medical attention.

If symptoms like exhaustion or brain fog — and there are many others that fit into the definition of long COVID — continue or crop up after a COVID-19 infection, you’ll want to get them checked out. “Any sort of new symptoms that occur should be evaluated and not just brushed under the carpet,” says Michael Risbano, M.D., assistant professor of medicine and codirector of the Post-COVID Recovery Clinic at the University of Pittsburgh Medical Center.

But depending on the severity of your symptoms — and that’s important — you may want to wait a few weeks before scheduling an appointment with your doctor. Or at least know that your doctor may not consider long COVID as a diagnosis until several weeks have passed since you first tested positive for the virus.

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Know the Symptoms of Long COVID

Symptoms can vary widely, but among the most common are:

  • Fatigue
  • Symptoms that get worse after physical or mental effort
  • Fever
  • Difficulty breathing or shortness of breath
  • Cough
  • Chest pain
  • Heart palpitations
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Headache
  • Sleep problems
  • Dizziness/ lightheadedness
  • Pins-and-needles feelings
  • Change in smell or taste
  • Depression or anxiety
  • Diarrhea
  • Stomach pain
  • Joint or muscle pain
  • Rash
  • Changes in menstrual cycles 

Source: CDC

The reason? It can take the body some time to fully shake an infection, which is why the CDC defines long COVID as symptoms that persist at least four weeks after infection. Some experts say it could take six weeks or more to fully recover from an illness like COVID-19, even if your case was mild or asymptomatic.

“That [timeline] is definitely going to vary among individuals,” says Fidaa Shaib, M.D., an associate professor in pulmonary, critical care and sleep medicine at Baylor College of Medicine in Houston. “But illness [still] going, or symptoms persisting, or new symptoms evolving after a six-week period is something where people might start thinking, ‘Okay, am I developing a long-term problem?’ ”

There are symptoms, however, that demand urgent attention, like chest pain and shortness of breath. You also shouldn’t delay care if you experience bad headaches, lightheadedness, fainting or any cognitive or stroke-like symptoms, Risbano says.

Research has linked COVID-19 to the development of pulmonary embolisms, or a blockage in one of the arteries in the lungs that can present with chest pain, shortness of breath and a feeling of dizziness, lightheadedness or fainting. A CDC report in May found that COVID-19 survivors have twice the risk for developing the potentially life-threatening condition.

“And if that’s the case, then that needs to be dealt with. A lot of times those patients may need to be hospitalized, and they need to go on blood-thinning medication. So that’s one thing that would be very important to pick up [quickly],” Risbano says.

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A few other symptoms that may necessitate a more immediate appointment: “if somebody’s now all of a sudden getting more anxious, depressed, or [experiencing] post-traumatic stress from the COVID,” says Tanjeev Kaur, M.D., assistant professor of clinical medicine at the University of Illinois at Chicago.

2. Make an appointment with your primary care physician. 

Curious as to whom you should see when it comes to long COVID concerns? A good place to start is your primary care physician — preferably someone who knows your medical history and who can help determine if your symptoms are due to COVID-19 or something else entirely.

This is especially true in older adults who are more likely to have underlying health issues that could be driving any new or worsening problems. Roughly 85 percent of older adults have at least one chronic health condition; about 60 percent have at least two, according to the CDC. And with symptoms of long COVID all over the map — from cardiovascular to cognitive — it’s easy to “mix up” what could be from COVID and what could be due to another health condition or illness, Shaib says.

“It’s unclear how COVID stirs the pot of other issues,” Risbano adds. Heart palpitations and lung scarring, for example, could be a direct injury from COVID-19, “or they could be completely unrelated to the COVID-19 infection.” He says that depending on the symptoms, “a thorough evaluation is probably warranted” to help pinpoint the problem.

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3. Prepare for your appointment.

When you first meet with your doctor, it’s important to come prepared — this can make “all the difference” when it comes to getting the proper evaluation, diagnosis and treatment, the CDC says.

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Before your appointment, be sure to write down when you first tested positive for COVID-19 and when the symptoms that are still bothering you first started. Also note how often these symptoms occur and anything that makes them worse.

Another thing: Think about how you were getting along with everyday activities before COVID-19 — running errands, going to work, paying bills, socializing with friends — and how you’re operating after your infection, Shaib says. Finally, don’t forget to bring a list of all the medications you take, including over-the-counter drugs and supplements.

There is no standard screening to identify long COVID, but your doctor may order a number of tests to reach a diagnosis and rule out others along the way.

4. Don’t expect immediate recovery.

Many patients with long COVID can be managed directly by their primary care physician, often with the aid of specialists like physical and occupational therapists to help rebuild strength and recoup lost skills. Your doctor may also refer you to an interdisciplinary Post-COVID Care Center (PCCC) — nearly every state has one.

Treatment looks different for everyone, Kaur says, but could include symptom management (breathing exercises to improve shortness of breath, for example, or pacing of activities for people whose symptoms worsen after physical or mental exertion) as well as an overall focus on nutrition, sleep and stress reduction.

Another option is to participate in a long-COVID study. The National Institutes of Health is investing more than $1 billion in the RECOVER research project to better understand the baffling condition, including how to prevent, test and treat it. More than 50 institutions across the U.S. are enrolling participants. You can find a RECOVER study site closest to you here.

Finally, know that recovery from long COVID isn’t overnight, and that the timeline for getting better varies. Some people bounce back in a few months; others battle it for much longer, though Shaib says six months is typically a reliable recovery estimate. Of course, “it depends on the individual and how they were impacted,” she adds.

Who’s most at risk for long COVID?

Anyone can wind up with long COVID, including children, but research suggests that some people may be more prone to the condition, including:

  • People who experienced a more severe case of COVID-19, especially those who were hospitalized or needed intensive care.
  • People who had underlying health conditions before catching COVID-19.
  • People who are unvaccinated against COVID-19. (Studies suggest that people who are vaccinated but experience a breakthrough infection are less likely to report long COVID symptoms.) 

Source: CDC

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