After patients test positive for Covid-19 and recover from their illness, they may think that the worst of the virus is behind them. But a portion of people who have Covid will go on to experience what the CDC calls post-Covid symptoms, or symptoms that continue for three months or more after the initial infection.
Colloquially, you may have heard post-Covid symptoms called “long Covid,” and the people who suffer from it call themselves “long haulers.” For many, the symptoms that come along with long Covid are worse than their initial infection.
With over 30 million people in the US having been infected, there’s a pretty big pool of potential long Covid patients. Chances are, some members of your community are long haulers.
Here are the answers to the most commonly asked questions about long Covid so you can be prepared to help your patients with persistent symptoms.
What are the symptoms?
Many of the most common long Covid symptoms are similar to the symptoms from the initial Covid-19 infection. They include:
- Fatigue
- Body aches
- Headache
- Insomnia
- Dizziness
- Chest pain
- Cough
- Shortness of breath
- Inability to exercise
- Depression or anxiety
- Loss of smell and taste
- Brain fog and difficulty focusing
In addition to those more common symptoms, some Covid long haulers experience rare and alarming symptoms that include:
- Menstrual changes
- Erectile dysfunction
- Blood clots
- Multisystem inflammatory syndrome
- Neurological problems, including “Alice in Wonderland” syndrome, in which people appear larger or smaller than they actually are
- Tinnitus
The good news is that patients with long Covid typically test negative for Covid-19, meaning they aren’t infectious and can’t spread the virus to other people.
Why does long Covid occur?
Right now, we don’t know exactly what causes post-Covid conditions. Post-viral fatigue and cough are common when patients have other viruses like the flu, so taking a long time to recover from viral illnesses isn’t unprecedented. But currently, all of the ideas about what causes long Covid are unproven.
Some people think that post-Covid conditions are caused by small pockets of the virus that stay in the body after the rest of the virus has been eliminated.
Others think that coronavirus over-stimulates the immune system, so it doesn’t return to normal function after the initial illness. The continued immune response can then cause further damage to the patient’s body.
Covid also has the potential to alter or damage organs, causing long-term health issues. Most commonly, Covid patients can experience scarring in their lungs, but there are also cases where the heart, kidneys, and brain experience changes because of Covid.
There is also a theory that Covid triggers an autoimmune response that causes the body to create antibodies that attack the brain.
Because there’s currently no clear indication of what is causing post-Covid conditions, developing an effective treatment is extremely difficult.
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How long does it last?
Many people improve over the course of about four to six months, but for others, the symptoms linger much longer. More than a year after the coronavirus pandemic began, there are patients that were infected at the very beginning who are still experiencing symptoms.
Jason Maley, a Harvard Medical School instructor, told the Harvard Gazette, “I suspect we’ll be seeing patients with this for several years to come.”
Who gets long Covid?
Anyone who has gotten Covid-19 can become a Covid long hauler. A survey in Nature found that around a third of Covid patients reported persistent long-term symptoms and 18.9 percent of people reported new or worsening symptoms.
Typically, people who had health issues before getting Covid-19 or people who had severe Covid-19 are more likely to experience long-term problems, but issues can crop up for anyone in any demographic.
Young people who had mild or even asymptomatic cases of Covid-19 initially have been known to develop much more severe post-Covid symptoms after the fact, so just because a patient didn’t have serious problems when they were initially infected doesn’t mean they are off the hook for long Covid.
Should long Covid patients get vaccinated?
The CDC recommends that everyone get the Covid-19 vaccine, even if they’ve already had Covid-19. It’s not yet known how long people are protected from the virus after recovering, so getting vaccinated makes it much less likely that patients will get reinfected.
Emerging research also suggests that long haulers can get some relief from their post-Covid conditions after they get the vaccine. Yale Medicine reported that as many as 30 to 40 percent of long haul patients reported an improvement in their symptoms after receiving the vaccine, including shortness of breath and brain fog disappearing.
Like everything else to do with post-Covid conditions, researchers haven’t conclusively pinpointed why the vaccine provides relief. Some theorize the vaccine helps take down any residual virus in the body or help to reset the immune system.
Unfortunately, between 10 and 15 percent of long haul patients reported feeling worse after the shot, and the rest reported no changes, but the increased immunity still means that all long Covid patients should get the vaccine.
How can you help long Covid patients?
Be prepared to address the questions and concerns your patients may have about long Covid.
There’s currently no treatment to address the underlying cause of post-Covid symptoms, but you can stock products that ease their symptoms. Have recommendations at the ready for over-the-counter products that help patients get a good night’s sleep or manage symptoms like headaches and body aches.
Because long haulers often struggle with anxiety and depression, they may benefit mental health resources. Offer mental health screenings like the PHQ-2 to help you identify potential mental health problems and connect patients with local mental health providers when needed.
Many long haulers have found solace in online support groups. Do some research to find out if there is a support group in your area that you can recommend to long haulers who may find it comforting to commiserate with people going through a similar experience.
Since the only way to prevent long Covid is to not get infected with Covid-19 in the first place, continue to encourage all your patients to get vaccinated.
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