Long COVID, sometimes referred to as post-COVID syndrome, refers to the variety of symptoms that last for weeks, months, or even years after an initial COVID-19 infection. These symptoms may linger from the time of initial infection, come and go over time, or reappear after a period of recovery. Long COVID is known by several names, including long-haul COVID, post COVID syndrome, post-acute sequelae of COVID-19 (PASC), and chronic COVID, among others. These terms all describe the prolonged health issues patients may experience after a COVID-19 infection.

The severity of long COVID symptoms ranges from mild to debilitating and may significantly impact daily activities, making it difficult for patients to return to work or school and perform routine tasks. People with long COVID may experience one or multiple symptoms at once and they can vary widely from one person to another. The most reported post-COVID symptoms include post-COVID fatigue and shortness of breath, but the condition can cause an array of symptoms that can affect any part of the body. If you experience lingering symptoms after a COVID-19 infection, talk to your doctor to determine if you might have long COVID.

Other long-term COVID symptoms include:  

• Weakness 
• Fever 
• Joint or muscle pain 
• Chronic cough 
• Chest pain, tightness, or pressure 
• Dizziness upon standing 
• Brain fog or difficulty concentrating 
• Headaches 
• Tremors 
• Sleep problems, including insomnia 
• Loss of or change in smell, taste, or both 
• Ringing in the ears 
• Blurry vision or light sensitivity 
• Depression and anxiety 
• Stomach pain, diarrhea, or constipation 
• Bladder problems 
• Changers in menstrual cycle

How long does Long COVID last?

While most people recover from COVID-19 within a few days or weeks, long COVID is identified if symptoms continue beyond four weeks after the initial infection. Long COVID can last for weeks, months, or even years, and may fall into one of the following categories:

• Persistent: Symptoms continue from the initial COVID-19 illness without improvement. 
• Recurrent: Symptoms disappear after the initial illness but then reappear. 
• New: Symptoms develop after the initial illness, even if they were not initially present. 

What causes Long COVID?

The exact cause of long COVID is not yet fully understood. Researchers are investigating and have identified some potential causes that may play a role. The interplay of these factors, among others, might be responsible for long COVID. Ongoing research is crucial to better understand and address this condition.

• Remaining virus: Fragments of the virus that persist in the body, even after the immune system has fought off the initial infection, can provoke an immune response and cause chronic inflammation. 
• Reactivation of latent viruses: Dormant viruses, like Epstein-Barr virus, may reactivate in response to a COVID-19 infection, contributing to long COVID symptoms. 
• Autoimmune response: The immune system might start attacking the body’s own tissues and organs, mistaking them for the virus, which leads to ongoing symptoms. 
• Organ damage: The immune response to the initial COVID-19 infection may cause lasting damage to organs and tissues, resulting in prolonged symptoms. 
• Tiny blood clots: Small blood clots might interfere with the functioning of vital organs like the lungs and brain without causing major events like strokes. 
• Inflammation: Persistent inflammation due to an overactive immune response can affect various organs long after the infection has been cleared. 
• Psychological effects: Severe COVID-19 illness and hospitalization can lead to mental health issues, such as anxiety and depression, which may contribute to long COVID symptoms. 

Do vaccinated people get Long COVID?

Anyone who has ever been infected with COVID can develop long COVID. People with underlying health conditions, those who have never received a COVID-19 vaccine, and people who were hospitalized or in intensive care due to a severe COVID-19 infection may have a higher risk of developing long COVID. While long COVID is more common in those instances, it can also affect people with mild or asymptomatic initial infections and those who have been vaccinated. Most cases occur in people who had mild symptoms during their initial infection. Both adults and children can be affected by long COVID, though it’s more prevalent in adults. Researchers are working to understand better who is most at risk of developing long COVID and why, with a particular focus on groups that have been disproportionately impacted by COVID-19. 

Long COVID treatment

There is no specific treatment for long COVID. The symptoms of this condition vary from person to person, so treatment plans need to be personalized. Given the complexity and variety of symptoms, treatment might require trying various approaches to find what works best for you. If you are experiencing long COVID symptoms, you should collaborate with your doctor to create a tailored plan that can help you manage your symptoms and enhance your quality of life.

At Penn Medicine, our experts work across disciplines to ensure you receive personalized and effective treatment for your long COVID symptoms. Depending on your symptoms, treatments may include medications, rehabilitation, counseling, and physical, occupational, or speech therapy, or other interventions recommended by specialists.