Health and Wellness
What is “long COVID-19” and what are the symptoms?
- July 30, 2021
- By Staff Writer
Many people who get COVID-19 recover within a few weeks, but others experience symptoms that stretch on long after their initial infection. Medical experts and the public have coined the terms post-COVID syndrome or “long COVID-19” to describe cases with continuing symptoms that last beyond a few weeks.
While long COVID-19 varies from person to person, it can include several different physical and mental complications, ranging from asthma to an elevated heart rate to brain fog.
We asked M Health Fairview experts experienced with COVID-19 treatment and rehabilitation how the virus may continue to affect the body and what care options are available for COVID “long-haulers.”
What are the most common symptoms of long COVID-19?
“Fatigue is the most common symptom I’ve been seeing in long COVID-19 patients,” said M Health Fairview Physiatrist Farha Ikramuddin, MD, MPH. “Other common symptoms include coughing, shortness of breath, heart palpitations, and mental fog.”
Ikramuddin helps lead M Health Fairview’s Long COVID-19 Clinic, a virtual clinic open to anyone struggling with long COVID-19 symptoms. Pulmonologist and Critical Care Physician Sakina Naqvi, MD, has also seen shortness of breath in many long COVID-19 patients. The virus can continue to impact the lungs and respiratory system in a variety of ways, she said.
“A lot of these patients are still short of breath. They’re very deconditioned,” said Naqvi. She treats patients at the M Health Fairview ICU Survivorship Clinic, which helps COVID-19 patients and others who were hospitalized and spent time in an ICU continue recovering. “We see scarring in their lungs and windpipes. Some patients also develop asthma after COVID-19.”
Another common symptom of both acute and long COVID-19 is change in taste and smell. M Health Fairview Otolaryngologist Holly Boyer, MD, estimates that approximately 80 percent of patients will experience parosmia, or a distortion in their sense of smell. COVID-19 can damage the cells that support the nerves responsible for your sense of smell, but typically these cells regrow over time and symptoms eventually disappear.
Boyer works with the M Health Fairview Adult Post-COVID Clinic – a third care option for COVID-19 survivors. A team of specialists typically meets with hospitalized patients a few weeks post-discharge, as well as non-hospitalized patients who have ongoing function loss. For patients with parosmia, Boyer and her team do smell retraining therapy during their recovery.
Naqvi reports seeing elevated heart rates in some long COVID-19 patients. She also notes that COVID-19 survivors who spent time in the ICU often have post-traumatic stress disorder (PTSD).
“Many COVID-19 patients experienced extreme isolation, because they were hospitalized for months,” said Naqvi. “A lot of patients are scared to be left alone. Family members say survivors want to hold their hands at all times.”
Are certain people at higher risk for long COVID-19?
While new discoveries are being made daily, early evidence shows that a wide range of adults develop lasting COVID-19 symptoms. According to Ikramuddin, the severity of a person’s initial infection doesn’t determine the risk of developing long COVID-19 – although it can affect what ongoing symptoms they experience. Many long COVID-19 patients were not admitted to the hospital.
“I’ve seen patients with certain medical histories – including a car accident or concussion – struggling more with mental fog or other neurological symptoms after COVID-19,” she said.
However, Ikramuddin often works with younger people who have no pre-existing medical conditions. One major question is whether COVID-19 can bring out other diagnoses that a person was pre-disposed to but hadn’t developed. For example, she has seen younger people who had joint pain get diagnosed with rheumatoid arthritis or diabetes after a COVID-19 infection.
Long-term effects of COVID-19 in children
It’s also important to note that COVID-19 can lead to lasting complications in children, even after an asymptomatic infection. While less data is available for long COVID-19 in children, M Health Fairview Infectious Disease Physician Beth Thielen, MD, MPH has seen a number of cases of multisystem inflammatory syndrome (MIS-C) in kids following a COVID-19 infection.
“Children come in with high fevers and heart inflammation. It’s often severe enough that they need to go to the ICU for blood pressure support,” said Thielen. “Pediatricians are a good first line of evaluation. They can look at the whole picture, measure inflammation and refer families to specialists.”
Like adults, children can have ongoing symptoms even after mild illness. Physicians at M Health Fairview are caring for pediatric “long-haulers” through a dedicated COVID-19 follow-up clinic.
What treatments are available for long COVID-19?
Ikramuddin and Naqvi see long COVID-19 patients through two unique M Health Fairview clinics. Ikramuddin helps run the Long COVID-19 Clinic, while Naqvi helps run the ICU Survivorship Clinic.
The ICU Survivorship Clinic works exclusively with patients who were hospitalized for COVID-19, as well as people who spent time in the ICU for other illnesses. Visits are held virtually. Patients spend an hour discussing their hospitalization and any lasting affects with Naqvi and Pulmonologist and Critical Care Physician Nicole Roeder, MD.
They also meet with a clinical psychologist, who evaluates the lingering mental health needs of patients who spent time in the ICU. After that initial meeting, the clinic develops a treatment plan and refers patients out to get the necessary care for their unique symptoms.
Ikramuddin also meets with patients virtually. The Long COVID-19 Clinic is a multidisciplinary clinic with many specialists. It’s open to anyone with long COVID-19 symptoms, whether they were hospitalized or not. No proof of a positive COVID-19 test is required.
Importance of prevention
The good news is that most long COVID-19 cases clear up within three to six months with proper treatment and symptom management. However, Naqvi is quick to point out that we have yet to discover the even longer-term impacts of the virus.
Doctors have seen potential lifelong complications from other known illnesses. For example, after someone has chicken pox, the virus remains in their body and can cause shingles years later. It’s possible that exposure to the COVID-19 virus could trigger other complications further down the road.
With that in mind, all three doctors stressed that prevention is the best medicine.
“The virus is still here, and we don’t know what these variants are going to do,” said Naqvi. “Even if you get a mild illness, we also don’t know what it could do five years down the road.”
She encouraged people to continue to wear masks in public and get vaccinated. The vaccines are the best way to treat COVID-19, by preventing not only an initial infection, but an entire range of long-term complications.