What is “long COVID-19” and what are the symptoms?
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.”
With you for the long haul – learn more about our commitment to long COVID-19 care.
What are the most common symptoms of long COVID-19?
“The most common symptoms of long COVID-19 are fatigue, brain fog, and shortness of breath,” said Farha Ikramuddin, MD, MPH, a physiatrist with M Health Fairview. “Other common symptoms include coughing and heart palpitations.”
Ikramuddin helps lead the M Health Fairview Adult Post-COVID-19 Clinic, a virtual clinic open to anyone struggling with long COVID-19 symptoms.
Sakina Naqvi, MD, a pulmonologist and critical care physician who sees patients in our ICU Survivorship Clinic, 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. “We see scarring in their lungs and windpipes. Some patients also develop asthma after COVID-19.”
Naqvi and her colleagues at the M Health Fairview ICU Survivorship Clinic help people who were hospitalized both due to COVID-19 patients and other illness or injury along the road to recovery. She reports seeing elevated heart rates in some long COVID-19 patients and says 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.”
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. Typically, these cells regrow over time and symptoms eventually disappear.
Boyer works out of our otolaryngology clinic and partners with our Adult Post-COVID-19 Clinic to care for patients with ongoing changes in smell. Through our Adult Post-COVID-19 Clinic, 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 recommend smell retraining therapy during their recovery.
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 necessarily determine their 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.
People with milder cases, and those who are vaccinated against COVID-19, may be less likely to develop long COVID-19, but many still do.
A person’s medical history may also influence what long-term symptoms they experience, according to Ikramuddin.
“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, she 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 important to note that COVID-19 can lead to lasting complications in children, even after an asymptomatic or mild infection. Beth Thielen, MD, MPH, a pediatric infectious disease physician, has seen several 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 care for children with long COVID-19 through our dedicated Pediatric COVID-19 Clinic.
What treatments are available for long COVID-19?
M Health Fairview is committed to helping people manage the potential long-term effects of COVID-19. In addition to our pediatric clinic, we have three unique adult programs. Boyer and Ikramuddin see patients at the Adult Post-COVID-19 Clinic, while Naqvi helps run the ICU Survivorship Clinic. We also offer a COVID-19 Rehabilitation Therapy Program.
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 Nicole Roeder, MD, who is also a pulmonologist and critical care physician.
Patients within our ICU Survivorship Clinic also meet with a clinical psychologist, who evaluates any ongoing mental health needs related to their time in the hospital. After that initial meeting, the clinic develops a treatment plan and sets up a referral process to help patients receive the appropriate care for their unique symptoms.
Ikramuddin and Boyer also meet with patients virtually through the Adult Post COVID-19 Clinic, which is open to anyone with long COVID-19 symptoms, whether they were hospitalized or not. The Adult Post-COVID-19 Clinic is a multidisciplinary clinic with many specialists, and no proof of a positive COVID-19 test is required to seek care.
