Do I Have Long COVID?

At this point, COVID-19 infection has touched most of our lives either directly or indirectly through an active infection. However, for some people who get sick with it, the problems don’t end when the infection does. Approximately 6-15% of people with a COVID infection experience a wide range of symptoms for three months or more. This is a condition that is broadly identified as long COVID.

“Considering the several millions of people infected with COVID-19, this corresponds to a lot of people and translates to a significant physical, psychological, and economic impact and burden,” says Folusakin Ayoade, M.D., an infectious disease specialist for the University of Miami Health System.

“Post-COVID is more common than many people realize. I have seen several patients who were once active and highly functional law enforcement, accountants and university professors, to name a few, who came down with long COVID and have not been able to return to their baseline, pre-COVID-19 status. Several studies suggest that more than 50% of long COVID patients have some functional limitations in activities of daily living that persist for four months or longer after acute COVID-19.”

Long COVID can often look different from one patient to another.

In fact, the Mayo Clinic estimates that more than 200 possible symptoms of long COVID have been identified.

“In my clinic, I often see fatigue or weakness in one group and varying degrees of cognitive impairment or concentration problems (so-called ‘brain fog’) in the other group,” says Dr. Ayoade. “Several overlaps occur, and many patients have both weakness and cognitive impairment.

Another common feature is respiratory problems. This is (more or less) a continuation of the initial respiratory symptoms they presented with at the initial outset, with varying degrees of severity.”

But there are more. Dr. Ayoade frequently sees patients who are experiencing:

• Sleep problems
• Anxiety
• Tingling sensations
• Headaches
• Dizzy spells
• Shortness of breath
• Problems with smell and taste

In June 2024, the U.S. National Academies of Sciences, Engineering and Medicine gave long COVID an official clinical definition.

This step will make it easier for health care providers to diagnose and begin treating long COVID by outlining what constitutes a case of long COVID.

According to the academies, “Long COVID (LC) is an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.”

Though this definition is helpful, Dr. Ayoade says that the condition still poses many challenges — including the many conditions being identified as long COVID.

“It is unclear why some people get long COVID even after a very mild COVID-19 infection, while others do not,” he says. “It appears that individuals with more severe COVID-19 symptoms are more likely to have long COVID than those with milder symptoms. While individual physiologic and genetic changes are likely to play a role, it is evident that multiple pathophysiologic mechanisms are involved, explaining the wide spectrum of symptoms and severity.”

Treatment of long COVID is also an area of ongoing research.

The antiviral drug Paxlovid has shown some promise, among other treatments. “Simple steps that I include in my treatment program include structured physical activity to improve exercise tolerance, word games to improve concentration and multivitamins, especially vitamins C and E due to their antioxidant properties,” says Dr. Ayoade.

“Treatment is often tailored to the patient’s symptoms – anti-anxiety medications for those with anxiety, sleep aids for insomnia and referral to specialists for other specific issues.”  

Wyatt Myers is a contributor for UHealth’s news service.

Tags: covid-19 in Miami, disease transmission, Dr. Folusakin Ayoade, lingering symptoms