DIAGNOSIS: Post-Acute Sequelae of SARS-CoV-2
Serious fatigue
One of the most common complaints of those living with long-haul COVID is profound fatigue. People report feeling run down while attempting even the simplest tasks, and say their overall energy levels are low.
Many people specifically report struggling with “post-exertional malaise” (basically, feeling wiped out after exertion), and it’s not exclusive to doing something physical.
“Anything that makes you have to work is making people feel pretty exhausted and spent afterwards,” said Putrino, who studies long-haul COVID. He added that even getting on a Zoom call can leave people reeling after.
Why people feel so rundown isn’t entirely clear, as experts are still studying what causes long-haul COVID and the reasons are likely complex. One theory is that antibodies produced after infection may target the autonomic nervous system, which regulates bodily functions people don’t actually think about (like heart rate, body temperature and digestion).
COVID-19 might “throw your autonomic nervous system off-balance,” Putrino said. That could contribute to the overwhelming fatigue many people experience, as the body is confused and working very hard.
Brain fog
Cognitive symptoms are another top complaint of people with long-haul COVID.
“Informally, this is known as ‘brain fog,’” Putrino said. “It’s more of a broad umbrella term that describes people who are having problems with short-term memory, executive function, holding concentration, making decisions, finding the right word when they’re trying to communicate. We’re seeing broad subsets of cognitive issues that are emerging.”
Shortness of breath or chest pain
COVID-19 is a respiratory virus, so it’s no surprise that many long haulers struggle with difficulty breathing, coughing and chest pain months after their initial infection.
Physical tasks that were not difficult pre-infection — like climbing stairs — lead many people with long-haul COVID to experience exhaustion and difficulty breathing. That said, breathing exercises and respiratory therapy have been shown to help.
Heart palpitations and elevated heart rate
Heart palpitations
A fast-beating or pounding heart — are among the most common long-haul COVID symptoms, according to the Centers for Disease Control and Prevention.
Experts are increasingly aware of the ways in which COVID-19 can impact cardiac function. One small study suggested that up to 60% of COVID-19 survivors experienced inflammation of the heart after contracting the infection.
Loss of smell or taste
Loss of taste and smell is often one of the first symptoms people experience with COVID-19, and that issue may linger for many.
“For about a quarter of people with COVID-19 who have one or both of these symptoms, the problem resolves in a couple of weeks,” according to Johns Hopkins. “But for most, these symptoms persist.”
Estimates also suggest, however, that up to 80% of those people experience an improvement in their ability to taste or smell within a year.
Depression and anxiety
Many patients with long-haul COVID experience poor mental health long after being sick. Research suggests that up to one-third of people with COVID-19 were diagnosed with a mental health or neurological condition within six months of their initial coronavirus diagnosis.
Studies have not established clear cause-and-effect, nor is it entirely understood how long-haul COVID and mental health conditions are linked. It could be that the stress and pain of dealing with symptoms over time takes a toll on people’s emotional well-being.
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