Nearly 90 million people in the U.S. have tested positive for COVID-19 since the pandemic began, data from the Centers for Disease Control and Prevention (CDC) show.
Some people who have contracted the virus continue to experience symptoms or complications for months afterward, a post-COVID condition generally referred to as “long COVID.”
Several VERIFY readers have emailed the team with questions about long COVID, including how the condition is defined and whether those who have it can continue to test positive for the virus.
We are answering some of the most common questions about long COVID.
THE SOURCES
- The Centers for Disease Control and Prevention (CDC)
- World Health Organization (WHO)
- Mayo Clinic
- Johns Hopkins Medicine
- Natalia Covarubbias-Eckardt, M.D., medical director of the Inpatient Rehabilitation and Post-COVID Rehabilitation Program at Providence St. Jude Medical Center in Orange County, California
- Ilhem Messaoudi Powers, Ph.D., chair and professor in the department of microbiology, immunology and molecular genetics at the University of Kentucky College of Medicine
FAST FACTS
- Definition of long COVID: Long COVID, also known as post-COVID conditions, occurs when a person experiences long-term effects from their coronavirus infection. People with long COVID experience ongoing, recurring or even new symptoms for weeks, months or even years after their initial infection.
- Common long COVID symptoms: Some of the most common symptoms reported by people with long COVID include fatigue, shortness of breath, “brain fog,” and anxiety, medical experts say. People can also experience other heart and respiratory issues, or neurological problems.
- Mild infection and long COVID: The CDC and other medical experts say long COVID appears to be more common in patients who had a severe case of the virus, though it can also affect people who had mild symptoms.
WHAT WE FOUND
What is long COVID and how is the condition defined?
Long COVID, also known as post-COVID conditions, occurs when a person experiences long-term effects from their infection with the virus that causes COVID-19. People with long COVID experience ongoing, recurring or even new symptoms for weeks, months or even years after their initial COVID-19 infection.
The CDC and Mayo Clinic have generally determined that a person is suffering from long COVID if they continue to experience symptoms more than four weeks after their COVID-19 diagnosis.
The World Health Organization (WHO) has also developed a clinical definition for a post-COVID-19 condition. It is one that develops in people with a “history of probable or confirmed” coronavirus infection, “usually three months from the onset of COVID-19 with symptoms,” according to the public health agency.
Symptoms of a post-COVID-19 condition last for at least two months and “cannot be explained with an alternative diagnosis,” the WHO says.
What are some common symptoms of long COVID?
There is a wide array of long COVID symptoms, but some of the most common include fatigue, shortness of breath, “brain fog” (difficulty thinking or concentrating), and anxiety, Natalia Covarubbias-Eckardt, M.D., medical director of the Inpatient Rehabilitation and Post-COVID Rehabilitation Program at Providence St. Jude Medical Center in California, said.
The CDC also lists commonly reported symptoms that fall into several different categories. One of those is respiratory and heart symptoms, which can include cough, chest pain and heart palpitations.
Some of the common neurological symptoms include headache, sleep problems, lightheadedness, and changes in smell and taste.
People with long COVID have also reported diarrhea and stomach pain, joint or muscle pain, rash, and changes in their menstrual cycles, the CDC says.
Many long COVID symptoms are similar to those caused by an acute infection of COVID-19.
“It’s very diverse and nebulous,” Ilhem Messaoudi Powers, Ph.D., an immunology expert and professor at the University of Kentucky College of Medicine, told VERIFY. “It's really hard to wrap your arms around what long COVID is, and unfortunately, there isn't a really good way to test for long COVID. It's all subjective and it's all people reporting their symptoms.”
Can people with mild infections develop long COVID?
“Yes, patients who haven't even had a positive test, but believe that they have had COVID based on the symptoms we actually have seen, can have long COVID,” Covarubbias-Eckardt said.
Johns Hopkins Medicine and the CDC say long COVID appears to be more common in patients with initial severe illness, though it can affect people who had mild symptoms, too.
Experts are still studying why certain people develop long COVID while others don’t. Based on current data available, some believe that the condition may be tied to people who have a heightened immune response to the virus, leading to ongoing symptoms, according to Covarubbias-Eckardt.
As researchers study available data, they are hoping to be able to determine who is more likely to suffer from long COVID and develop more targeted treatment options, she added.
Can people with long COVID continue to test positive months later?
Anyone who has been infected with and recovered from COVID-19 can test positive for the virus on a PCR test for months after infection. This doesn’t necessarily mean a person has long COVID.
Some COVID-19 tests, like a PCR test, are more sensitive to picking up the virus, even when your body isn’t actively shedding it, Covarubbias-Eckardt said.
Messaoudi Powers agrees.
“The PCR [test] is so sensitive that it could still pick up all those little debris of RNA that's still hanging out in the nasal passages or in the back of your throat from the nasal drips. So it is not unusual – we actually have lots and lots of cases where people test positive for a very long period of time without any symptoms,” she said.
VERIFY previously found that a person can test positive for COVID-19 on PCR tests for up to 12 weeks after infection.
Some people who are immunocompromised, including those with cancer who are undergoing chemotherapy or people with autoimmune disease who take immunosuppressive therapies, may also continue to test positive for long periods of time, Messaoudi Powers said.
Are there treatment options for people with long COVID?
There isn’t a specific treatment for people suffering from long COVID, as the best course of action depends on a person’s symptoms, Covarubbias-Eckardt explained.
“A lot of the treatments that we have for the symptoms come from other diagnoses that seem similar,” she said.
For example, a person struggling with “brain fog” or difficulty with their words may see a speech therapist. Someone experiencing ongoing respiratory symptoms may work with a team of pulmonologists to receive the care they need.
“But there isn't like a magic pill that is for [long] COVID-19,” Messaoudi Powers said. “We're now treating each one of these consequences with what we have available on hand in terms of tools.”
Some health care centers have launched specialized long COVID clinics, Messaoudi Powers said. According to Becker’s Hospital Review, a magazine sharing hospital news, these programs typically “involve an initial evaluation and, as needed, referrals to a network of specialists such as pulmonologists, cardiologists and neurologists, among others.”
As of February 2022, at least 66 hospitals and health systems had launched COVID-19 recovery programs, Becker’s Hospital Review said.
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