A Third of COVID-19 Patients Experience Lasting Symptoms, Study Finds

The first doses of the COVID-19 vaccine offer a light at the end of the tunnel for one of the deadliest pandemics in U.S. history. But for long-haulers—people who experience lasting effects after months after contracting COVID-19—the end doesn't feel as imminent. A December study published by the Annals of Internal Medicine looked at the evolution and persistence of COVID-19 symptoms, showing that the long-hauler phenomenon may affect a third of people infected. 

Genevan physicians analyzed results from 669 study participants, including healthcare workers and hospitalized patients. The study found that a loss of taste or smell was common early on. At the 30- to 45-day mark, 32% of the 669 participants reported at least one or more symptoms—meaning persistent symptoms are present in at least one-third of COVID-19 cases. Among those symptoms were:

• Fatigue
• Loss of taste or smell
• Shortness of breath
• Cough

Growing List of Persistent Symptoms

According to Jacob Teitelbaum, MD, a board-certified internist and fibromyalgia expert based in Hawaii, that growing list of long-term symptoms also includes insomnia, widespread pain, brain fog, and palpitations. “It occurs in a range of severities,” Teitelbaum tells Verywell. 

When Suzanne Pham, MD, FAAP, medical director of the COVID-19 response team at Weiss Memorial Hospital in Chicago, was treating patients, she noticed fatigue was the most commonly reported lasting symptom. “People tend to tell me that they had issues with concentration that they never had noticed prior to having had COVID-19,” Pham tells Verywell. 

Some research studies hypothesized that COVID-19 could be a neurotropic virus, a virus that affects the nervous system, which could be leading to these persistent effects. Symptoms increasingly apparent in long-haulers such as brain fog, tremors, limb stiffness, and confusion, can be tied back to the body's nervous system. The challenge that researchers will face in the months ahead is figuring out the exact molecular mechanisms that cause chronic neuro-COVID-19 symptoms and how to treat them.

According to Pham, patients that had a more severe illness or spent time in the intensive care unit (ICU) were at higher risk for becoming long-haulers.

The long-term impacts have dire consequences for long-haulers. “It certainly seems to cause them to be unable to fully return back to their daily function,” Pham says. “Many of these patients were highly functional prior to having had COVID-19.” 

“It leaves them unable to work, parent, or go to school,” Teitelbaum adds. 

How To Manage Long-Term COVID-19 Symptoms 

Pham suggests symptomatic relief—therapy that eases symptoms without addressing the cause of the disease—as the way forward for patients. For people with persistent coughs, cough suppressants might provide relief. And if you have joint pain or muscle aches, anti-inflammatories may aid in the regaining of strength that was lost. 

Other options Pham recommends include physical therapy to increase endurance and cognitive exercises to help patients with concentration issues.

Further investigation is needed to look at more serious long-term complications. Currently, data does not yet exist for COVID-19’s long-lasting impact. 

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Next Steps 

More research is needed to determine the long-term effects of COVID-19. “We absolutely need to follow these patients to determine what effect COVID-19 has had on their bodies that’s causing this persistence,” Pham says. “We haven’t been able to see biopsies, pathology reports that give us enough information to make any conclusion, so we should follow these patients for the duration of their symptomatology and further investigate them.”

Teitelbaum says that long-hauler syndrome is being researched in order to examine people before infection and after developing the infection, to see how the immune system responds.

These lasting symptoms are legitimate and do exist. The research study concludes that adequate communication will be needed to provide reassurance to those experiencing lasting symptoms, reduce feelings of anxiety, and optimize the recovery process. Incorporating patient knowledge into how long-haulers are studied will aid this process.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.