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Emerging Medicine: What We Know About Long COVID

January 27, 2024

A woman struggles with fatigue from long COVID.

While the global COVID-19 pandemic may be over, COVID is here to stay with cases spiking in the wintertime alongside the flu, colds and RSV. For some patients with COVID, the disease can stick around long after infection in what’s now become recognized as long COVID or post-COVID conditions.

Patients began describing lingering symptoms of COVID around summer 2020, just months after the pandemic began. In the last four years, physicians and researchers have made significant headway in learning how and why some patients experience lasting COVID symptoms, but, as the virus continues to evolve, questions remain. David Sousa, MD, a fellowship-trained pulmonologist and critical care specialist with Atlantic Health System, shares more about this condition, how to treat it and, most importantly, how to prevent it.

What is Long COVID?

Although there are no clear-cut definition of the stages of COVID-19 recovery, people are generally considered to have long COVID if they have symptoms that develop during or after COVID-19 and persist for three months after initial infection. While it’s hard to understand the prevalence of long COVID, many experts agree that around 6-15% of patients with COVID go on to develop lasting symptoms.

The CDC describes long COVID as signs, symptoms and conditions of COVID that last beyond that initial, acute infection. However, these signs and symptoms can vary from person to person. Broadly, they may include:

  • Chest discomfort
  • Cough
  • Fatigue
  • Impaired memory
  • Poor concentration
  • Psychiatric conditions like anxiety, depression and PTSD
  • Shortness of breath

“When we think about what it means to have long COVID, there are no great, slam dunk answers,” says Dr. Sousa. “This condition has been around for less than four years. By comparison, we’ve known about cardiovascular disease for centuries and we’re still learning better ways to diagnose and treat it. We still have a long way to go to understand long COVID.”

While anyone can develop lasting symptoms after COVID infection, some patients may be more vulnerable than others. Patients who are assigned female at birth, older age, more severe infection and preexisting conditions like diabetes and obesity are more prone to long COVID.

How to Prevent and Treat Long COVID

Because symptoms of long COVID vary so much from person to person, treatment is often specific to the symptoms of each patient. For example, a patient experiencing long-lasting brain fog might see a speech-language pathologist and undergo neurocognitive rehabilitation. Similarly, patients with fatigue might undergo sleep studies and treatment with lifestyle modifications. Physicians also may look for underlying conditions, like sleep apnea, that mimic COVID symptoms.

“The important thing is to have good communication with your doctor,” says Dr. Sousa. “People may minimize or ignore symptoms, but it’s important to figure out what your symptoms are and make sure you get help when you feel like you need it.”

The best way to prevent long COVID is to avoid getting a COVID infection in the first place. That includes, first and foremost, getting the updated COVID vaccine. Other ways to prevent initial infection and long COVID include:

  • Avoiding contact with people who have COVID
  • For high-risk patients, seeking treatment immediately after infection
  • If infected, taking medications to decrease the severity of disease
  • Improving ventilation in indoor spaces
  • Washing your hands

“Like many things in medicine, prevention is one of the best things we can do to prevent severe disease,” says Dr. Sousa. “We know that anything that decreases the incidence and severity of COVID decreases it for long COVID, especially getting vaccinated.”

  • COVID-19