What we know about long COVID so far


Long COVID: The name says it all. It’s an illness that, for many people, has not yet stopped.

Eric Roach became ill with COVID-19 in November 2020, and he’s still sick. “I have brain fog, memory loss,” says the 67-year-old Navy veteran from Spearfish, S.D. “The fatigue has just been insane.”

Long COVID, more formally known as post-acute sequelae of COVID (PASC), is the lay term to describe when people start to recover, or seem to recover, from a bout of COVID-19 but then continue to suffer from symptoms. For some, it’s gone on for 2 years or longer. While the governments of the United Statesand several other countries formally recognize the existence of long COVID, the National Institutes of Health (NIH) has yet to formally define it. There’s no approved treatment, and the causes are not understood.

Here’s what is known: Long COVID is a postviral condition affecting a large percentage of people who become infected with the coronavirus. It can be utterly debilitating or mildly annoying, and it is affecting enough people to cause concern for employers, health insurers, and governments.

First, the many symptoms

According to the Centers for Disease Control and Prvention, long COVID symptoms may include:

  • Tiredness or fatigue that interferes with daily life.
  • Symptoms that get worse after physical or mental effort.
  • Fever.
  • Difficulty breathing or shortness of breath.
  • Cough.
  • Chest pain.
  • Heart palpitations.
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”).
  • Headache.
  • Sleep problems.
  • Dizziness when standing.
  • Pins-and-needles feelings.
  • Change in smell or taste.
  • Depression or anxiety.
  • Diarrhea.
  • Stomach pain.
  • Joint or muscle pain.
  • Rash.
  • Changes in menstrual cycles.

“People with post-COVID conditions may develop or continue to have symptoms that are hard to explain and manage,” the CDC says on its website. “Clinical evaluations and results of routine blood tests, chest x-rays, and electrocardiograms may be normal. The symptoms are similar to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and other poorly understood chronic illnesses that may occur after other infections.”

Doctors may not fully appreciate the subtle nature of some of the symptoms.

“People with these unexplained symptoms may be misunderstood by their health care providers, which can result in a long time for them to get a diagnosis and receive appropriate care or treatment,” the CDC says.

Health professionals should recognize that long COVID can be disabling, the U.S. Department of Health and Human Services says. “Long COVID can substantially limit a major life activity,” HHS says in civil rights guidance. One possible example: “A person with long COVID who has lung damage that causes shortness of breath, fatigue, and related effects is substantially limited in respiratory function, among other major life activities,” the HHS notes.


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