What to Know About COVID-19 Long Haulers

Healthcare News

What to Know About COVID-19 Long Haulers

COVID-19.Mental Health
Dr. Joseph Mosquera
By Dr. Joseph Mosquera
Feb 23, 2021 - Updated Apr 12, 2021
What to Know About COVID-19 Long Haulers

The overwhelming majority of those who become infected with COVID-19 will recover from symptoms within a few weeks. Those who do not recover from symptoms within 4-6 weeks, or who remain disabled by symptoms for more than 28 days are known as long haulers.

The data continues to emerge and varies based on geography but to date, approximately 10% of people who were infected with the coronavirus continue to experience lasting symptoms.

Here’s what we know as of this writing about COVID-19 long haulers.

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What is a COVID-19 long hauler?

In reality, anyone including yourself may have the potential to become a COVID-19 long hauler. Even those who experienced relatively mild illness from coronavirus can continue to experience lingering symptoms. Those who became seriously ill from the coronavirus infection may also struggle with lasting symptoms. All ages are at risk for lasting symptoms though the average age group of long-haulers is individuals in their mid-40s.

In addition, many who have certain underlying conditions (comorbidities), such as heart disease, kidney disease, diabetes, pulmonary conditions, etc., continue to experience an exacerbation of the underlying conditions as the result of COVID-19.

The symptoms that some long haulers experience after being released from the hospital are very often tied to the chronic health condition they had before the onset of the coronavirus infection. The medical term for this is sequela, which means an aftereffect of a disease, or a condition or state that follows a disease as a consequence.

For example, those who already had heart disease may have had a heart attack as the result of coronavirus. So, although they may have been relatively asymptomatic before contracting COVID-19, now the symptoms of that underlying condition are worse. Those who had vascular issues may have had a stroke due to coronavirus, and are now dealing with lasting effects of the stroke.

Indeed, for nearly everyone with an underlying condition, coronavirus made it much worse.

What are common symptoms COVID-19 long haulers experience?

In my practice, I’m seeing both general and specific symptoms that vary widely from person to person. The most common general symptom is fatigue (chronic fatigue syndrome). Concurrent with fatigue, general, widespread symptoms include both mental and physical fatigue. In other words, COVID-19 long haulers are both bodily and mentally depressed.

Specific symptoms in COVID-19 long haulers include symptoms that may be linked to pre-existing conditions, or linked to symptoms caused by the virus itself. Specific cardiac symptoms include an inflamed heart (pericarditis), or a rapid heart rate (tachycardia). Specific pulmonary symptoms are also common, including lingering shortness of breath and coughing.

Specific circulatory symptoms such as blood clots are affecting some individuals who developed blood clots during their illness. Likewise, many, many COVID-19 long haulers are dealing with mental health impacts, which include brain fog, anxiety, and depression.

Other specific symptoms impacting COVID-19 long haulers include a lingering loss of taste and smell. Others are dealing with ringing in the ear (tinnitus), or neuromuscular symptoms, which are best described by patients as “feeling as if their muscles are on fire.”

Lasting Mental Health Symptoms from COVID-19

The mental health symptoms left behind in the wake of COVID-19 are impossible to ignore. According to a recent UK study, one in three COVID-19 survivors has been diagnosed with a brain or psychiatric disorder within six months. Of these disorders, anxiety and depression are the most common. They do not appear to be linked to how sick coronavirus made you.

From fear of reinfection to financial stress, grief, anxiety, and depression, the mental health implications of the coronavirus pandemic are incalculable. Many individuals, particularly those who were severely ill, or had a loved one get seriously ill, or die from the novel coronavirus, are dealing with psychological symptoms that require professional treatment.

I encourage all individuals who are dealing with feelings of fear, anxiety, grief, or depression to inform their health care provider immediately and seek immediate medical attention from a health care professional. It is vitally important to begin treating these mental health symptoms, particularly in those who have underlying conditions. These mental scars need to be addressed so that people who for example, have a pulmonary condition, aren’t too afraid of reinfection, or treatment, to see their pulmonologist.

Free Mental Health Resources for COVID-19 Long Haulers

To cope with anxiety, fear, and depression, it is always best to seek professional treatment. However, in the interim, there are wonderful free resources available including websites, podcasts, and other online resources available to help with mental health.

Also, please remember if you or someone you know is experiencing suicidal thoughts, call the National Suicide Prevention Hotline at 1–800–273–8255 or text HOME to the Crisis Text Line at 741741. You may also reach out to the Samaritans by calling or texting (877) 870-HOPE (4673).

What do we know right now, about COVID-19 long haulers and their prognosis?

Right now, we don’t have enough information to accurately predict when some of these lasting symptoms in COVID-19 long-haulers may resolve. We are seeing the emergence of post-COVID clinics from coast to coast that are treating COVID-19 long haulers. These clinics provide care and support for COVID-19 long haulers and will play an invaluable role in helping our nation recover.

Fortunately, there may be new hope on the horizon for COVID-19 long haulers who receive the vaccine. In my practice, I’m seeing the same encouraging signs that have been reported in the media, regarding the impact that vaccines have on lingering symptoms. Many long haulers are reporting a reduction in symptoms after receiving the vaccine, which is a huge relief to see.

This is not surprising, as the vaccines help your body to develop antibodies. So, when a COVID-19 long hauler gets the vaccine, it appears to help the body to finally clear any lingering virus. In a way, it is as if the vaccine is rallying your own body to continue to recover.

The data on long haulers who are finally experiencing relief after receiving the vaccine is still coming in and will continue to evolve. Thus far though, it seems that the vaccine is helping some to begin to finally experience relief from lasting symptoms.

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How soon after I had COVID-19 should I get the vaccine?

I recommend everyone speak with their health care provider about when they should get their vaccine after they have recovered from COVID-19. In my practice, I routinely perform antibody testing to check levels of antibodies in those who have recovered. Those with abundant antibodies will have a natural immunity to the virus initially. So some may want to wait 30, 60, or 90 days before getting the vaccine. This may also help reduce the likelihood of side effects of the vaccine.

On the other hand, for those who have recovered, but don’t have a strong antibody level, it may be better to receive it sooner. There is no one-size-fits-all date that you should receive your vaccine after COVID-19, so speak with your doctor, and follow their recommendation.

What will be the long-term effects of COVID-19 on long haulers?

It is too soon to say what the future looks like for those dealing with lasting symptoms. Many long haulers were severely sick and infected very early in the pandemic. The medical field knows so much more now, than we knew in March, April, and May, as COVID-19 ravaged certain areas in our nation.

It is my hope that because we now know what treatments should be started immediately (antivirals, anticoagulants, etc.), and we know how to make better use of medical devices (ventilators, respirators, etc.), fewer individuals will become COVID-19 long haulers, should they contract the virus before they can get vaccinated.

Why You Should Get the COVID-19 Vaccine As Soon as You’re Eligible

Many states are opening eligibility to all adults within the coming weeks. We need everyone to get their vaccine as soon as they are eligible, or as early as recommended by their doctor after recovery from COVID-19. Although older Americans have gotten vaccinated in huge numbers, we need the younger members of society to get their vaccine ASAP as well. Otherwise, we will continue to have surges, sickness, and loss of life.

However, if we can get the majority of younger people vaccinated as well, we will finally see the pandemic dissipate. Coronavirus will become endemic, with clusters popping up, rather than widespread infection across the country.

So, do your part when it’s your turn, and remember -- schedule your shot.

Dr. Joseph Mosquera

Dr. Joseph Mosquera

Dr. Joseph Mosquera has over 35 years of experience as an integrative general practitioner in Newark, NJ. Mosquera is a graduate of Rutgers Medical School (now UMDNJ). He studied neurology at George Washington University Hospital and completed his residency and training in Internal Medicine at Hackensack University Medical Center. He then went on to graduate from the University of Arizona Medical School’s Program in Integrative Medicine in 2004. Dr. Mosquera is also a Harvard Medical School Fellowship graduate in Structural Acupuncture and Traditional Chinese Medicine and is certified in Ericksonian Hypnotherapy and Psychotherapy. He has served as the Clinical Director of Integrative Medicine at St. Michael’s Medical Center (Newark, NJ), an Associate Professor of Medicine at the University of Arizona Medical School, an Instructor at UMDNJ in “The Art of Medicine”, and a Lecturer of Integrative Medicine at both Harvard and Georgetown University Medical Schools. He has held a Board Certification in Internal Medicine since 1984 and is licensed to practice medicine in five states (NY, NJ, MA, NH, FL). Since 2003, Dr. Mosquera has been a regular Medical/Health expert and contributor to Univision, Telemundo, as well as CNN and NBC’s the “Today Show.” He has served as a Medical and Health expert for Consumer Reports Health since 2008. He is currently a medical expert for RxSaver.

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