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8th September, 20207 min read

Long COVID — what do we know so far?

Medical reviewer:Healthily's medical team
Author:Alex Bussey
Last reviewed: 09/09/2020
Medically reviewed

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Coronavirus has been spreading for almost 9 months and there’s still a lot that we don’t know about it.

What we do know is that the virus is thought to be spread by respiratory droplets that are released when you cough, sneeze or talk. We also know that it can cause a wide variety of symptoms — most commonly a temperature (or fever), a dry cough, and shortness of breath.

But recently, there have been reports of ‘long COVID’ or ‘long coronavirus’. This is where people who have recovered from coronavirus continue to report lasting effects or symptoms.

Some early studies suggest that up to 87% of coronavirus patients continue experiencing symptoms 2 to 3 months after their infection. The UK’s College of General Practitioners also says it’s preparing for a “significant influx” of patients with long-term symptoms.

But it’s hard to know just how many people are affected by this.

Doctor Manoj Sivan, an associate clinical professor at the University of Leeds, is currently running a study on ‘long coronavirus' patients. He shares his knowledge of the condition so far.

What is 'long COVID' and what are the symptoms?

Studies suggest that people with mild coronavirus normally recover after about 2 weeks, but it’s now clear this isn't the case for everyone.

It’s taking some people several months to get over their symptoms, in what Dr Sivan calls “post-COVID syndrome” or "Long COVID".

“People are experiencing fatigue (tiredness), shortness of breath, cognitive problems and psychological problems,” he says. “Cognitive problems meaning problems with concentration and memory and psychological problems meaning things like low mood, depression, anxiety or post-traumatic stress disorder.”

Other symptoms include muscle weakness or pain, and groups like the British Lung Foundation report that people are also experiencing loss of appetite and trouble sleeping.

Nobody can be sure how long these symptoms will last, but Dr Sivan points out that we can learn some important lessons from the past.

He explains that with infections like MERS-CoV (another form of coronavirus which has caused outbreaks since 2012), 15% to 20% of people had symptoms for up to 12 months after catching the illness.

What causes ‘long COVID'?

It’s not clear why the virus affects some people for longer.

The Royal College Of Occupational Therapists (RCOT) say that symptoms of fatigue and sleepiness could be linked to a condition called post-viral fatigue.

This is a long-term illness that develops while your body is trying to fight off a virus, and can persist for some time afterwards. But it’s harder to explain symptoms of breathlessness, anxiety or depression.

Doctor Sivan says that it might have something to do with the way coronavirus attacks the body. “Coronavirus starts in the lungs, but it spreads throughout the body — invading the nervous system, your blood vessels and your gastrointestinal tract,” he says.

“It then gets cleared up by the immune system, but it’s already caused lasting damage to your organs.”

This means the breathlessness would be caused by long-term damage to your lungs, and mental health problems like depression or anxiety may be linked to nerve damage, explains Dr Sivan.

Who’s affected by ‘long COVID'?

It’s difficult to say how many people with coronavirus will go on to develop long-term symptoms.

Dr Sivan is currently leading a large-scale research project exploring the long-term impact of COVID-19. He’s surveyed 100 patients so far and says that about two-thirds of this group were still reporting symptoms 2 months after recovering.

These symptoms include:

  • fatigue (up to 70% of patients)
  • breathlessness (up to 60% of patients)
  • post-traumatic stress disorder (up to 50% of patients)
  • muscle pain and weakness (up to 25% of patients)

A study published in July 2020 showed that 87% of patients in an Italian hospital were still reporting at least 1 symptom on average 60 days after their symptoms first began.

But it’s important to note these findings are all in people who have been admitted to hospital with coronavirus.

People who have a mild form of the illness — or manage to fight off the virus at an early stage — will have less damage, and a better chance of recovering quickly, Dr Sivan explains.

But he also highlights that anyone could get post-viral symptoms.

“Everybody’s immune system is different,” he says. “And the after-effects are determined by the way your body responds to the infection.”

Could people with mild coronavirus get ‘long COVID' symptoms?

Asthma UK and the British Lung Foundation ran a survey in June 2020 asking people with mild and moderate coronavirus to tell them about any long-term health complaints.

Of the 1,000 people who responded to this request, 800 had recovered from coronavirus at home.

The survey found that up to 83% of people had breathing problems, while 85% had extreme fatigue and 75% had struggled to sleep over a 4-week period.

But this study is quite small, and data from the UK Coronavirus Symptom Study app, which has collected symptoms from nearly 4 million users, suggests that about 10% of people are sick for 3 weeks or more.

The Your.MD symptom mapper — an online tool which helps people compare their symptoms with other people around the world — found even lower numbers affected by such long-term symptoms. Of more than 100,000 people surveyed to date, 5.4% reported their illness lasting 22 days or more.

This makes it very hard to tell how many people are likely to have long-term coronavirus symptoms, but calls for new research mean that we could have a better idea soon.

What can you do if you’ve got 'long COVID'?

If you think that you might have ‘long COVID', Dr Sivan says that it’s important to remember that you’re not on your own.

You should speak to a doctor as they will be able to help you treat and manage your condition. And remember to follow any advice you were given from hospital if you were admitted to one.

If you have a mild form of the disease and you’ve recovered at home, experts say that you should follow these tips:

  1. Get plenty of rest — fighting off an infection uses up a lot of energy and it’s important to let your body recover. If you have to go back to work, tell your employer about your condition and see if you can work reduced hours.
  2. Get plenty of sleep — this may be difficult, but you may be able to improve the quality of your sleep by sticking to regular bedtimes, avoiding caffeine before bed and keeping your bedroom as dark as possible.
  3. Stay hydrateddehydration can make symptoms of brain fog or poor concentration worse. Try to drink plenty of water throughout the day (at least 6 to 8 glasses), and remember that fruit juices, tea and coffee count too.
  4. Eat well — try to eat regular meals and focus on maintaining a balanced diet.

When to see a doctor

See a doctor if you have new symptoms, or your symptoms get suddenly worse. They may be part of your body’s response to coronavirus, or they may be something else entirely, so it’s important to get help as soon as you can.

You should also see a doctor straight away if you experience any of the following symptoms:

  • losing weight
  • coughing up blood
  • chest pain
  • trouble breathing
  • severe abdominal (tummy) pain
  • blood in your poo or pee
  • pain in your back or side

Key points

  • some people take longer than expected to recover from coronavirus
  • the symptoms vary from person to person, but people are reporting problems with their breathing, fatigue, concentration and trouble sleeping
  • studies suggest that between 10% and 87% of patients could be affected, but more research needs to be done
  • if you’re worried about your symptoms, it’s best to see a doctor
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