After a Covid-19 infection, some people experience long-term health effects. These post-Covid conditions are commonly referred to as Long Covid.
Long Covid is a complex illness that can include a wide variety of symptoms, so we asked Christine Kuryla, a public health scientist and researcher at the Columbia University Mailman School of Public Health, to provide clarity. Below, she answers frequently asked questions about Long Covid.
How is Long Covid defined?
Definitions vary, but generally someone is considered to have Long Covid if symptoms either persist or appear at least two to three months after their initial Covid-19 illness. It presents as a constellation of symptoms, from neurological manifestations such as “brain fog,” to extreme fatigue, or problems with any number of organ systems, such as the heart, lungs, kidneys, or gastrointestinal system, and even newly elevated blood sugar in those with no prior history of diabetes. The symptoms can either persist following the acute infection or reappear after the initial phase of the illness has ended. Long Covid is a separate diagnosis from Covid-19.
How common is Long Covid?
About 10-30% of Covid-19 cases end up developing Long Covid, which amounts to over 20 million people so far in the US alone.
Who is predisposed to Long Covid?
Long Covid is more common among people who are older, female, and who had a more severe initial illness. However, anyone can get Long Covid — new data suggests that Long Covid can occur after an initial Covid-19 infection of any severity, including mild and asymptomatic cases, although it does correlate more with severe initial illness. Nevertheless, there are far more Long Covid cases among those with mild or asymptomatic Covid-19 because of the sheer volume of people in that category. Long Covid occurs in people who are both vaccinated and unvaccinated, of any age, and of poor or good health.
What are the treatment options?
Currently, the only treatment options involve treating individual symptoms as they occur. The diagnosis is made by ruling out other causes of the symptoms. There is no treatment for the underlying disease, however physicians can sometimes try to help manage the symptoms and help patients cope with them.
What does the research show about Long Covid?
Research is still ongoing. There is accumulating evidence that an abnormal immune response may cause Long Covid. On the other hand, some studies have shown that the virus can hide inside certain tissues or organs, meaning that the infection is ongoing or hasn’t completely cleared. We do not know why it happens to certain people and not others. It is still very much an open question and there are many groups actively researching it now.
How are clinicians collaborating to respond?
Long Covid clinics have opened at medical centers around the country. Groups are being formed to help connect people with doctors who are putting in a particularly strong effort to stay in the know. Research is ongoing and treatment guidelines are developing.
What should people do if they think they have it?
If you think you have Long Covid, you should go to your doctor and see if there are any other causes for your symptoms. The diagnosis can be tricky, but the illness is real. You can also seek out Long Covid support groups, both in person and online, to help you cope with having the condition.
Is there anything else that you think it's important for people to know about Long Covid?
Long Covid is already affecting our society. It may be hard to determine why your symptoms are happening, especially because at this point most people have had Covid-19. However, it’s important to remember that it can happen to anyone, not just people who are predisposed or with pre-existing conditions. While some people may not take your symptoms seriously, Long Covid is a real, validated disease that demands ongoing new research and new approaches to diagnosing and therapy.
If you or someone you love is facing a health challenge, coping with a new diagnosis or chronic illness, or needs support maintaining their good health, reach out to an expert health advisor.
