What Do We Know About Post-COVID Conditions?
Initial diagnosis and recovery doesn’t mean the end of dreaded virus
Post-COVID conditions is the CDC term used to describe health issues that persist more than four weeks after a person is first infected with the virus that causes COVID-19. The exact cause of and risk factors for developing post-COVID conditions are not yet fully understood.
Most individuals with COVID-19 get better within weeks of illness; however, some experience ongoing medical issues. In fact, there is no correlation between the severity of the initial illness and developing long-term symptoms. Individuals with underlying health conditions and older individuals are certainly at increased risk, but even individuals who tested positive for COVID and are young and healthy have reported long-lasting symptoms and conditions after the initial illness, including those with asymptomatic infection. Furthermore, at the onset of the pandemic, testing was not readily available and, as a result, there are individuals who never had a positive test result that are experiencing post-COVID conditions.
Signs and Symptoms
Post-COVID conditions are generally characterized by the development and persistence of new or recurrent symptoms that occur after the acute illness has resolved and are often referred to as long COVID, post-acute COVID syndrome, chronic COVID, just to name a few.
The list of common symptoms being reported is growing and currently includes:
- Difficulty breathing or shortness of breath
- Tiredness or fatigue
- Symptoms that get worse after physical or mental activity
- Difficulty thinking or concentrating (brain fog)
- Chest or stomach pain
- Heart palpitations
- Joint or muscle pain
- Pins-and-needles feeling
- Sleeping problems
- Dizziness on standing (lightheadedness)
- Mood changes
- Change in smell or taste
- Changes in menstruation cycles
COVID-19 can also cause long-term damage in multiple body systems including those involving the heart, lung, kidney and brain. These effects can include conditions that occur shortly after the acute phase of the infection, like multisystem inflammatory syndrome (MIS) and autoimmune conditions. MIS is a condition where different body parts can become inflamed.
Conditions also include longer-term effects of COVID-19 treatment or hospitalization, such as severe respiratory infections caused by other viruses or bacteria. Effects of COVID-19 treatment and hospitalization can also include post-intensive care syndrome, which refers to health effects that remain after a critical illness. Post-intensive care syndrome includes severe weakness, brain dysfunction, and mental health issues like stress disorders. Some of these symptoms can overlap with those observed with long COVID.
Treatment for post-COVID currently involves focusing on specific symptoms and/or conditions; underlying medical and psychiatric diagnoses and developing a comprehensive management plan focusing on improving physical, mental, and social wellbeing may be helpful for some patients. The goal of medical management of post-COVID is to optimize function and quality of life. The CDC recently published guidelines for health care providers and it is expected that these will evolve as further studies are conducted and evidence is presented.
Large medical centers across the country are opening specialized clinics to provide care for people who have persistent symptoms or related illnesses after they recover from an initial COVID-19 diagnosis. Support groups are available as well. There are currently over 150 post-COVID clinics across 42 states. These clinics generally offer all specialties needed to support the multitude of symptoms and conditions individuals may be experiencing.
Long COVID and the ADA
In July, the Departments of Health and Human Services and Justice announced that long COVID may qualify as a disability under the Americans with Disabilities Act (ADA). Eligible individuals are now entitled to the same protections from discrimination as any other person with a disability under the ADA. Individuals may claim a disability if their conditions or any of its symptoms is a “physical or mental” impairment that “substantially limits” one or more major life activities.
A physical impairment includes any physiological disorder or condition affecting one or more body systems, including, among others, neurological, respiratory, cardiovascular, and circulatory. A mental impairment includes any mental or psychological disorder, such as an emotional or mental illness. “Major life activities” include abilities that allow a person to function on a daily basis. An individualized assessment is necessary to determine whether a person’s long COVID condition or any of its symptoms substantially limits a major life activity.