How do I know if I’m experiencing long COVID?

COVID-19 symptoms are broad, and long COVID is no different. If navigating your long COVID journey is proving difficult, Maple can help. Maple is a telehealth platform that lets you connect with Canadian-licensed doctors and specialists from your phone, tablet, or computer.

What is long COVID and how long does it last?

Long COVID can be hard to pin down. It can include physical or neuropsychiatric symptoms, or both, and may appear weeks after infection or be present continuously from the moment of illness onset. Currently, however, long COVID — also known as post COVID-19 condition — is defined as experiencing COVID-19 symptoms for longer than two months after your initial infection.

As the virus that causes COVID-19 — SARS-CoV-2 — is still relatively new, it’s not yet clear how long post COVID-19 condition can last, or what causes it. It seems that certain effects such as loss of smell are likely to fade over time, while other effects such as certain kinds of lung damage may be life-long. The truth is that with such a new illness, a lot, including the duration of symptoms, remains unknown.

How common is long COVID?

Exactly how many people have been infected with COVID-19 isn’t clear. During the first months of the pandemic, testing was mostly inaccessible. Later, as testing requirements shifted and more people switched to at-home rapid antigen tests, daily case counts stopped reflecting the true number of infections.

This means that not everyone with long COVID tested positive for the virus in the first place. They may have had mild symptoms they mistook for something else. Or, they may have been one of the four out of 10 people with COVID who are asymptomatic.

Because of these factors, the exact numbers are difficult to know. A 2021 study estimates that more than a quarter of those with COVID-19 go on to develop long COVID. Other studies show that this number may be higher in those who need hospital care as a result of the virus — affecting up to 50%. In individuals who don’t require hospitalization, however, long COVID estimates generally range from 10% – 40%.

Who’s at risk of developing long COVID?

While anyone who gets COVID-19 runs the risk of potentially developing post COVID-19 syndrome, certain individuals seem to be more likely to experience it. These include:

• Those with more severe cases of the virus, especially if they required hospitalization or an ICU stay
• Individuals with underlying medical issues prior to their infection
• Those who experienced multisystem inflammatory syndrome (MIS) during or after their infection
• The unvaccinated
• Individuals with health inequities and barriers to care

Can vaccinated people get long COVID?

Unfortunately, yes. Vaccination doesn’t completely protect you from getting long COVID. The good news is that vaccination does seem to reduce your chances of it. One study shows that one vaccine may reduce your chances of becoming a long hauler by almost 13%, and a second one by an additional almost 9%.

Vaccines may also be beneficial for those already dealing with post COVID-19 condition. One survey of long haulers reported that about 58% found that vaccination improved or entirely eliminated their long COVID symptoms.

But, it’s not a slam dunk for everyone. A minority of respondents — about 18% — reported the opposite. They felt that vaccination worsened their long COVID symptoms. Research is still ongoing, however, and the full effects of vaccination on long COVID are still being determined.

What long-term health problems is COVID-19 causing?

Individual accounts of long COVID detail myriad symptoms, ranging from disrupted menstrual cycles to hair loss and beyond. Certain ones, however, show up repeatedly. Here are some of the top long-term health problems associated with long COVID.

1. Fatigue

Fatigue is the most commonly reported ongoing symptom when it comes to long COVID. While it affects the whole body, the underlying causes of fatigue can range from cardiac issues to an overactive immunological response.

2. Cognitive issues

Affecting the brain, cognitive issues like brain fog, headaches, dizziness, and memory and attentional problems are another set of symptoms whose genesis isn’t entirely clear. In some cases, these neurological issues might be the byproducts of the insomnia that many long haulers report. Alternatively, their origin might be in damage to organs like the heart, lungs, or brain.

3. Insomnia

If you’ve been plagued by insomnia since your brush with COVID, you’re definitely not alone. Affecting both long haulers and those who recover completely, up to three out of four report sleep issues as a lasting effect of their infection.

4. Mental health issues

The post-viral period for as many as 26% of long haulers includes depression and anxiety. Many, especially those who were hospitalized with the virus, may also find themselves wrestling with PTSD.

5. Difficulty breathing

An ongoing post COVID-19 cough and shortness of breath are seen in many long haulers. While some breathing problems are the result of scarring or damage to the lungs, others involve a more temporary reduction in lung capacity.

6. Gastrointestinal issues

Many long haulers report symptoms like nausea, heartburn, and diarrhea. In some cases, this is owing to the continuing presence of RNA fragments from the SARS-CoV-2 virus in their gastrointestinal tract. For others, post-viral digestive issues may be due to ongoing inflammation or a disruption of your gut’s natural microbiome. Persistent diarrhea may also indicate the bacteria C. difficile, especially if patients received antibiotics recently.

7. Kidneys

Kidney damage after COVID-19 is possible, even with a mild COVID-19 infection. This increases your risk for kidney disease, and not everyone with kidney issues will have symptoms. Those that do, however, may experience swelling around the eyes, ankles, or legs, reduced urine output, tiredness, feeling short of breath, nausea, and confusion.

8. Heart trouble

Long COVID risks include myocarditis and pericarditis, which both involve inflammation of parts of the heart. Both conditions typically result in some combination of chest pain, heart palpitations or arrhythmia (unusual heartbeat), and shortness of breath.

9. Blood vessel damage

Damage to your blood vessels and arteries isn’t uncommon in post COVID-19 condition. This can trigger blood clots or blood vessel damage that impedes the flow of blood to your heart, brain, lungs, or other parts of the body. Symptoms can include discomfort, numbness, tingling in a part of the body, fatigue, and chest pain.

10. Type 2 diabetes

A large study in the Lancet shows that your risk of developing diabetes rises by about 40% after a COVID infection. Initial symptoms of diabetes include increased urination, extreme thirst, unintentional weight loss, and blurred vision.

The list of long-term COVID effects doesn’t end here. Additional health effects include but aren’t limited to blood clots, liver damage, hair loss, pain, and loss of taste and smell. There’s also ongoing research about the link between Postural Orthostatic Tachycardia Syndrome (POTS) and COVID-19. Studies have shown that POTS — a disorder which affects blood flow — may be a complication after contracting COVID-19.

Is long COVID contagious?

Despite the ill effects it wreaks on you, long COVID isn’t transferable to others. Once you recover from your initial COVID infection, you’re no longer contagious — even if you continue to have long COVID symptoms for months afterwards.

How do I live with long COVID?

Living with long COVID can be quite an adjustment. Start by pinpointing your exact symptoms and discussing them with your healthcare provider. The following strategies can also help.

• Don’t rush to get back to “normal.” Many long haulers report that overexertion makes their symptoms worse. Talk to your HR department and see if a flexible return-to-work plan is a possibility.
• Outside of that, go easy in your personal life. Give up vacuuming your apartment, and press pause on that volunteer job. Everything but the fundamentals can wait until you’re better.
• Focus on your mental health. Long COVID can wreak havoc on your psyche. Incorporate daily relaxation rituals like meditation or deep breathing to keep you feeling calm.
• Figure out when your energy levels are highest. If you find your productivity peaks in the morning, for example, try planning your most intense tasks for then.
• Get your boosters, or get vaccinated once your healthcare provider recommends it. Vaccines may help to alleviate symptoms of long COVID in some.
• Don’t stop exercising. Regular physical activity will help strengthen your body — just make sure not to overdo it. As a bonus, exercise releases endorphins, serotonin, and dopamine, which are powerful mood boosters.
• Gather your emotional support. Reach out to friends and family, or find a long COVID support group. Bearing the mental and emotional weight of a long-term health condition is easier with others to help share the load.
• Boost your immune system by making good choices. Eating well, drinking enough water, getting enough sleep, and cutting out alcohol should be at the top of your list — at least until you feel 100% better!

How does long COVID impact mental health?

The effects of COVID-19 on mental health are clear, and it’s not hard to see why. Big life changes — like a major illness — are often a precipitating factor for depression, anxiety, and PTSD. Chronic fatigue, loss of energy, and being unable to complete the daily activities of living are a springboard for depression and other mental health concerns. And insomnia is especially famous for destroying mental health.

Any of these makes long COVID the perfect storm for creating mental health problems. But, COVID adds another dimension to the issue as it can also trigger inflammation or hypoxia (lack of oxygen) in the body, both of which may contribute to mood disorders. It’s no wonder that long COVID often affects mental health.

How virtual care can help

While some find that they can continue living relatively normally, others find themselves completely incapacitated by long COVID, unable to even leave their house. If long COVID is making it hard for you to connect with a healthcare provider, Maple can help. With Maple, you can see a Canadian-licensed doctor online within minutes, no matter where you are.

If you’re one of the many experiencing mental health challenges brought on by long COVID, seeing a mental health physician can help. Not only can they provide an appropriate diagnosis based on your symptoms, but they can also prescribe medication, if necessary, to help support your recovery. Furthermore, they’re able to provide guidance when it comes to coping with insomnia.

For ongoing mental health support, speaking to a therapist may be your next step. A therapist can help you develop coping mechanisms for dealing with a challenging illness, guiding you through the grief and stress of the condition.

If you’re concerned that long COVID has left you with lasting health effects but don’t know where to start, consider booking a general health assessment. You’ll be able to discuss any areas of concern with your provider and they can order additional testing if they think it makes sense to do so.

The long-term effects of COVID can be debilitating. If you’ve been sick for a while, it can be hard to see the light at the end of the tunnel, but long COVID research is continuing.

In the meantime, speak to your healthcare provider about rehabilitation services. Physical therapy, mental health therapy, medication, and breathing exercises for long COVID are all possible alternatives depending on your symptoms. You won’t always feel like this.