What is a COVID ‘Long Hauler’?

For some individuals diagnosed with COVID-19, symptoms can continue to affect their health for weeks or months after they first tested positive.

Dec. 27, 2021 6   min read

More than 800,000 Americans have passed away from COVID-19 as of December 2021. Approximately 50 million Americans have tested positive for the virus since the start of the pandemic.

Research published in the journal JAMA Network Open suggests as many as 50 percent of all patients who contracted the virus are living with long-term symptoms that affect their ability to function normally on a daily basis.

For a deeper perspective on these patients, commonly referred to as ‘long haulers’, we asked Emil Lesho, DO, an infectious disease specialist with Rochester Regional Health.

Defining a ‘long hauler’

After being diagnosed with COVID-19, some patients resolve their cases in about two weeks.

Per the CDC, people who experience COVID-related symptoms more than four weeks after initially testing positive for the virus – referred to as ‘long haulers.’ Other terms used include Post-Acute Sequelae of SARS-CoV-2 infection (PASC), long COVID, long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID.

The symptoms that persist are wide-ranging in scope and severity. They may include:

  • Difficulty breathing or shortness of breath
  • Difficulty thinking or concentrating (referred to as ‘brain fog’)
  • Fatigue
  • Changes in smell or taste
  • Cough
  • Chest or stomach pain
  • Headaches
  • Heart palpitations
  • Joint or muscle pain
  • Sensation of pins and needles
  • Sleeping problems

Some patients experience multi-inflammatory syndrome (MIS) after dealing with COVID-19. In these situations, multiple organs in the body become inflamed – including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. This can happen in both adults and children.

In July 2021, long COVID was added to the list of disabilities covered under the Americans with Disabilities Act.

“One of the things that makes COVID ‘long haulers’ so complex is that it doesn’t matter how severe their initial infection was,” Dr. Lesho said. “Some patients who had mild cases of COVID-19 are reporting symptoms that last several months. The same is true of some patients who had severe initial COVID cases.”

How many people does this affect?

In the months following the start of the pandemic in 2020, experts initially estimated 10-20 percent of all COVID patients were living with long COVID after resolving their case.

Children and adolescents are less likely to experience symptoms of long COVID compared to adults, but some cases have still been reported. Similar to adults, child and adolescent patients who had both mild and severe COVID-19 illnesses have dealt with long COVID.

What causes the ‘long hauler’ cases?

Research is still being conducted on exactly what leads to these long-term symptoms and conditions. Scientists around the world are studying small and large groups of COVID ‘long haulers’ to determine how the virus may be doing what it does.

In December 2020, Congress awarded the National Institutes of Health $1.1 billion over four years to support research into the prolonged health consequences of COVID-19.

“Despite this specific virus existing for more than two years, there is still quite a lot to learn about the virus itself, its short-term and long-term effects on patients, and many other areas of interest,” Dr. Lesho said.

Risk factors

There are several underlying conditions that are correlated with more severe COVID-19 cases.

Increased risk was linked to patients who also had:

  • High blood pressure
  • Obesity
  • Diabetes
  • History of smoking

While these factors may be linked to more severe COVID-19 cases, more research needs to be done about whether they are also correlated with long COVID.

Treatment for ‘long hauler’ patients

As with the cause and risk factors for long COVID, scientists are continuing their research to better understand how certain therapies may be able to help COVID 'long haulers'. Studies are being conducted in small and large groups to know how symptoms of long COVID originate and how to develop potential treatments.

The best steps you can take to prevent long COVID are to take precautions against getting COVID-19. This includes:

  • Getting the COVID-19 vaccine and booster
  • Keep 6 feet away from others in public places
  • Wearing a mask or face covering while in indoor public settings
  • Washing your hands often for at least 20 seconds
  • Avoid crowds and poorly ventilated places

Scientists around the world are discovering new information about COVID-19, vaccines, treatments, and more every day. Rochester Regional Health is keeping you informed about the latest developments and research.

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