Long COVID Symptoms List: What They Are and Why They Stick Around

Millions of people who tested positive for COVID-19 continue to experience ongoing health issues, clinically known as long COVID. If you’re one of these people, you may experience a range of issues found on the long COVID symptoms list, including fatigue, shortness of breath, brain fog, aches and pains, and other symptoms. 

While there is still uncertainty surrounding COVID-19 complications and their long-term side effects, extensive studies offer insight into:

• Post–COVID symptoms
• How long COVID can impact your body and lifestyle
• Treatment methods that can help mitigate long-haul COVID effects

It can be incredibly challenging to navigate these symptoms and find strategies to manage them. Rest assured, there is hope. To help those experiencing long COVID, Aviv Clinics has research-backed information on what the condition entails and what you can do.

Long COVID Explained

Long COVID refers to continuing signs and symptoms that persist, or even develop, after recovering from a COVID-19 infection. In some cases, symptoms may appear to disappear, only to return after a matter of days or weeks. 

Below, we detail what long COVID is, how it affects your body, and what you can do to treat it. 

As you read through this, keep in mind:

• Each person has a unique experience with COVID-19.
• Therefore, speaking with a doctor is an essential first step.
• Several alternative terms are used for long COVID, such as post-COVID, long-haul COVID, post-acute COVID, and chronic COVID.

How the CDC and WHO Define Long COVID

Throughout the pandemic, these agencies collaborated to monitor and support public health. Based on the list of long COVID symptoms, the CDC and WHO have addressed long COVID as an ongoing health concern:

• The Centers for Disease Control and Prevention (CDC) defines long COVID as a condition where individuals “experience long-term effects from their [COVID-19] infection” that can last for weeks, months, or years after their first infection.

• The World Health Organization (WHO) defines long COVID as persistent symptoms “at least 3 months after” the acute infection that continue, not relapse, and have been reoccurring with no other explanation for those symptoms.

Some estimates put the number of people living with long COVID at “65 million individuals worldwide,” with cases increasing daily.

Acute vs. Long-Term COVID Symptoms

Many of the symptoms of an acute COVID infection overlap with common ailments found on the long COVID symptoms list. For a comprehensive understanding of what long-haul COVID is, it’s important to note some differences between acute COVID symptoms and the symptoms of long COVID.

Acute COVID

• Acute COVID is the initial phase of a COVID-19 illness, when a person is actively infected with the virus.
• During this phase, people commonly experience respiratory symptoms such as cough, fever, and difficulty breathing.
• Individuals may experience COVID-19 symptoms for up to four weeks, starting from the onset of illness.
• The virus can still be found in the body for up to 12 weeks, with people experiencing subacute COVID symptoms. 

Long COVID

• Long COVID involves ongoing or new symptoms that continue after an acute COVID infection has subsided.
• Individuals continue to experience COVID-19 symptoms for an average of three months from the onset of illness, sometimes longer.
• Long-haul COVID symptoms may either begin after initial recovery from acute COVID or persist from the initial illness.
• Long COVID symptoms cannot be explained by an alternative diagnosis.

The Numbers of People Affected Long Term 

In 2021, the WHO released the first clinical definition of long COVID, more than a year after patients coined the term in the face of ongoing symptoms. From nearly the beginning of the pandemic, health organizations studying the virus were seeing long-term side effects and symptoms of impairment from COVID-19 infections.

You aren’t alone if you don’t feel like yourself after having COVID-19. New data suggests that among those who have reported a COVID-19 illness, “nearly one in five (19%)…are currently still having symptoms” months after they first caught the virus. 

While many long COVID cases may go undocumented, researchers have estimates for its prevalence:

• Between 10–30% of nonhospitalized cases
• Between 50–70% of hospitalized cases
• Between 10–12% of vaccinated cases

By other estimates, anywhere from “31%–69% of COVID-19 survivors will experience long COVID symptoms after initial recovery.”

Understanding the List of Long COVID Symptoms

By scrutinizing four key areas from the long COVID symptoms list, patients can better understand the symptoms associated with long-haul COVID.

Physical symptoms:

• Fatigue
• Dyspnea (labored breathing)
• Chest pain or tightness
• Cough
• Dysgeusia (loss of taste)
• Anosmia (loss of smell)
• Joint or muscle pain

Cognitive & psychological symptoms:

• Memory decline
• Attention and concentration difficulties
• Brain fog
• Anxiety
• Depression
• Sleep disturbances
• Headaches
• Generalized disabling pain
• Lung symptoms
• Shortness of breath
• Chest pain or tightness

Cardiac symptoms:

• Myocarditis (inflammation of heart muscles)
• Heart palpitations
• Shortness of breath
• Elevated blood pressure
• Drops in oxygen saturation

Can Long COVID Symptoms Come and Go?

According to current research, yes, long COVID symptoms can come and go over time. Some people may experience periods of improvement, where symptoms lessen or seem to disappear, followed by a relapse or a return of symptoms. In some cases, this relapse can mean a worsening of symptoms. These fluctuations are common in people living with long COVID, with most people reporting “fluctuating (57.7%) or relapsing symptoms (17.6%).”

How Long Until COVID Symptoms Go Away?

The duration of COVID-19 symptoms, in both acute and long-haul cases, vary widely from person to person. Most mild cases resolve within a couple of weeks. Long COVID cases are less predictable. As of now, “more than 200 symptoms have been identified with impacts on multiple organ systems.” 

The nature of long-haul COVID, and the way it affects one individual compared to another, suggest that treatment and resolution of symptoms may rely on many personal factors.

If you are experiencing long COVID symptoms, contact our team of certified medical professionals today.

Why Long COVID Symptoms Persist

The persistence of COVID-19 symptoms can be attributed to several factors.

1. Ongoing Inflammation

The initial COVID-19 infection triggers an immune response in the body that results in inflammation. For some people, this immune response continues even after the virus has been cleared. 

2. Immune Dysregulation

COVID-19 can affect the immune system long after the initial infection. Long COVID patients can experience immune dysregulation that remains “persistently high at eight months after the infection.”

3. Post-Viral Syndrome

Many viral infections can cause a condition known as post-viral syndrome, which is defined by the presence of persistent symptoms after fighting an infection. This may be the case with the COVID-19 virus. 

4. Autoimmunity

Some people may develop an autoimmune response, where the immune system mistakenly attacks healthy cells and tissues. While it’s far from certain, “one theory is that long COVID could be an autoimmune disease” itself. 

5. Persistent Viral Presence 

Some studies suggest that fragments of the virus can remain in some tissues of the body after recovery of the initial infection. After one year, viral proteins and/or RNA can be found in various bodily systems in some long COVID patients. 

Long COVID affects more than just the respiratory system. As stated above, lingering symptoms can affect the cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. Recent research has found that people with long COVID are “at increased risk of a range of cardiovascular disorders,” among other issues.

Of particular concern is the impact of COVID-19 on brain health, specifically because of the presence of many brain-related ailments on the long COVID symptoms list.

The Hard Truth: Long COVID & Brain Injuries

Essentially, COVID-19 impacts the brain. This is why the majority of long COVID symptoms are cognitive and may lead to brain injuries, depending on how severely your body is affected by the virus. According to Dr. Mohammed Elamir, MD, FACP, although there are no patterns between the severity of COVID-19 and the likelihood of experiencing long COVID, there are patterns between:

• Where the virus attacks in the brain
• How that location in the brain impacts long COVID symptoms

Here are four ways that connection can manifest.

1. Direct Brain Invasion

The COVID-19 virus travels through the nose, into the olfactory sensory neurons, and into the insula, which is located between the frontal and temporal lobes of your brain. The olfactory neurons manage taste and smell, while the insula oversees an “overwhelming variety of functions,” including memory and executive function. Depending on where the virus attacks and the level of damage it creates, an individual may experience prolonged COVID symptoms.

For example, when the virus significantly attacks your olfactory nerves, this may induce a loss of taste and smell. This is why these symptoms are such a strong indicator of the virus.

2. Blood Vessel Injury

Studies show COVID-19 can result in “microvascular injury in the brain.” In other words, it can injure blood vessels that feed blood to the brain. As the virus circulates throughout your bloodstream, the inner blood vessel lining is susceptible to damage. When the inner lining deteriorates, this allows the virus to seep into the tissues or inhibit blood flow to the brain. Both can cause brain injuries. And depending on where those injuries occur, specific brain functions (memory, concentration, etc.) may decline more rapidly than normal.

3. Dysregulated Immune Response

Damage to the inner blood vessel lining can also inhibit the growth of cells—the exact opposite of what our immune system should be doing. Dysregulated immune responses are common, with “marked dysregulation in severe cases” of COVID-19. When the body cannot adequately produce a normal immune response, it either: 

• Under-reacts to foreign invaders, causing viruses to spread quickly
• Overreacts to foreign invaders, causing the immune system to attack even healthy cells, tissues, and organs

4. Cellular Dysfunction

On a cellular level, COVID-19 can affect metabolic function through the mitochondria. This cell damage slows the body’s response rate to infection, leading to high inflammatory conditions.

How Long Will Patients Have to Deal with COVID Symptoms?

According to Dr. Mohammed Elamir, MD, FACP, the answer isn’t available. But a key guiding factor is the extent of blood vessel damage.

Dr. Elamir explains: 

“There’s still a lot to learn about how [mitochondrial dysfunction] will last but it will probably be tied to the level of microvascular change or blood vessel damage. The more blood vessel damage you have, the more [long COVID symptoms] you’re likely going to have. Also, the amount of real estate that those microvascular changes are occupying will probably dictate how long [symptoms] will last.”

WATCH: Long COVID Treatment at Aviv Clinics

Aviv Clinics’ Treatment for Long COVID Symptoms

Long COVID is a complex disease. Finding a treatment plan that will work for you may take some time. Because there is no one-size-fits-all approach, speaking with a medical professional is essential. Watch Danielle’s remarkable recovery story:

The right physician will take a holistic approach. 

Because of the complexity of long COVID, it’s important to find a treatment program that:

• Is rooted in data and research
• Offers a comprehensive assessment process
• Connects you with a diverse medical team

Aviv Clinic’s team of certified physicians achieves all of the above to ensure you’re provided with a tailored treatment plan that works for you. We connect our patients with a team of physicians, neuropsychologists, physiotherapists, nurses, and more to provide a multidisciplinary health plan.

Our post-COVID symptom treatment plan can be broken down into three parts:

• In-depth medical assessment:
  Leveraging advanced brain imaging, our clinical team conducts physical, cognitive, and neurological exams to gain a thorough understanding of your health.

• Tailored treatment program:
  Based on your assessment, our medical team crafts a personalized treatment plan tailored to your health goals.

• Post-treatment assessment:
  Our team initiates another round of tests to assess your progress and unique findings on any cognitive and physical improvements.

Diagnosis and Management of Long COVID

Diagnosing long COVID can be complex due to the range of symptoms you can experience. Because of this, a multidisciplinary approach is crucial to address the nature of the condition. Current management options include: 

• Symptomatic treatment: This treatment option focuses on relief of long COVID symptoms, including medication and therapies tailored to specific ailments. 

• Physical therapy: Rehabilitation and physical therapy play a role in restoring physical function, which can help improve quality of life.

• Counseling and support groups: Living with a list of long COVID symptoms can be incredibly difficult. These therapies offer a valuable place to gain insights and coping strategies. 

• Cognitive and psychological support: COVID-19 presents unique cognitive challenges that manifest in different ways. Various cognitive therapies can help to restore brain function.

Multiple forms of support can be found through the Aviv Medical Program, which incorporates cognitive training, symptomatic relief, and physical therapy to enhance cognitive performance and improve cardio symptoms.  

Future Outlook for Long COVID Patients

Looking ahead, the future for long COVID patients holds promise. As researchers and medical professionals continue to study the condition and its effects, the medical community gets closer to understanding the mechanisms behind long COVID and implementing effective treatment options. 

If you live with symptoms of long COVID, know that the outlook is optimistic. As medical professionals learn more, they will be able to further tailor treatment options to target the underlying cause of each issue on the long COVID symptoms list using customized approaches. 

Maximize Your Health and Performance with Aviv Clinics

Though COVID-19 may have brought ongoing health challenges, the Aviv Clinics team is here to help you and your loved ones get back to optimal health. The Aviv Medical Program delivers a personalized protocol to enhance your mind and body and feel like yourself again. 

Learn more about our team, and contact our clinic to schedule a free phone consultation.

Maximizing your health and performance begins with Aviv Clinics.