COVID-19 Long-Haulers

March 2, 2021

Some people who have had COVID-19 can experience prolonged symptoms months after having the virus, health experts have learned. These people are often referred to as long-haulers.

The most common long-term symptoms of the virus: extreme fatigue, shortness of breath, a chronic cough and chest discomfort, said Dr. Jane Weida, a family medicine physician at University Medical Center. There are also psychological symptoms, she said, including brain fog, memory impairment, sleep problems, depression, anxiety, mood changes and post-traumatic stress disorder.

Weida provided the information in a presentation in February to The University of Alabama OLLI program. Her presentation, “Long-term effects of COVID-19,” was part of the Mini Medical School series hosted by The University of Alabama College of Community Health Sciences, which operates UMC.

Weida is also chair of the CCHS Department of Family, Internal, and Rural Medicine.

She said researchers and health experts don’t yet understand why symptoms can persist for so long in some people who have had COVID-19. She said it could be due to an over-reactive immune response to the virus, or the result of persistent inflammation after the initial infection.

While COVID-19 can affect adults of all ages, Weida said those most at risk are the elderly, those in nursing homes, those who are immunocompromised, minority populations because of underlying health disparities, as well as those with chronic health conditions, including diabetes, heart disease, lung disease, high blood pressure, cardiovascular disease, cerebrovascular disease and severe obesity.

According to data from the Alabama Department of Public Health, people over the age of 65 with COVID-19 have a 10% chance of dying, but that doubles to 20% for people over the age of 75.

Fever is the most common symptom of acute COVID-19 illness, “but it’s not fool proof,” Weida said. Other symptoms include cough, shortness of breath, smell and taste abnormalities, sore throat, muscle aches, headache, runny nose, nausea, vomiting, diarrhea, fatigue, confusion and chest pain. These symptoms can last up to four weeks following onset of the virus, she said.

Between 30% and 40% of people who have COVID-19 have no symptoms, Weida said.

While most people with COVID-19 recover and return to normal health, some patients can have ongoing symptoms that can last from four to 12 weeks, and even for more than 12 weeks – the long haulers, Weida said. She noted one study found that one-third of outpatients with mild symptoms still had symptoms three weeks later, while another study that included hospitalized patients found less than 1% were symptom free at 79 days.