Long-Haul COVID-19: Lingering Health Problems Even With Mild Symptoms

Medical researchers now have a better understanding of the long-term effects of COVID-19. A growing body of evidence shows that even people who experienced only mild symptoms during the acute phase of their infection may suffer health problems for weeks or months afterward.

Frequently referred to as COVID Long-Haul Syndrome, the reason why some patients experience lingering complications and others do not, is still not known. Long-haul syndrome is not well-defined and can involve a wide range of ailments including headache, muscle and joint pain, dizziness, brain fog, cough, shortness of breath, fever, depression, anxiety, heart and neurological problems. In fact, it can affect all of the body’s major organ systems.

Nobody knows how many people infected with COVID-19 will have long-term complications. One recent study found about 30 percent or more of adult patients infected with COVID reported symptoms for as long as nine months, with fatigue being the most common complaint.

Another study by the U.S. Centers for Disease Control found almost seven in 10 non-hospitalized adult COVID-19 patients sought medical care one to six months after diagnosis. Most were diagnosed with new problems.

A Multi-Pronged Dilemma

It’s possible that ongoing symptoms result from an autoimmune reaction, but much of the available information so far is based on patient reports. It will take some time for studies to provide additional, evidence-based insights into long-haul syndrome.

“There’s a lot of different manifestations in long-haulers, and the question is how to treat these different disorders,” says David Rosenberg, MD, a UH pulmonary disease specialist and Medical Director of the UH COVID Recovery Clinic.

“It involves different organ systems. You can have lung problems. You can have inflammation of your heart, heart attacks, stroke and neuropathy. One of the most common complaints is just fatigue and weakness.”

In addition, Dr. Rosenberg says some 20 percent to 40 percent of recovering COVID-19 patients have anxiety or depression. The array of problems requires an integrated approach among specialists from many areas of medicine.

“You get over the acute phase of COVID-19 and it doesn’t stop. It’s like the Energizer bunny that keeps going and going,” Dr. Rosenberg says. “Using a multidisciplinary approach, we are now much more prepared to treat all of the manifestations we are seeing in post-COVID patients.”

Kids Suffer, Too

While healthcare providers are developing dedicated clinics for adults with COVID Long-Haul Syndrome, pediatric specialists are working on similar treatment guidelines for kids suffering from ongoing problems associated with COVID-19.

“We see a whole constellation of symptoms in kids,” says Amy Edwards, MD, a UH Rainbow pediatric infectious disease specialist. “It can be anything from simple fatigue and new onset headaches or migraines, all the way to inability to get out of bed, chronic recurrent fevers, diarrhea and stomach pain.”

Dr. Edwards said pediatricians are looking for guidance, but it’s been challenging coming up with solutions.

“We don’t know what percentage of children have long-haul syndrome,” she says. “I’m sure there are kids who have mild symptoms and probably kids with more severe symptoms out there who haven’t come to our attention. In the coming weeks and months, as we develop a treatment plan, I hope people will reach out to us, so we can do everything we can to help them.”

Dr. Edwards says there are signs of hope. Some early data shows intense supplementation of specific vitamins, particularly B vitamins, might help with symptoms. Also, there have been reports of the COVID-19 vaccine eradicating lingering ailments in some patients.

“Perhaps that tells us that the immune system is playing a role in long-haul syndrome,” she says.

Related Links

Initial research suggests that fewer children than adults develop fever, cough, or shortness of breath or need hospitalization with COVID-19. However, severe illness has been reported in children with COVID-19 -- most often in infants younger than a year old. Learn more about the impact of coronavirus in children and young adults.