While most people can recover from COVID-19 and go back to their normal lives, many still have symptoms for months after an initial infection, according to new research from Scotland.
A study published Wednesday in the Nature Communications journal followed 33,281 people with recent COVID-19 infections, as well as a control group of 62,957 people who had never been infected, to determine what symptoms were most associated with long COVID-19. This way, vague symptoms that are often dismissed ― like “brain fog” or confusion ― could be more definitively linked to long COVID.
Researchers found that among those infected with COVID-19, people who went on to show signs of long COVID were more likely to persistently suffer from 24 of 26 tracked symptoms. Most commonly, those with long COVID experienced breathlessness, palpitations, brain fog and chest pain. When compared with those who had never had COVID-19, study participants with long COVID symptoms were 3.5 times more likely to report breathlessness.
The new findings underscore what other research has also found: People who had severe COVID-19 infections were more likely to have long COVID symptoms. Additionally, people with asymptomatic infections were less likely to suffer from long COVID.
The study also showed that vaccination may be linked to a lower risk of long COVID and was specifically connected with a reduced risk of developing seven of the 26 tracked symptoms.
But if you have a mild infection and are vaccinated, that doesn’t mean you are not at risk for developing long-haul symptoms, said Dr. Andrew Schamess, an internal medicine physician who treats patients at The Ohio State University Wexner Medical Center’s Post-COVID Recovery Program.
While participants in the Scottish study were less likely to deal with long COVID if they were vaccinated and asymptomatic, developing the condition is still possible — and COVID-19 is an ever-changing and unpredictable virus.
“You may be vaccinated, you may get a mild infection [and] you could still wind up with your life completely turned upside down by long COVID,” said Schamess, who was not involved with the new research.
In a particularly grim finding, the study discovered that 6% of infected participants had not recovered from COVID-19 at all, while 42% reported partial recovery six to 18 months after infection. Additionally, older adults, women and people with economic challenges were more likely to suffer from long COVID symptoms.
It’s worth noting that 91% of study participants were white, so further research is needed to determine the exact impact on other communities.
At what point does COVID-19 become long COVID?
According to Schamess, long COVID has two definitions. First, the National Institutes of Health and the Centers for Disease Control and Prevention suggest that symptoms lasting for a month or more can indicate long COVID.
That said, a lot of people may need a month to fully recover from COVID-19, according to Schamess. Just think of all of the people you know (maybe including yourself) who had trouble getting back to working out or had a lingering cough for weeks after infection.
“I think the better definition to me is the World Health Organization’s, which sets three months as the mark” for long COVID, he said. In the Scottish study, symptoms persisted for as long as a year and a half after infection.
It’s important to keep protecting yourself and others from COVID-19 infections
While certain factors may put you at higher risk of developing long COVID, you can take some steps to protect yourself.
First, get vaccinated against COVID-19 and make sure you are up to date on your booster, too. A new bivalent shot targeting the omicron variant is available for people ages 5 and up.
Next, if you do get sick, make a treatment plan with your doctor. Treatments like Paxlovid and short-acting monoclonal antibodies are available for some people, Schamess noted.
Additionally, if you are immunocompromised and may not mount a good response to the vaccine, you may be eligible to get Evusheld, “a long-acting monoclonal antibody that gives you extra protection against COVID,” he said. (However, new data suggests that Evusheld may not protect against all variants, and antibody treatments have shown limited efficacy against omicron. So it’s best to talk to your doctor about what approach is best for you.)
Lastly, be sure to still take precautions like mask-wearing in crowded indoor spaces.
“I do think this is going to be the hidden aftermath of the pandemic,” Schamess said of long COVID.
“While we’re seeing less immediate death and people in the [intensive care unit] ... I think as long as COVID is circulating, we are going to see these cases of long COVID, which can be utterly disabling.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.