Post-COVID Syndrome
Post-COVID is a multi-system disease in which patients experience persistent, fluctuating symptoms more than 3 weeks from their initial COVID infection. These lingering symptoms can significantly impact a person’s quality of life.
Currently unknown and still under investigation.
Estimates vary between 10-35% of infected unvaccinated COVID patients. Vaccinated people have a 49% lower risk for post-COVID.
Varies (higher risk for older people, and those with underlying medical problems, such as heart disease, diabetes, chronic lung disease, and cancer, are more likely to develop serious illness.)
Symptoms
What are the symptoms of post-COVID syndrome and how does it progress?
The most common symptoms are fatigue, shortness of breath, cough, joint pain, and chest pain. Other lingering symptoms include fevers, brain fog, headache, loss of taste or smell, palpitations, abdominal pain, and skin rash. Anxiety, depression, PTSD, and sleep disturbances have been reported in more than 30% of post-COVID patients. All of these symptoms can fluctuate and change over time and can affect almost any system in the body.
The good news is that most people do eventually recover from post-COVID syndrome on their own, though sometimes within several weeks to months. Still it can be slow going. A recent study found that 26% of participants still had symptoms between 6 and 8 months after their initial infection.
Medically, what makes you worry if someone needs more treatment or attention?
If someone is having trouble breathing, experiencing persistent chest pain or pressure, confusion, inability to wake or stay awake, or has a blue tint to their lips or face, seek emergency medical care immediately.
How long would you typically have symptoms to suspect post-COVID syndrome?
If you have one or more symptoms for three weeks or more, it’s possible you have post-COVID syndrome.
If I catch COVID and experience mild symptoms, am I at risk for post-COVID?
Symptom severity does not correlate with risk of post-COVID syndrome. Instead, early studies support a possible connection between the number of symptoms experienced during the first week and the likelihood of developing post-COVID syndrome (i.e. more symptoms may mean a higher risk of post-COVID syndrome)
Causes
Why do some patients with COVID-19 go on to develop post-COVID syndrome?
This question is still under investigation, but we do know that it really depends on the person’s immune system and how it responds to the virus. People who experience persistent symptoms are thought to have a prolonged inflammatory response, which may cause a chain of events that lead to many different symptoms.
Who is more likely to develop post-COVID syndrome?
A study from the UK found that older people, women, and those presenting with more than five different symptoms in the first week of their illness were more likely to develop post-COVID syndrome.
Can you get post-COVID syndrome if you’re vaccinated?
If you’re vaccinated and get a breakthrough COVID infection, you can get post-COVID syndrome. However a recent study suggests you would be 49% less likely to develop it than if you were unvaccinated and infected.
Testing
Do you need to have a positive COVID test to have post-COVID syndrome?
No. Currently, post-COVID syndrome is diagnosed based on history and clinical symptoms alone. Having a positive COVID (PCR or antigen) test within the initial 2 weeks of illness or a positive COVID antibody test after 2 weeks of illness is helpful but not required for diagnosis.
If you have a negative COVID test can you still have post-Covid?
Absolutely. In fact, post-COVID is often defined as having persistent symptoms after the infection has resolved and a patient is testing negative for COVID.
Are people with post-COVID syndrome contagious?
If you have a negative PCR test, you are no longer contagious.
Current evidence shows that people with mild to moderate COVID-19 are typically no longer contagious 10 days after symptom onset, and people who are hospitalized with more serious illness are generally no longer contagious 20 days after symptom onset. But the best way to know for sure is to test.
Are there any tests recommended for someone with post-COVID syndrome?
Depending on the person’s symptoms, obtaining additional tests may be helpful only if you’re suspecting another condition or disease. For example, in a patient with post-COVID syndrome who may be experiencing persistent shortness of breath, ruling out anemia with a complete blood count test may be useful.
For all post-COVID syndrome patients, we do recommend self-monitoring of oxygen saturation levels at least once a day for at least 2 weeks using a portable pulse oximeter device. These devices can be purchased online or at a local pharmacy or retail store for about $10-15.
Typically, a device like this should be placed over a clean, warm finger without nail polish and after resting for at least 20 minutes. The highest reading obtained should be recorded after the reading stabilizes. Any reading above 95% is generally considered healthy. Talk to your doctor about determining an action plan for low numbers.
Treatment
What treatments are currently recommended for post-COVID syndrome?
Much of current treatment has been focused on symptomatic management and rehabilitation. How you’ll be treated largely depends on your symptoms and their severity, but the CDC provides an overview of some common approaches. These include a healthy diet, a gradual plan for exercise, keeping a diary to monitor symptoms and in some cases physical or occupational therapy, speech and language therapy, and neurologic therapy.
What about vitamins and herbal supplements?
Currently, there is not enough scientific data to support the use of over-the-counter vitamins and supplements in the treatment of post-COVID syndrome. You’re better off eating a healthy diet with fresh vegetables and fruits which will provide all of the nutrients you need for a healthy immune system.
Is there anything else you recommend to help speed up the recovery process?
We recommend adopting healthy lifestyle choices, including eating a well-balanced diet, engaging in a gradual exercise regimen, aiming for 7-9 hours of sleep per night, and eliminating or limiting tobacco, alcohol, and caffeine.
Also, since COVID-19 can affect the brain and mental health, it’s crucial to seek help if you’re suffering from anxiety, depression, or panic attacks, or nightmares. Regular social engagement, either in person or virtually, is also important for recovery since living with post-COVID syndrome can create social isolation.
Prevention
Is there anything I can do to protect myself and others?
Yes, the preventive measures that have been proven to help reduce the spread of COVID-19 include:
- Social distancing
- Wearing a mask
- Avoiding crowds or large gatherings
- Practicing hand hygiene and avoiding touching your face
- Being vaccinated against COVID-19
Can I get COVID again after recovering from post-COVID syndrome?
Yes, it’s possible. Based on what we know from other related human coronaviruses, most people appear to become susceptible to reinfection 3 months after initial infection. Furthermore, the virus can change over time and develop new mutations to evade a person’s immune system, as we’ve seen with recent variants. Therefore, practicing the preventive measures above is still recommended after recovering from post-COVID syndrome.
Should I get the COVID vaccine if I’ve recovered from post-COVID syndrome?
Yes, the CDC currently recommends vaccination for those who’ve recovered from COVID, due to the fact that reinfection with COVID-19 is possible.
Useful Links
Information on managing Post-COVID syndrome (NHS)
Another resource on managing Post-COVID syndrome (WHO)
Frequently asked questions on COVID-19 (CDC)
Nonprofit organization dedicated to supporting patients with COVID-19 (Survivor Corps)
Connect with our physicians
Andrew Cunningham, MD and Nora Lansen, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Post-COVID Syndrome or any of the many other conditions we treat.