A few months into the COVID-19 pandemic it became clear that not everyone was fully recovering from the highly infectious virus. In fact, some people, who initially suffered mild to moderate infections, were experiencing curious symptoms several months after the virus had gone away. These people are now referred to as “long haulers” and their condition, long hauler syndrome or Post-acute COVID Syndrome. A new systemic review and data analysis has compiled much of the data collected from long haulers, and put together a comprehensive list ranking their symptoms. Here are the 48 most common long hauler symptoms, ranked from least to most prevalent. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
One extremely rare but frightening symptom experienced by COVID long haulers is paranoia. According to the surveys examined, 0.3 percent of people suffered from the psychological condition after battling COVID-19. The New York Times recently profiled those who suffered mental health complications after an infection, detailing the paranoia—and even hallucinations—some experienced.
Per the NIH, an arrhythmia is a problem with the rate or rhythm of the heartbeat. “During an arrhythmia, the heart can beat too fast, too slowly, or with an irregular rhythm,” they explain. According to the surveys, 0.4 percent of long haulers experience either tachycardia, when a heart beats too fast, or bradycardia, when a heart beats too slowly. "Arrhythmia is caused by changes in heart tissue and activity or in the electrical signals that control your heartbeat,” the NIH explains. These changes can be caused by a variety of factors ranging from genetics or injury to disease—including COVID. “Often there are no symptoms, but some people feel an irregular heartbeat. You may feel faint or dizzy or have difficulty breathing.”
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event, according to the NIH. Due to the fact that COVID-19, especially in severe cases, can fit this description, it isn’t surprising that 1 percent of long haulers identify with PTSD.
COVID-19 can damage many organs, including the kidneys. According to this research, about 1 percent of long haulers report kidney failure. C. John Sperati, MD, MHS., a Johns Hopkins expert in kidney health, explains that some people suffering with severe cases of COVID-19 are suffering kidney damage—some who had no underlying kidney problems before they were infected with the coronavirus. “Many patients with severe COVID-19 are those with co-existing, chronic conditions, including high blood pressure and diabetes. Both of these increase the risk of kidney disease,” he says. There are a number of reasons how the virus can damage the kidneys including an extreme immune response to the virus leading to what is called a cytokine storm, a lack of oxygen, and blood clots clogging the kidneys.
Myocarditis is an inflammation of the heart muscle (myocardium), usually caused by a viral infection—including COVID-19—per the Mayo Clinic. “Myocarditis can affect your heart muscle and your heart's electrical system, reducing your heart's ability to pump and causing rapid or abnormal heart rhythms (arrhythmias),” they explain. Chest pain, fatigue, shortness of breath, and arrhythmias are all signs of myocarditis, which was reported by just 1 percent of long haulers.
High blood pressure (hypertension) “is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease,” per the Mayo Clinic. However, what isn’t common is new hypertension reported by one 1 percent of long haulers.
Obsessive Compulsive Disorder (OCD)
Mental issues were a common complaint of long haulers. “Adults have a double risk of being newly diagnosed with a psychiatric disorder after the COVID-19 diagnosis,” the researchers wrote, noting that 2 percent complained of obsessive compulsive disorders.
Dysphoria is one of the many mental health related complaints of long haulers, defined as “a state of unease or generalized dissatisfaction with life.” According to the surgery, 2 percent of long haulers struggle with it.
Mood disorders were reported by 2 percent of respondents. “Prompt diagnosis and intervention of any neuropsychiatric care is recommended for all patients recovering from COVID-19,” the researchers wrote.
The CDC explains that viruses and infections can cause sore throats. While many COVID sufferers report a sore or scratchy throat as an initial symptom of the virus, 3 percent of long haulers report that it lingers long after their initial infection.
A stroke is one of the most severe symptoms reported by long haulers. According to those surveyed, 3 percent with the condition claim to have suffered the medical condition that occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
Feeling dizzy or unbalanced is another neurological manifestation of the virus, reported by 3 percent of respondents. “This may be due to the weakness many patients have after a tough bout with COVID, but any balance or persistent dizziness should be evaluated by a medical professional,” F. Perry Wilson, a Yale Medicine physician and clinical researcher and associate professor of medicine at the Yale School of Medicine, previously explained to Eat This, Not That! Health.
According to the Mayo Clinic, edema is swelling caused by excess fluid trapped in your body's tissues. “Although edema can affect any part of your body, you may notice it more in your hands, arms, feet, ankles and legs,” they explain. It can be the result of a variety of factors, including medication or an underlying disease, “often congestive heart failure, kidney disease or cirrhosis of the liver.” According to the survey, 3 percent of long haulers reported limb edema.
Sputum is basically thick mucus, aka phlegm, and was reported by 3 percent of those surveyed.
4 percent of long haulers reported diabetes mellitus, or a new onset of diabetes. “New-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19,” explained one study surrounding the relationship between the two.
Discontinuous flushing was reported by five percent of long haulers surveyed. “Flushing is an involuntary (uncontrollable) response of the nervous system leading to widening of the capillaries of the involved skin,” reports RXList.
According to the Mayo Clinic, pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. “This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath,” they explain. The survey found that five percent of long haulers identified with this severe symptom of long hauler syndrome.
Pink eye is an uncommon symptom of COVID-19. However, according to those surveyed, 6 percent of long haulers also report that “red eyes” to be an issue. This could be due to the fact that many long haulers experience “lingering sinus congestion and runny nose,” per Dr. Wilson. However, it is just one of many vision related complaints of those who previously battled COVID.
As previously mentioned, psychiatric illness has been reported by many long haulers, some of who are forced to seek inpatient care as a result. 6 percent of those surveyed reported psychiatric illness as a symptom.
Health Care-Related Mental Health
7 percent of those surveyed reported health care-related mental health issues. This could have something to do with the stress caused by an infection-related hospitalization. Nonetheless, researchers encourage “an increase in mental health attention models in hospitals and communities” during and after the COVID-19 pandemic.
Just as fever is a common long hauler symptom, so is the chills, which was reported by 7 percent of all those surveyed.
Sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts, according to the Mayo Clinic, is one of the many sleep conditions reported by long haulers. “If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea,” the Mayo Clinic explains. Per the surveys, 8 percent of respondents reported it.
Reduced Pulmonary Diffusing Capacity
Abnormalities in pulmonary function, such as decreased diffusion capacity for carbon monoxide, were present among 10% of patients in this meta-analysis, according to the researchers. “Although these findings are not as high as compared to other available studies of survivors with COVID-19 or SARS, where the estimate of lung dysfunction is 53% and 28% respectively, the reasons behind these differences could be distinct follow-up periods, definitions of pulmonary dysfunction, or characteristics of the patient population. Nevertheless, residual radiographic findings or lung function abnormalities require additional investigation on their clinical relevance and long-term consequences,” they write.
Yes, COVID can even impact your sleep. According to the survey, 11 percent of long haulers identified sleep disorder as a symptom. “Sleep disturbances might contribute to the presentation of psychiatric disorders,” the researchers pointed out.
Temperature fluctuations—including low body temperature and fever—are commonly reported by COVID long haulers. In fact, 11 percent of those surveyed reported an intermittent temperature spike.
Pain in one form or another was reported by 11 percent of long haulers, per the survey. This pain can be in the muscles or joints.
One of the many heart-related symptoms of long hauler syndrome is heart palpitations—“feelings of having a fast-beating, fluttering or pounding heart,” per the Mayo Clinic—reported by 11 percent of those surveyed. “Stress, exercise, medication or, rarely, a medical condition can trigger them,” they explain.
Resting Heart Rate Increase
As previously mentioned, heart fluctuations are a common sign of long hauler syndrome. 11 percent surveyed reported an increase in their resting heart rate.
According to 12 percent of long haulers, the virus manifests itself in skin and dermatological conditions. Some of them experience pernio/chilblains, or redness and swelling of the feet and hands, which has come to be commonly known as "COVID toes."
12 percent of long haulers claim they lost weight as a result of their condition. This could be due to the fact that many simply lose their appetite, which “might be due to the loss of sense of smell that many patients report,” Dr. Wilson pointed out.
Digestive disorders—including constipation and diarrhea—were reported by 12 percent of long haulers. “A lot of patients with lingering symptoms report constipation or diarrhea that persists for a few days, then resolves, then returns again,” says Dr. Wilson.
Due to a variety of factors, including the physical and mental toll that COVID-19 and long hauler syndrome can take on an individual, it isn’t surprising that 12 percent of long haulers report depression.
Similar to depression, 13 percent of long haulers report experiencing anxiety. "Ah anxiety, my old friend," says Tessa Miller, author of the book What Doesn't Kill You. "This is such a common symptom of chronic illness that I dedicated a whole appendix (on top of the existing writing within the chapters) to it in the book. The very thing that carries you around the world (your body) has become wild, unpredictable, unrecognizable. Of course you're anxious! You feel irritable and exhausted, like your mind is constantly spinning and you can't concentrate. You can't sleep, or when you do, you have nightmares. You're isolating from your support systems. You're trying to distract yourself all the time to avoid getting at the root of what's making you feel this way. More severely, you might experience panic attacks, which speaking from experience, feel like literal death."
Hearing Loss or Tinnitus
According to the Mayo Clinic, tinnitus is defined as “ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss.” 15 percent of long haulers report a loss of hearing, and according to case reports, sudden onset sensorineural hearing loss (SSNHL) can be irreversible.
Since COVID-19 impacts the neurological system, memory issues are just one of the many neuro manifestations that plagues long haulers. According to the findings, 16 percent report a difficulty remembering things.
COVID-19 is known to wreak damage on the lungs and respiratory system, and according to 16 percent of long haulers, chest pain and discomfort plague them long after the virus is gone. According to the Mayo Clinic, sudden, sharp chest pains—aka pleurisy—may indicate that the lung walls are inflamed, which can signal pneumonia or other types of infection. “Chest symptoms like cough, congestion, rattling, can persist in some patients,” Dr. Wilson said.
Nausea or Vomit
There are many digestive complaints from long haulers, including nausea and vomiting reported by 16 percent, likely the result of the gastrointestinal damage wreaked by the initial COVID-19 infection. “Some patients report gastrointestinal symptoms after COVID, like nausea and diarrhea,” Dr. Wilson previously explained.
Temperature fluctuations are a common complaint of long haulers. According to the research, 17 percent complained of the sweats.
Another incredibly common long hauler symptom is a cough—which is also one of the main symptoms of an initial infection. According to the survey, 19 percent reported it. The study points out that abnormalities in CT lung scans are also quite common.
Joint pain was reported by 19 percent of long haulers. The Mayo Clinic explains that joint pain often arises as a result of inflammation. It has been established that inflammation is common in COVID-19 infections. “Inflammation attacks joint tissues, causing fluid in your joints, swelling, muscle damage, and more,” explains Penn Medicine orthopedic surgeon, Christopher S. Travers, MD.
According to the survey, over one in five surveyed reported post-activity polypnea—a difficulty breathing after exertion.
The loss of smell is one of several neuropsychiatric symptoms experienced by long haulers. According to the research, over one out of five (21 percent) long haulers reported it as a symptom. “Some patients still haven't fully recovered their sense of smell months after they lost it during the initial infection,” Dr. Wilson explained. “Many people might not recognize how serious this is, but without smell people may not eat as well, may inadvertently expose themselves to contaminated food, and, more broadly, life just feels less colorful. Though we don't often think about it, smell is hugely important for our well-being.”
Similar to loss of smell, loss of taste was even more common. 23 percent of those surveyed reported ageusia post COVID infection.
Dyspnea is defined as difficulty or labored breathing—aka shortness of breath—and was reported by nearly one in four (24 percent) surveyed. John Hopkins Medicine explains that shortness of breath is when you feel like you can't get enough air or your chest is tight. While this might be normal after a workout or period of exertion, post COVID shortness of breath can occur at any time—even when laying in bed or sitting on the couch.
Hair loss after COVID-19 could be considered as telogen effluvium, defined by diffuse hair loss after an important systemic stressor or infection, and it is caused because of premature follicular transitions from active growth phase (anagen) to resting phase (telogen). It is a self-limiting condition that lasts approximately 3 months, but it could cause emotional distress
While this survey didn’t include “brain fog,” they did find that 27 percent of those surveyed reported experiencing a difficulty paying attention after a COVID-19 infection.
Headache was the most common neuropsychiatric symptom, reported by 44 percent of long haulers. “The etiology of neuropsychiatric symptoms in COVID-19 patients is complex and multifactorial,” the researchers write. “They could be related to the direct effect of the infection, cerebrovascular disease (including hypercoagulation), physiological compromise (hypoxia), side effects of medications, and social aspects of having a potentially fatal illness.”
Fatigue is the most common symptom of long and acute COVID-19, experienced by 58 percent of long haulers per the research. “It is present even after 100 days of the first symptom of acute COVID-19,” the researchers explain. The symptoms observed in post-COVID-19 patients, resemble chronic fatigue syndrome (CFS), “which includes the presence of severe incapacitating fatigue, pain, neurocognitive disability, compromised sleep, symptoms suggestive of autonomic dysfunction, and worsening of global symptoms following minor increases in physical and/or cognitive activity,” they explain. If you experience fatigue or any of the symptoms you’ve just read about, contact a medical professional and tell them you may have Long COVID. There is no cure but you may find relief from certain symptoms. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.