Long COVID leaves an estimated 10-20% of people who had Covid with lasting fatigue, poor focus and body aches. Doctors still cannot explain it. There is no reliable lab test and no symptom unique to it. Treatment exists anyway, including physical therapy, drugs, and interventional procedures such as complex regional pain syndrome treatment.
The covid pandemic is still going on. It has hit more than 600 million adults and caused more than 6.5 million deaths. Those are huge numbers. What is worrying is that more than 99% have fully recovered, yet many still do not feel well. Many still live with constant fatigue, poor focus, and other health problems. Doctors now call this long Covid. The number of people with long Covid is huge. The WHO estimates that 10-20% of those who had the coronavirus infection are living with long covid. These people feel tired, cannot focus, feel anxious, and often lack a clear mind. Many may also have body aches. For many, it is so disabling that they must quit their jobs and stay home.
One of the biggest problems doctors face is that they know very little about it. They do not know why post-Covid syndrome lasts so long in some people. They feel helpless because they lack answers. Most lab tests are close to normal in people with long Covid and chronic pain. So lab tests are of little use here. Still, long Covid cannot be ignored. No one can say it is just in the head for some people. What doctors see shows that long Covid must be taken seriously. Many people with long Covid see other health problems get worse.
Clinical studies now also confirm that long Covid must be taken seriously, because people with it are more likely to die early. Studies suggest the risk of early death with long Covid is almost twice as high as in those who fully recovered. That is a significant difference.
There are many reasons doctors find it so hard to diagnose. There are no reliable lab tests. There are no symptoms unique to it. And every patient with long covid is different. For some, heavy fatigue is the main problem. For others, it is poor focus.
Still, health experts have noticed that fatigue is one of the biggest problems. It shows up in most cases. People with long Covid struggle to stay active in body and mind. But fatigue is fairly common in many health problems. And doctors feel helpless when fatigue is the main complaint and there are no other signs.
That does not mean there is no progress on long Covid. Researchers have already found some early clues. One study found that coronavirus spike protein, used to diagnose a current infection, stays in small amounts even after full recovery. Spike protein can be found even one year after recovery. This spike protein may be causing inflammation and chronic fatigue.
So far, researchers cannot say what causes long Covid. Some experts think tiny blood clots may cause it. Heart and blood vessel problems after Covid are also common. Since the condition is poorly understood, patients are not sure where to go for care. So some see general doctors and others see psychiatrists. But pain medicine specialists may also help in many cases, mainly when chronic body pain and fatigue are the main complaints.
Frequently asked questions
What are the most common lingering effects of COVID?
Fatigue is the big one. It shows up in most cases of long COVID and makes it hard to stay active in body and mind. People also report poor focus, a foggy mind, anxiety and body aches. For many, the mix is disabling enough that they have to quit their jobs and stay home. The WHO estimates that 10-20% of people who had the infection live with long COVID.
How is long COVID diagnosed?
There is no reliable lab test for it. Most lab results come back close to normal in people with long COVID and chronic pain. No symptom belongs to long COVID alone. Every patient looks different. For one, fatigue rules. For another, it is the loss of focus. That is why doctors have to take the full story seriously, not wait for a test to confirm it.
What causes long COVID?
Researchers have not pinned it down yet. One study found small amounts of coronavirus spike protein in the body even a year after full recovery. That leftover protein may drive inflammation and chronic fatigue. Other experts point to tiny blood clots. Heart and blood vessel problems after COVID are also common, which adds to the picture.
What’s the best treatment for long COVID?
Because the condition is poorly understood, patients are often unsure where to go. Some end up with general doctors, while others see psychiatrists. When chronic body pain and fatigue are the main complaints, a pain medicine specialist can help. Long COVID deserves serious care. Studies suggest people with it face almost twice the risk of early death of those who fully recovered.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
