What It Means to Be a Coronavirus “Long-Hauler”

A Q&A about lingering symptoms of COVID-19
man with corona at home in isolation

In the ever-evolving story that is coronavirus (COVID-19), along comes another plot twist – people experiencing symptoms of the illness many weeks or even months after having it.

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According to one report, most people fall into one of two groups when it comes to the virus. Approximately 80% of those with COVID-19 end up having a mild response and most of those cases resolve in about two weeks. For people who have a severe response to the virus, it can take between three and six weeks to recover.

But now, there is growing concern over a separate group who don’t seem to fall into either of those categories. A number of people are now reporting lingering symptoms of the illness for one, two or even three months. This new group is mixed with those who experienced both mild and severe cases. As health experts step in to try to manage these patients and learn more, many are referring to this group as coronavirus “long-haulers” or “long-termers.”

“We’re now seeing a percentage of patients whose symptoms seem to be lasting a while,” explains family medicine provider Christopher Babiuch, MD. “This is challenging because everyone’s needs are so unique. We’re finding that collaborating as a team between different specialists helps to manage and support these patients, but there’s a lot that we just don’t know yet.”

Here Dr. Babiuch answers your questions about everything we know so far (and don’t know yet) when it comes to coronavirus long-haulers.

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Q: What is the average age of a long-hauler?

A. At this point we can’t determine the average age or predict who may have long-term symptoms. There is a mix of relativity young, healthy people who we’re seeing in this long-term group as well as older individuals who we may anticipate to have longer lasting symptoms. Hospitals are still working to analyze the data about this group and a lot of collaboration and research is happening.

Q: Do most long-haulers have underlying or chronic medical conditions?

A: We think so, but it’s still too early to say for sure. Our experience shows most long-haulers tend to fall into the high risk category, but there’s also a growing percentage of people who were otherwise healthy before they became infected. From what we know so far, it still seems random as to who experiences these long-lasting symptoms and who doesn’t.

Q: What symptoms do coronavirus long-haulers typically experience?

A: Long-lasting symptoms are fairly similar to what people experience in the acute phase of the illness, but typically not as severe. It often includes: coughing, tightness in the chest, shortness of breath and diarrhea. But perhaps the most significant symptom that is being seen across the board in coronavirus long-haulers is fatigue. Often times this group feels very run down and tired. They can’t exert themselves or exercise and simple tasks (like walking to the mailbox) will often leave them feeling exhausted. Chronic fatigue like we’re seeing in this group can be incredibly debilitating and frustrating.

Q: Are coronavirus long-haulers still contagious?

A: We don’t think so, but it’s a sticky question to answer. Typically after having an active infection like COVID-19, the contagiousness goes away after a few weeks and you start to recover. We less commonly see persistent fevers in this group, which hints that they probably aren’t infectious months later, but it can vary. Long-haulers should work with their doctor to determine a treatment plan and monitoring program so that they can receive patient-specific advice about isolation, how they can interact with their contacts and how to manage their symptoms.

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Q: Why are some people experiencing long-lasting symptoms and others aren’t?

A: We know that COVID-19 starts an inflammatory response in the body, which can cause a chain of events with many different symptoms. Unfortunately at this time, more research needs to be done to help us explain why this can lead to prolonged symptoms. In the future, we’ll be able to tell the long-term effects COVID-19 has on the kidneys, lungs and heart, but we just aren’t there yet. I anticipate at some point there will be specialty clinics and clinical trials focused on following these patients so that we can learn more about why this happens to some people and not others.

Q: If someone is experiencing symptoms months after testing positive for COVID-19 (or if they believed they had it in the past), what should they do?

A: If someone tested positive (or believes that they were infected) a month or two ago, but is still experiencing symptoms – they should contact their doctor. Together you can determine the best course of treatment and your doctor can monitor you. It’s also important to drink fluids to stay hydrated, rest, focus on your sleep and eat well.

Q: How are doctors treating and managing coronavirus long-haulers?

A: Most health systems are starting to form monitoring programs for these patients. There is a lot of collaboration and research happening as more data is collected and we start to piece together the long-term effects of COVID-19 on the body. Most programs are geared towards managing acute symptoms and provides patients with resources and support. Many long-haulers aren’t admitted, so specialists from primary care, pulmonology, infectious disease and even mental health touch base with these patients periodically (depending on the patient’s medical history and the severity of the long-lasting symptoms). The team is there to identify symptoms that worsen and get them to the right level of care. We’re also seeing that depression and anxiety are big issues for these long-haulers, so checking in to see how they’re doing is another important aspect in the monitoring program.

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