Every day researchers are learning more about long hauler syndrome, formally referred to as post-acute sequelae of COVID-19 (PASC) with the hopes of eventually being able to treat it. “Emerging data suggest that the effects of infection with SARS-CoV-2 are far reaching extending beyond those with severe acute disease,” explains the authors of a new pre-print study published this week. “Specifically, the presence of persistent symptoms after apparent resolution from COVID-19 have frequently been reported throughout the pandemic by individuals labeled as ‘long-haulers.’" Using data from The University of California Covid Research Data Set, they identified the most common symptoms reported by those identifying with the condition, 61 days after their initial infection. Read on to find out what they are, ranked here from least common to most common—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
Conjunctivitis, aka pink eye, was linked to COVID-19 early in the pandemic. Per the Mayo Clinic, it is defined as an inflammation or infection of the transparent membrane that lines your eyelid and covers the white part of your eyeball. They add that it is commonly caused by a bacterial or viral infection.
While you may not be familiar with the medical term hyperhidrosis, the Mayo Clinic explains that it is characterized by abnormal, excessive sweating unrelated to heat or exercise. Due to the fact that many long haulers report irregularities in temperature, ranging from the chills to fever, it is unsurprising that heavy sweating could be a manifestation of PASC.
Rhinitis is defined as chronic sneezing or a congested, drippy nose, by the Mayo Clinic. According to the study, this was a relatively common complaint amongst long haulers.
Dysfunction of Eustachian Tube
According to a study, Eustachian tube dysfunction may occur when the mucosal lining of the tube is swollen, or does not open or close properly. “If the tube is dysfunctional, symptoms such as muffled hearing, pain, tinnitus, reduced hearing, a feeling of fullness in the ear or problems with balance may occur,” it explains. All of these symptoms have been linked to PASC.
According to the U.S. National Library of Medicine, a tremor is an involuntary, uncontrollable “rhythmic shaking movement” that occurs because of muscle contractions. Due to COVID’s ability to attack the neurological system, this could explain why some people experience these types of shakes.
Ansomnia, or loss of sense of smell, is one of the most COVID-specific symptoms. While the majority of people who are infected with the virus get their sense of smell back, others struggle to smell for several months. “Some patients still haven't fully recovered their sense of smell months after they lost it during the initial infection,” 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. “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.”
Hypotension, or low blood pressure, can result in dizziness or fainting, per the Mayo Clinic. Its causes? They can range from dehydration to serious medical disorders. According to this study, COVID is one of them.
Sore Throat or Pain in Throat
Per the CDC, viruses and infections can cause sore throats. While a sore or scratchy throat has been established as an initial symptom of the virus, some long haulers claim that it lingers long after their initial infection.
The Mayo Clinic defines tinnitus as “ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss.” One study found that 40% of those who had COVID-19 symptoms reported a worsening of their existing tinnitus, linking it to PASC. "The findings of this study highlight the complexities associated with experiencing tinnitus and how both internal factors, such as increased anxiety and feelings of loneliness, and external factors, such as changes to daily routines, can have a significant effect on the condition," explained study author Eldre Beukes. "Poor treatment of tinnitus in the early stages often leads to much worse cases, and severe tinnitus can have a huge impact on mental health," added study co-author David Stockdale, chief executive of the British Tinnitus Association.
A number of dermatological manifestations have been linked to PASC, including skin rashes and lesions. Rash-like morbilliform” lasted a median of seven days and four days, respectively, for patients with lab-confirmed COVID-19, with a maximum duration of 28 days, according to the authors of one study.
Due to the fact that COVID-19 can attack the neurological system, it isn’t surprising that some long haulers report memory loss as a symptom.
As previously mentioned, a loss of taste generally goes along with a loss of smell for some COVID-19 sufferers, and continues into the long version of the virus.
Gastrointestinal issues are not uncommon for those infected with COVID. "Heartburn occurs when stomach acid backs up into the tube that carries food from your mouth to your stomach (esophagus)," the Mayo Clinic explains. For some, this symptom continues into the longer form of the virus.
Syncope (pronounced “sin ko pea”) is the medical term for fainting or passing out. “It is caused by a temporary drop in the amount of blood that flows to the brain,” the Cleveland Clinic explains. “Syncope can happen if you have a sudden drop in blood pressure, a drop in heart rate, or changes in the amount of blood in areas of your body.” Since many long haulers report fatigue, dizziness, and balance issues, it isn’t surprising that it leads to this condition.
The Mayo Clinic explains that heart palpitations are “feelings of having a fast-beating, fluttering or pounding heart” that can be triggered by “stress, exercise, medication or, rarely, a medical condition.” One study published in JAMA Cardiology found that out of 100 recovered COVID-19 patients, 78 reported "cardiac involvement" while 60% had ongoing myocardial inflammation. And, even those who initially suffered from mild to moderate infections, reported ongoing heart issues, such as palpitations.
While a fever is a trademark symptom of an initial COVID-19 infection, many long haulers report a recurrent or persistent temperature spike over 100.4F.
Alopecia, aka hair loss, is one of the more common visual symptoms reported by those suffering from PASC. Per the National Alopecia Areata Foundation, it is considered in autoimmune disorder. In other words, the immune system attacks the hair follicle.
Achy muscles can be a sign that you are battling an infection, and also one that your body already has. “One of the more common long-hauler symptoms, muscle aches—particularly after exercise—can limit activity,” says Dr. Wilson.
The Mayo Clinic explains that tachycardia is the medical term for a heart rate over 100 beats per minute. Many long haulers report irregularities in their heart rate.
Feeling uncomfortably nauseous is not an uncommon complaint of long haulers. “Some patients report gastrointestinal symptoms after COVID, like nausea and diarrhea,” says Dr. Wilson.
A headache is a common complaint for those suffering from many various types of infection. However, for long haulers, they become a regular part of life. One case report focuses on a woman whose post COVID headache lasted for several months. “New daily persistent headache (NDPH) is another chronic headache that can be triggered by viral diseases,” the researchers explain.
Per the Mayo Clinic, joint pain and inflammation often go hand-in-hand. And, since it is known that COVID-19 infections provoke inflammation, it isn’t surprising that people are left with joint pain for several months after. “Inflammation attacks joint tissues, causing fluid in your joints, swelling, muscle damage, and more,” explains Penn Medicine orthopedic surgeon, Christopher S. Travers, MD.
Constipation, diarrhea, and nausea are just a few of the gastrointestinal symptoms reported by long haulers. “A lot of patients with lingering symptoms report constipation or diarrhea that persists for a few days, then resolves, then returns again,” Dr. Wilson previously explained to Eat This, Not That! Health.
Sleep disturbances are common for those suffering from the long form of COVID-19. According to one survey of more than 1,500 people in the Survivor Corp Facebook group, half of patients recovering from COVID-19 reported insomnia. Some experts believe that post-COVID insomnia could be the result of anxiety and stress created by the illness.
One of the key signs you have PASC is extreme exhaustion or fatigue. According to a Nature study, 53% of 143 people with COVID-19 discharged from a hospital in Rome reported fatigue two months after experiencing their first symptom. And, a new systemic review and data analysis identified it as the most common symptom, 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.”
Low Back Pain
Back pain and aches, specifically in the lower region, is another one of the most common complaints of long haulers. Achy muscles are a sign that your body is battling an infection. “One of the more common long-hauler symptoms, muscle aches—particularly after exercise—can limit activity,” says Dr. Wilson.
Dry cough is one of the defining symptoms of an initial COVID-19 infection, and can last for several months according to long haulers. Per the American Lung Association this could signify permanent damage to the lungs, which may in turn affect the ability of the body to function normally. However, they do note that some long haulers experience symptoms such as a dry cough, “without apparent damage to vital organs.”
Abdominal pain is a common gastrointestinal problem reported by many long haulers.
Anxiety is one of the many mental health issues plaguing long haulers. And, while it may have to do with the stress of being sick, it is likely associated with nerve damage as a result of the virus as well. Tessa Miller, author of the book What Doesn't Kill You, explains that anxiety is often linked to chronic illness. "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."
Difficulty or labored breathing—aka shortness of breath or dyspnea—is one of the most reported symptoms of those suffering from PASC. Per John Hopkins Medicine defines shortness of breath as not being able to get enough air or a tightening in the chest. While 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.
Chest pain, or tightening of the chest is the most common long hauler symptom per the study. “Chest symptoms like cough, congestion, rattling, can persist in some patients,” Dr. Wilson maintains. If you feel this or any of the symptoms mentioned above, contact a medical professional. Although there is no “cure” for Long COVID, they may be able to treat your symptoms. Long Haulers are also encouraged to get vaccinated when it becomes available to you, 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.