Some people who have been infected with the virus that causes COVID-19 can have long-term effects. Other people who have had COVID-19 can have new health conditions that appear after they are sick with the virus. These post-COVID conditions are different for different people and are commonly known as “long COVID.”
Long COVID is currently defined as: signs, symptoms, and conditions that continue or develop after COVID-19 infection and are present for at least three months after the initial illness. These effects may involve multiple body systems, may come and go, and may get worse over time. They can include severe and life-threatening health problems months or years after getting sick from COVID.
Other infections have similar post-infection syndromes
Like COVID-19, other infectious diseases can be followed by chronic symptoms in some people. These are called post-acute infection syndromes (PAIS). Some of the diseases that are linked to PAISs include: mononucleosis (“mono”), which is linked to Epstein-Barr virus; Lyme disease; West Nile virus; polio; and campylobacter infection.
Other names for long COVID
People call long COVID by many names, including:
- Post-COVID conditions
- Long-haul COVID
- Post-acute COVID-19
- Long-term effects of COVID
- Post-acute sequelae of SARS CoV-2 infection (PASC)
We are still learning about long COVID.
There are still many things we do not know about post-COVID conditions. Medical researchers are working to find answers. Scientists think there are probably many different kinds of long COVID.
Symptoms of long COVID
Long COVID does not affect everyone the same way. According to the Centers for Disease Control and Prevention (CDC), people with long COVID most commonly report symptoms like the ones listed below.
| General symptoms |
|
|---|---|
| Respiratory and heart symptoms |
|
| Neurological symptoms |
|
| Digestive symptoms |
|
| Other symptoms |
|
For some people, COVID-19 infections may cause other health conditions to start, including diabetes, blood clotting (including stroke), heart disease or heart failure, brain and nerve problems, or a condition called multisystem inflammatory syndrome in children (MIS-C). Other people may have symptoms that don’t fit into these categories easily.
Who can get long COVID?
Anyone who has been sick with COVID-19 can develop long COVID, even children. People who had very mild symptoms from COVID-19 can also get long COVID.
Scientists are working to learn how common long COVID is and which groups of people are most likely to develop long COVID. Early evidence shows that some people may be at more risk of long COVID, including:
- People who had severe COVID-19, especially if they were hospitalized
- People who had underlying health conditions before they had COVID-19
People who get COVID after being vaccinated are less likely to report long COVID compared to people who got COVID and had not been vaccinated.
Health inequities may put some people from racial or ethnic minority groups and some people with disabilities at greater risk for developing long COVID. Researchers are studying this issue.
Getting help for long COVID
If you think you may have long COVID, you should make an appointment with your health care provider to discuss your symptoms.
How to tell if you have long COVID
There is no single test to diagnose long COVID at this time. Health care providers look at many factors to make a diagnosis. New, ongoing, or worsening health conditions more than four weeks after a COVID-19 infection may be a sign of long COVID.
Your health care provider may perform several tests to better understand your symptoms. Because long COVID is not the only cause of these kinds of symptoms, these tests may be important to rule out other possible causes.
Some people with long COVID have symptoms that are not explained by tests. These kinds of symptoms are like the ones experienced by people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or other poorly understood chronic illnesses that may occur after other infections.
Treating long COVID
Although there is currently no cure for long COVID, there are treatments that can help. The best care plan addresses your specific symptoms and may require a team approach. Your first step is to talk with your health care provider, who can help you get referrals to medical specialists.
Medical specialists who help with long COVID may focus on the heart, lungs, digestion, diet and nutrition, sleep, mental health, neurology, physical therapy, or other fields of medicine.
Some people discover that their symptoms improve over time. As we learn more, better tests and treatments may become available.
Health insurance
If you don’t have health insurance, you can use the Massachusetts Health Connector to find options that may work for you. You may be eligible for free or low-cost health insurance plans.
Rights and supports for people with long COVID
Long COVID can be considered a disability under the American with Disabilities Act if it substantially limits major life activities. Talk to your health care provider to see if your symptoms may qualify as a disability. People with long COVID have certain rights and resources available to them.
The federal government has guidance on long COVID's status as a disability, which can be found here: Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557.
The U.S. Department of Health and Human Services (HHS) has published a guide of federal programs and recommendations: HHS: Services and Supports for Longer-Term Impacts of COVID-19 (PDF).
Preventing long COVID
The best way to prevent getting long COVID is to not get sick with COVID-19. Every time you get COVID-19, you risk getting long COVID.
Staying up-to-date with your COVID-19 vaccinations is the single best way to protect yourself. You can add extra layers of protection by:
- Getting tested for COVID-19 if you have symptoms and asking your doctor about treatment if you test positive
- Using a well-fitting mask when COVID-19 activity is high or you hear about people in your area getting sick from COVID-19
- Using the best air ventilation you can when you are with groups of people, especially if you aren’t sure if they are vaccinated against COVID-19
- Staying home when you are sick
- Avoiding close contact with people who have COVID-19 or have COVID-19 symptoms
- Washing your hands often or using alcohol-based hand sanitizer
Studies suggest that people who get COVID-19 after they have been vaccinated are less likely to get long COVID, when compared to people who are unvaccinated.
Long COVID resources and support
Post-COVID clinics provide a centralized location to evaluate long COVID symptoms and coordinate care. Treatment at a post-COVID clinic may involve an initial evaluation and, as needed, referrals to a network of specialists such as pulmonologists, cardiologists, and neurologists who have experience treating people with long COVID symptoms.
Your health care provider can help you get a referral to a post-COVID clinic.
Post-COVID clinics in Massachusetts
- Boston Medical Center: ReCOVer Long Covid Clinic
- Beth Israel Lahey Health/Beth Israel Deaconess Medical Center: Critical Illness and COVID-19 Survivorship Program
- MGB/Brigham and Women’s Hospital: COVID Recovery Center
- Boston Children’s Hospital: Post-COVID Clinic
Get involved in a long COVID study
If you or someone you care for has long COVID, you may find it helpful to be part of a research study. You will also be helping other people with long COVID. Three major research studies are:
- CDC’s Inspire Study
- National Institutes (NIH) of Health RECOVER Initiative
- RECOVER sites in Massachusetts
- NIH CARING for Children with COVID
Caring for someone with long COVID
Caring for someone with long COVID can be challenging. The CDC has a helpful web page, Caring for People with Post-COVID Conditions. It has practical information about how to care for someone living with long COVID. Topics include talking with schools and employers about long COVID, communicating with health care providers, information about disability, and managing caregiver stress.
If you are struggling with mental health and need help
For immediate medical assistance, dial 911.
The 988 Suicide & Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress, available 24/7. Call or text 988, or chat online at 988lifeline.org/chat.
The Massachusetts Behavioral Help Line (BHHL) connects individuals and families to the full range of treatment services for mental health and substance use offered in Massachusetts, including outpatient, urgent, and immediate crisis care. Call or text (833) 773-2445, available 24/7, or chat online at masshelpline.com.
For more resources, visit Finding Mental Health Support in Massachusetts.
Learning more about long COVID
The CDC, other federal agencies, academic institutions, and research organizations are working to understand more about long COVID.
At the end of July 2023, the U.S. Department of Health and Human Services launched the Office of Long COVID Research and Practice (OLC). The OLC works across the federal government to coordinate the nation’s response to the longer-term impacts of COVID-19, including long COVID.
More information about how the CDC is using science to learn about long COVID is available on its website at CDC Science behind Long COVID | CDC.
Current research on long COVID
We are still learning how the virus that causes COVID-19 can impact people. Current studies are focusing on topics such as:
- If lasting organ damage occurs, and how
- If there are remnants of the virus that stay in the body
- If it involves problems with the way the body’s immune system responds
- If ongoing inflammation can contribute to long COVID
These issues are linked to post-acute infection syndromes for other infectious diseases, so they may also be linked with long COVID.
Resources for health care providers
- CDC Science behind Long COVID | CDC
Information from CDC on the science behind long COVID. - Information on Long COVID from the National Institutes of Health (NIH)
Information on long COVID and the RECOVER Initiative (Researching COVID to Enhance Recovery). - Health+Long COVID: Human-Centered Design Report (HHS)
Framework and recommendations, including a map of the "ideal" versus "actual" treatment journey and patient-identified pain points. Published November 2022. - Long COVID/PASC Education: (University of California)
Short videos for providers. Topics include evaluation in primary care settings, pediatrics, health disparities, post-ICU complications, psychiatry/behavioral health, emergency medicine, and more. - Project ECHO: Long COVID and Fatiguing Illness Recovery Program
Monthly learning series, resource library, and quarterly short course for providers who care for patients with post-COVID conditions. - HHS: Services and Supports for Longer-Term Impacts of COVID-19 (PDF)
An overview of federal programs and recommendations with patient input throughout. Includes "Chapter 3: Enabling Health Care Personnel to Improve Treatment of People Experiencing Long COVID." Published August 2022.