This page was last updated on 7 March 2023. If you believe the information on this page is out of date, please get in touch with us.
What is long COVID?
There is increasingly robust evidence that COVID can cause ongoing symptoms and effects after the onset of the illness.
Long COVID can look different for every person, which can make diagnosing it difficult and may require doctors to rule out other conditions with similar symptoms or effects.
The National Institute for Health and Care Excellence (NICE) in the United Kingdom categorises long COVID into the following definitions
- ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from 4–12 weeks.
- post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.
National Institute for Health and Care Excellence (NICE)
There is not clear evidence of how many people who have had a COVID-19 infection will develop long COVID, with estimates being less than 1 in 20 people¹,². There is some evidence that long COVID is less likely for people who were recently vaccinated or who are younger, and more likely for people with certain pre-existing health conditions. The likelihood of long COVID also varies depending on the variant of COVID-19 a person has.
How long does long COVID last?
Evidence has shown that:
- the median duration of long COVID in community infections is 4 months,
- the median duration of long COVID in hospitalised cases is 9 months, and
- in individuals with long COVID, 15.1% of patients continued to experience symptoms 12 months after acute infection.²
How can I manage long COVID?
There is little evidence about the best or most productive ways of managing and recovering from long COVID.
The National Clinical Evidence Taskforce for COVID-19 in Australia³ recommends working within primary care pathways for ongoing management, i.e. to see your regular doctor or a local GP to help with creating a management plan. You can find a list of trans affirming doctors here.
What are the symptoms of long COVID?
The section below is taken in part from the NSW Government Agency for Clinical Innovation website. This list was accessed on their website and was last updated by them on 23 Feb 2023.
Symptoms may:
- range from mild to severe
- be singular or multiple
- be continuous or episodic
- fluctuate in severity
More than 100 persistent symptoms of COVID-19 have been reported in the literature. Only commonly reported and emerging symptoms have been included in here.
- Respiratory symptoms
- shortness of breath or difficulty breathing
- persistent cough
- chest pain or discomfort
Generalised symptoms
- fatigue
- weakness
- effort intolerance / post exertional malaise
- fever
Cardiovascular symptoms
- chest tightness and pain
- cardiac symptoms, including primary arrhythmia, palpitations, dyspnoea on exertion
- autonomic dysfunction including postural orthostatic tachycardia syndrome
Neurological symptoms
- cognitive impairment including memory loss, concentration difficulties and brain fog
- changes in brain structure
- headache
- peripheral neuropathy
Gastrointestinal symptoms
- irritable bowel syndrome
- diarrhoea, constipation, abdominal pain, nausea/vomiting and heartburn
Musculoskeletal symptoms
- musculoskeletal pain
- muscle weakness
Ear, nose and throat symptoms
- loss of smell or taste
- tinnitus
- sore throat
- dizziness
Dermatological symptoms
- rash
- hair loss / alopecia
Psychological / psychiatric symptoms
- psychiatric symptoms e.g. anxiety, depression, insomnia or psychotic disorder (particularly in women)
Other
- kidney outcomes
- sleeping problems
- case reports of diabetic ketoacidosis
- new onset diabetes
- menstrual cycle irregularities
- erectile dysfunction
- There are a number of chronic sequelae of severe acute COVID-19 disease that might lead to persistent impairment and may result in chronic disease:
- pulmonary fibrosis secondary to acute lung injury
- myocarditis which may lead to persistent cardiac dysfunction
- pulmonary thromboemboli
- diabetes
- cardiovascular disease (especially among hospitalised individuals) and cerebrovascular disease
- dyslipidaemia
Symptoms in children and adolescents can include:
- mood symptoms
- fatigue
- sleep disorders
- headache
- cough
- throat/chest pain
- adjustment disorder
References & Links
¹ Epidemiologic and economic modelling of optimal COVID-19 policy: public health and social measures, masks and vaccines in Victoria, Australia – The Lancet Regional Health, Western Pacific
³ Australian guidelines for the clinical care of people with COVID-19 – National Clinical Evidence Taskforce
Long COVID – NSW Government
