Recovering from long-term COVID-19

Most people who get COVID-19 recover within a few weeks. For some, symptoms can last weeks or months. Recovery can be prolonged, even if your first COVID-19 illness was mild. This condition is called long-term COVID-19. Other terms that refer to the same condition include “long-haul COVID-19,” “post-COVID-19 syndrome,” and “long COVID.” 

Symptoms of long-term COVID-19 can be different from initial COVID-19 illness. They can come and go and range from mild to severe. 

If you develop long-term COVID-19, we’re here to provide care and help you feel better.

We’re not yet certain why some patients develop long-term COVID-19 while others don’t. Although it appears more likely in patients who’ve had severe COVID-19 illness, it can also occur in those who had mild or moderate cases. This includes adults and children who were otherwise healthy prior to their COVID-19 illness. 

Long-term COVID-19 can also make underlying health conditions worse, such as asthma, diabetes, or other medical conditions.  

Talk with your doctor if you have ongoing symptoms, are concerned your child might have long-term COVID-19, or you’re pregnant or breastfeeding.

We can’t yet predict who may be at risk for long-term COVID-19. Some early studies of long-term COVID-19 patients suggest that about 1 in 10 adults who get COVID-19 may be affected.

Recovery from long-term COVID-19 varies widely. It depends on patients’ initial COVID-19 illness, symptoms, and overall health. Because COVID-19 is a new illness, we don’t yet know how long symptoms may persist. Some patients have symptoms for a couple of weeks, while others continue to have symptoms a year after their initial illness. 

We don’t yet know whether long-term COVID-19 causes lasting health effects.

Most people aren’t infectious after recovering from their initial COVID-19 illness. Please remember that until the COVID-19 pandemic is fully controlled, it’s important for everyone to continue safety practices. These include wearing a mask, maintaining distance from others, and washing hands often.

Yes. We recommend you start slowly and gradually increase daily activity and exercise. This helps you rebuild strength and energy. When you feel ready, add activities and bump up your exercise level.

Our recommendations depend on patients’ symptoms and work or school schedule. This includes children with long-term COVID-19. First, we treat patients’ individual symptoms. In general, we suggest a gradual return to daily activities. This can help you recover and return to your regular schedule. We help patients and their families along this path. If you need to modify your activities, we can suggest recommendations. Our goal is to help you recover from long-term COVID-19.

Most people’s COVID-19 symptoms get better within a few weeks. Some patients experience long-term COVID-19 symptoms that can last for weeks or months. These symptoms vary widely. Some patients have few symptoms, while others have several. Symptoms can come and go, change over time, and range from mild to severe. 

We understand that this experience can be frustrating for many. We’re here to provide the care you need and support your healing.

You can take care of common symptoms of long-term COVID-19, such as fatigue or cough, with self-care methods. These are methods you’d use at home to care for flu symptoms, for example. We have resources to help you care for symptoms at home.

Common long-term COVID-19 symptoms include:

• Fatigue 
• Trouble breathing 
• Cough
• Chest discomfort or pain
• Joint and muscle pain
• Headache
• Sleep problems
• Reduced sense of smell and taste
• Eating and digestive issues, such as diarrhea
• Fast or pounding heartbeat 
• Fever that comes and goes 
• Sweating

You may have emotional or mental symptoms as you face the challenges of long-term COVID-19. It can also take a toll on your family or other caregivers. They may also need support or treatment.

Emotional and mental symptoms can include difficulty thinking and concentrating (“brain fog”), depression, anxiety, and other emotional issues.

If you’ve had depression, anxiety, or other emotional issues, long-term COVID-19 can make them worse. This isn’t your fault, and it’s OK to feel this way. We have health resources to help you and your caregivers. 

Serious complications are more common in those who had severe cases of initial COVID-19 illness. The effects may need to be treated and managed over time.

Complications can include:

• Heart muscle inflammation (myocarditis)
• Blood and vascular disorders (thrombosis and others)
• Lung function problems (breathing and other respiration issues)
• Kidney (renal) injury
• Severe depression and other mood disorders
• Sensory, memory, and cognitive and other neurological disorders
• Skin rashes or hair loss (that doesn’t improve)

Some of your long-term COVID-19 symptoms may not be directly caused by the virus. For example, if you’re having a difficult recovery, you may feel depressed or anxious or have trouble sleeping. 

If you have one or more medical conditions, they may get worse when you have COVID-19. Symptoms caused by these medical conditions can also get worse. Having COVID-19 can also reveal a medical condition that you didn’t know you had.

We don’t know yet whether long-term COVID-19 will affect your future health. Researchers at the Centers for Disease Control and Prevention (CDC) and other medical research institutions around the world are studying these questions.

At this time, no special medications or other specific treatments are available for long-term COVID-19. We treat your symptoms or complications using the same methods we would use if they were caused by other conditions.

Because long-term COVID-19 is a new condition, we don’t yet know how long symptoms can continue. We do know that recovery time varies widely. For some people with long-term COVID-19, symptoms last only a few weeks. But recovery is prolonged for others. Some patients continue to have symptoms for more than a year after their initial COVID-19 illness. 

We also know that how long symptoms last can depend on a person’s initial COVID-19 illness severity, symptoms, and complications (if any), age, and overall health.  

Children can also experience long-term COVID-19 symptoms. If you’re concerned that your child may have symptoms of long-term COVID-19, please talk with their doctor.

People whose initial COVID-19 illness was severe are more likely to have ongoing symptoms. But long-term COVID-19 can also develop in people whose initial illness was mild. Talk with your doctor about your specific case.

Dealing with long-term COVID-19 can be frustrating and challenging for many patients and their caregivers. Contact your doctor if you have symptoms that could be due to long-term COVID-19. Your doctor can coordinate the care you may need. We’re here to support your healing, every step of the way.

You may need a combination of treatments, including self-care methods. This will depend on the specific physical and emotional challenges you’re facing.

Here are some examples:

• Relaxation techniques and gentle activities to help with fatigue and sleep problems 
• Medications to relieve common symptoms such as cough, pain, or headache 
• Counseling for emotional and mental health problems, such as depression or anxiety 
• Treatment for diabetes, heart disease, or other serious conditions that can be affected by long-term COVID-19
• Olfactory training to help regain your sense of smell

Your care team may include doctors, physical or occupational therapists, counselors, and other clinicians. For example, some people have ongoing problems with breathing, memory, focus, reduced sense of smell and taste, or digestion. Your doctor can arrange needed referrals or recommend programs or classes depending on your needs.

Most patients don’t require lab or imaging tests, such as bloodwork or X-rays. If necessary, your doctor will order tests for your specific care needs. 

Patients who’ve had:

• Mild illness probably won’t need any further lab tests 
• Moderate or severe illness with complications may need follow-up tests to monitor their recovery

You’d need this only if you have specific symptoms and your doctor recommends testing. We don’t routinely test patients for the COVID-19 virus during the weeks and months after their initial illness.

Yes, we recommend that adults who’ve had COVID-19 get vaccinated when it becomes available to them. If you have questions, talk with your doctor.

If you had COVID-19 while pregnant or breastfeeding and may have long-term COVID-19 now, talk with your doctor about your care. Generally, it’s safe to manage long-term COVID-19 symptoms using methods and treatments your doctor approved for you during pregnancy or breastfeeding. 

If you have additional medical conditions (such as diabetes or asthma) or other concerns about long-term COVID-19, please check with your doctor about treatment and vaccination.

COVID-19 is a new illness. Our doctors, including specialists in women’s health and pediatrics, work together to treat COVID-19 and long-term COVID-19. Kaiser Permanente has gathered input from our wide range of specialists that enables your doctors to create individualized care plans for you and your family. We can also refer you to these and other specialists and programs as needed.

Yes, you can try to regain your sense of smell with olfactory training. This technique has been shown to be effective in clinical studies, although the results may vary among patients. The improvement in smell is often slow and occurs over many months, or even up to 2 years.

The training consists of smelling 4 scents (rose, eucalyptus, lemon, clove), 2 times a day, and following these steps:

1. Choose 1 scent and smell it for 15 seconds while trying to remember what it once smelled like.
2. Rest for 10 seconds.
3. Smell the next scent for 15 seconds.
4. Rest for 10 seconds.
5. Repeat until all 4 scents have been sampled.

After 3 months, switch to a new set of scents (menthol, thyme, tangerine, jasmine) and train with them as described above. After another 3 months, switch to a different set of scents (green tea, bergamot, rosemary, gardenia) and train with them again as described above.

If there's a particular scent you want to be able to smell again, you can add this to your training. Essential oils containing scents can be purchased online or in holistic health and medicine retail stores.

Medical researchers are seeking answers to this question. Currently there are no treatments designed specifically for long-term COVID-19. We treat patients with medications and methods used for other conditions that cause symptoms or complications similar to long-term COVID-19.

We recommend you see your doctor first. They know you and your family’s medical history and can develop a treatment plan for your specific symptoms and needs. Currently, Kaiser Permanente doesn’t have a separate clinic for long-term COVID-19 patients.