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Types of Long COVID

The long-term effects of COVID-19 are varied and can be serious. Terms such as “Long COVID” and “Post-COVID Syndrome” are used broadly, but actually refer to three distinct outcomes following infection: organ or tissue damage caused by the virus; a prolonged recovery period from the initial infection; or the development of an extended, potentially permanent, post-viral illness, such as or similar to Myalgic Encephalomyelitis (ME).

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Each of these outcomes has different implications for care and recovery. Importantly, treatments that may benefit one group can harm another. For example, exercise-based approaches may support recovery in cases of cardiac or organ-related injury, but can lead to significant—and potentially permanent—worsening of symptoms and function in individuals with post-viral illness involving Post-Exertional Malaise (PEM).

Medical Worker

For this reason, it is essential to clearly distinguish between these different outcomes when discussing the long-term impacts of COVID-19, planning appropriate care, and conducting or interpreting research on Long COVID.

Livng With ME......
Organ and tissue damage

COVID-19 can cause significant and lasting damage to multiple organ systems, even in asymptomatic individuals.7

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This damage can include:

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  • Lung scarring, resulting in reduced lung function4

  • Cardiovascular issues, including increased risk of heart attacks and strokes4,7

  • Brain damage, such as loss of brain tissue and merged brain cells4

  • Kidney problems and liver injury1

  • Microthrombi (small blood clots) in various organs4

 

Studies have shown that 59% of COVID-19 patients had single-organ damage and 27% had multi-organ damage one year after infection.1

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Extended recovery time

Recovery from COVID-19 varies greatly among individuals:

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  • Mild cases may recover within 1-2 weeks5

  • Severe cases can take 6 weeks or longer to recover5

  • Some individuals experience symptoms lasting for months2

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Recent research suggests that COVID-19 may linger in the body for 14 months to two years after infection, even after symptoms subside.2

Post-viral illnesses

For some patients, what their doctor has diagnosed as “Long COVID” shares many symptoms with Myalgic Encephalomyelitis (ME) (ref).  ME can be triggered by various pathogens, including Epstein-Barr virus, Coxiella burnetii, and SARS-CoV-2 (the virus underlying COVID-19) (ref).

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When Long-COVID persists and meets ME diagnostic criteria, it is essentially ME (ref). Recent studies show a significant overlap between this type of Long COVID diagnosis and an ME diagnosis after COVID-19, with 89% of post-COVID ME cases also meeting Long COVID criteria (ref, ref2).

Image by Jan Kopřiva
Common symptoms of Long COVID/ME include:

  • Fatigue

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  • Cognitive impairment ("brain fog")

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  • When triggered by COVID-19, symptoms may also include persistent cough and lung issues

  • Autonomic dysfunction

 

  • Post-exertional malaise (an immediate or delayed, sometimes severe, worsening of symptoms that may occur even after minimal physical, emotional, cognitive or sensory exertion).

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