How to know if you have prolonged Covid and what to do about it

Over the past two years, new covid cases and deaths have risen and fallen along with variant and subvariant surges. One constant, experts say: a continued rise in long Covid cases.

The term “long covid” refers to the wide range of new, ongoing or recurring health conditions that can affect people weeks or months after they have recovered from a covid infection. Common symptoms include fatigue, shortness of breath, rapid heartbeat, mental confusion, dizziness, stomach pain, and altered sense of taste or smell, says the Center for Disease Control.

“There is definitely no slowdown in demand and the need for long-term Covid care. It continues to rise,” says Dr. Jason Maley, director of the long-term Covid clinic at Boston-based Beth Israel Deaconess Medical Center, which is part from a multicenter study. funded by the National Institutes of Health.

Long Covid is estimated to have affected as many as 23 million Americans as of March, according to the US Government Accountability Office. Part of the problem is that its symptoms can vary from person to person, making it difficult for experts understand them and doctors diagnose them.

“There is still a lot of lack of knowledge and familiarity with prolonged covid, even within the medical community,” says Maley.

To help you navigate those unknowns, CNBC Make It spoke with a series of Covid experts about what to look for, if you’re at risk, and what tools might help:

How do you know if you have long Covid?

If you test positive for Covid, Maley says, consider doing a self-test about a month after you’ve recovered. “Watch for common symptoms like changes in [your] thought, memory and [your] ability to perform at work or function effectively at home,” he says.

At first, some of the prolonged symptoms of Covid may not seem obviously related to the condition. Take fatigue, for example: Maley says a bout of late-onset tiredness, even days after strenuous activity, can be a sign of prolonged Covid.

“You may not feel exhausted when you’re active in the moment, but hours or even a day or two later, you may feel overwhelmed with exhaustion,” he says.

According to the CDC, people with “more severe COVID-19 illnesses” and “pre-Covid-19 underlying health conditions” may be at higher risk of developing long-term COVID-19 symptoms. So that self-monitoring could be particularly important for anyone hospitalized with covid or who needed intensive care to recover.

But everyone should be vigilant: Research published in the scientific journal Pathogens in November 2021 indicates that a small portion of people with prolonged Covid were asymptomatic and didn’t even know they had Covid in the first place.

What should you do if you have long Covid?

Everyone’s experience with prolonged Covid is a little different, says Dr. Thomas Gut, associate chair of medicine and director of ambulatory care services at Staten Island University Hospital. Usually, he says, symptoms last about three months. In rarer cases, he notes, that time frame can be extended to six months or more.

There are currently no comprehensive treatments for long-term Covid patients, but experts say some at-home strategies may prove helpful. For example, if you experience a lot of fatigue after recovering from Covid, try to identify the activities that trigger your severe exhaustion and intentionally avoid them for a while.

“It’s called pacing,” explains Maley.

Rhythm also involves adjusting your daily schedule to include built-in rest periods for both your mind and body to avoid “serious” crashes. Avoiding those bouts of burnout can help you recover more effectively from prolonged Covid, Maley adds.

Maley also says that her patients who suffer from shortness of breath often find yoga-based breathing exercises helpful: long, slow, deep breaths that inhale and exhale through the nose. He says that some breathing exercises help strengthen the breathing muscles, while others help with breath control and breath sensations.

Typically, patients with prolonged covid don’t have any lung function damage, says Maley: “We think [the shortness of breath] it may be related to the muscles and nerves that control breathing, rather than an injury inside the lung like a scar or something left over from an infection.”

Does being vaccinated help prevent prolonged Covid?

The CDC notes that unvaccinated people may be at higher risk of developing prolonged post-Covid infection. Maley says that most studies so far have been “a bit mixed in terms of how strong of a protection it can provide.”

Dr. Nisha Viswanathan, co-director of the UCLA Health COVID-19 ambulatory monitoring program and the Long COVID program, agrees. “We know from our earliest studies that about one in three who [were] unvaccinated were showing signs of prolonged covid,” he says. But now, with a mixed population of vaccinated and unvaccinated people, researchers are seeking more clarity on who is still experiencing long-term symptoms.

Covid vaccines can lessen the severity of illness in people who become infected with the virus. Similarly, says Maley, multiple studies suggest that vaccinated people who develop long-term Covid show less severe symptoms than unvaccinated people with long-term Covid.

But, he adds, he can’t guarantee that being vaccinated will completely protect someone against Covid for very long, at least not without more research.

Who is more at risk?

Gut notes that recent mutations of the Covid virus are causing increasingly milder infections, and since milder infections appear to cause fewer long-term Covid cases, he doesn’t expect the next wave to lead to a long-term surge in Covid.

Still, Maley says, he’s currently seeing patients of all age groups with prolonged Covid symptoms, especially young adults. Some studies also suggest that prolonged covid is affecting women more than men.

The reason for that, says Maley, is not yet known.

Viswanathan says that most of his long Covid patients already had pre-existing conditions such as cardiovascular disease, high cholesterol and obesity. “So, ways to help prevent [long Covid]in addition to vaccination, they really consist of a cleaner diet [and] regular exercise,” she says.

It’s not a “foolproof” strategy, says Viswanathan: Many healthy people still develop Covid for a long time.

“But I will say that their number is much less,” he adds.

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