WATCH: Dr. Elise Sullivan, Family Medicine, discusses what Long COVID is and how it affects individuals experiencing prolonged symptoms of their COVID infection.

Dr. Elise Sullivan

You’ve probably been hearing the term “long-haul COVID” or “long COVID” a lot lately. Physicians like Elise Sullivan, a family doctor at Memorial Regional Health’s medical clinic, have been learning about the condition, which researchers are calling “post-acute sequalae SARS-CoV-2,” or PASC for short.

What is long COVID, and what should you do if you might have it? Dr. Sullivan has seen many patients with long COVID at the MRH clinic. Here are her professional thoughts and recommendations.

What is long COVID?

If you’ve had COVID—whether confirmed by a positive test or a probable case based on symptoms and exposures—and you are still struggling with symptoms three months (or longer) later, you may well have long COVID.

Symptoms of a new COVID infection usually last for about ten days but can linger for up to six or so weeks. Long COVID is what’s happening later—three months and beyond the new COVID infection.

Who gets long COVID?

Anyone can get long COVID. You can develop long COVID after a relatively mild or moderate case of COVID—one you were able to treat at home. You can also have an asymptomatic COVID infection become long COVID. The highest rates of long COVID, however, are among people who had to be hospitalized for their initial COVID infection, especially those who required ICU care.

Recent studies are showing that the first COVID variant—Delta—was more likely to result in long COVID than the newer Omicron variant, but any COVID variant can cause long COVID.

What are the symptoms of long COVID?

Symptoms of long COVID can vary a lot. Common ones include fatigue, shortness of breath, a racing heart, chest pain, changes in smell or taste, chronic diarrhea and cognitive dysfunction such as difficulties with memory or focus. Most people have a few of these symptoms but not all. It’s also possible for an individual’s long COVID symptoms to be different than the early, acute COVID symptoms.

“People with long COVID often come to me complaining about their energy levels,” said Dr. Sullivan. “They say, ‘I don’t have enough energy to get through the day and do what I used to be able to do.’ Trouble concentrating and shortness of breath are other symptoms my patients describe. They say they can’t get enough breath to climb stairs, shovel snow or mow the lawn, for example. And sometimes people’s continued inability to smell or taste is giving them trouble. They may be losing weight because food isn’t appealing.”

If you’re having chest pain or shortness of breath, Dr. Sullivan says you need to be evaluated by your doctor right away. A simple chest X-ray, lung-function test or EKG can help determine if your heart or lung issues are serious and may require special treatment. In addition, blood clots caused by COVID can cause chest pain. This is sometimes an emergency situation requiring an ER visit.

Dr. Sullivan also cautions that long COVID can cause depression because people become disheartened that they’re still not feeling well after many months.

What can I do to get better?

It’s appropriate to see your primary care provider if you think you might have long COVID. “We’re still learning a lot about long COVID and how best to treat it,” Dr. Sullivan said. “So it’s good to see your practitioner for an assessment. After that, it’s generally a condition that requires patience and good self-care. The best thing you can do is to take good care of your body.”

She recommends making it a priority to get ample good sleep and gently exercise every day. “If you can only walk for 5 or 10 minutes, that’s OK—walk for 5 or 10 minutes a day this week, and then next week see if you can increase the duration of your walking to 15 minutes a day.”

Taking on a reduced work or life schedule until symptoms start to ease can also be important, she said. It’s better to take it easy than to overdo it, because overdoing it can lead to setbacks.

Emotional and spiritual health support are just as important to recovery from long COVID, according to Dr. Sullivan.

“Spend time with the people you have good relationships with. You might also seek out mental health support from a counselor so you can talk through your concerns and fears. If you’re depressed, which is understandable, talk to your primary care provider about your depression as well.”

Can people with long COVID get COVID again?

The short answer is yes. Dr. Sullivan explains that as new COVID variants emerge, they can escape detection by our bodies’ immune systems, and we can get reinfected. Long COVID does not provide additional immune support.

“I’ve had patients who’ve had two and now three COVID infections over the last couple years,” she said. “And we don’t yet know what happens to long COVID symptoms after a subsequent new infection.”

Does vaccination help with long COVID?

The research data proves that COVID vaccination helps prevent long COVID, Dr. Sullivan said. “While both unvaccinated and vaccinated people can get long COVID, vaccination reduces the rates of long COVID by about 50 percent.”

In addition, when an unvaccinated person gets vaccinated after the onset of long COVID, they tend to feel better. “Getting even one dose of vaccine has been shown to reduce long COVID symptoms by about 40 percent,” she said. “What we think happens is that in long COVID, your immune system has gotten stuck on high response, and when you receive a dose of vaccine, it helps your immune system turn the switch back off again.”

So if you have long COVID and haven’t been vaccinated, Dr. Sullivan recommends getting vaccinated as soon as possible.

Click here to learn more about COVID-19 vaccines.

Should I take zinc?

Zinc can help shorten the duration of a cold, said Dr. Sullivan, but used over the long run, it can also cause zinc toxicity, she explains. “Zinc is a heavy metal,” she said. “We tend to get enough zinc in our diets, and our bodies don’t clear excess zinc as well as they clear water-soluble vitamins. What happens is that taking zinc for a long time can cause symptoms like fatigue and diarrhea that mimic long COVID. So I talk to my patients about the dose they’re taking and often recommend they take less or stop taking it for a while.”

Can we expect anything new to come from the research into long COVID?

Numerous long COVID studies are underway, and Dr. Sullivan is hopeful that they’ll uncover new treatments for the condition as well as other illnesses. She believes it’s possible that given the similarities between long COVID and autoimmune diseases such as fibromyalgia and chronic fatigue, effective new treatments will emerge that help significant percentages of the population with a host of conditions, including long COVID.