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Experts don’t know why some people with COVID-19 experience persistent symptoms. Westend61/Getty Images
  • A new study published in the Annals of the American Thoracic Society adds to a growing body of research on the phenomenon of long-haul COVID-19.
  • Experts don’t know why some people with COVID-19 experience persistent symptoms long after the initial infection.
  • For people with long-haul COVID-19, supportive care may help them manage symptoms and improve their overall well-being.

Since last spring, experts have been sounding the alarm about COVID-19 “long-haulers,” people who experience lasting symptoms for months after being diagnosed with COVID-19.

A new study published in the Annals of the American Thoracic Society adds to a growing body of research on this phenomenon.

The authors of the study invited patients who had been diagnosed with COVID-19 to attend a follow-up appointment months after their diagnosis.

Among patients who attended an appointment, many felt they had not yet returned to full health. Breathlessness while walking was common, and nearly half of participants reported persistent fatigue.

Some of the patients with lingering health effects had been hospitalized with COVID-19. However, others had only mild initial infections.

“We were surprised by our findings,” Dr. Liam Townsend, lead author of the new study and an infectious disease specialist at St. James’s Hospital in Dublin, Ireland, said in a press release.

“We expected a greater number of abnormal chest X-rays. We also expected the measures of ongoing ill-health and abnormal findings to be related to severity of initial infection, which was not the case,” he said.

The study’s findings don’t come as a surprise to Dr. Allison Navis, a neurologist who works at the Mount Sinai Center for Post-COVID Care in New York City.

The clinic opened last spring to treat people who experience persistent symptoms following COVID-19.

Providers at the clinic thought most of the patients would be people who’d been seriously ill and hospitalized with the disease, Navis said.

However, they’ve found that many people who need post-COVID-19 care had only mild initial symptoms and were never admitted to the hospital.

“I would say that that’s the vast majority of the patients that I’m seeing. They did not require hospitalization, and they may have had very minimal symptoms,” Navis said.

Navis has been treating patients at the clinic who have neurological symptoms such as brain fog, headaches, or unusual nerve sensations following COVID-19. Shortness of breath and fatigue are also common.

Experts don’t know why some people who develop COVID-19 experience persistent symptoms after the virus is no longer detectable in their body.

When healthcare providers order chest X-rays, CT scans, or other tests to look for potential causes of long-haul symptoms, the results often come back negative.

“Objective evidence on diagnostic imaging — something that would explain the symptoms — is showing up in a very small number of patients that we’re looking at,” Navis said.

“We’re doing all these workups, and very little is coming back with positive findings,” she said.

The authors of the new study also found that few patients who reported lingering symptoms showed signs of damage on imaging tests, including chest X-rays and CT scans.

Over 60 percent of the study participants said they had not yet returned to full health an average of 75 days after their diagnosis. However, only 4 percent showed signs of lung scarring on CT scans.

Although many questions remain about the cause of long-haul symptoms, Navis emphasized that patients aren’t simply imagining them.

“We have enough people with very similar symptoms to know that something’s occurring,” she said.

“It can be very challenging trying to figure out what’s causing these issues, but it does seem that there may be a bigger process going on that’s contributing to them,” she added.

For people who do have lasting effects from COVID-19, supportive care may help them manage symptoms and improve their overall well-being.

“Having appropriate resources in place is essential for aiding recovery in the painful and long months after acute infection,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

“Long COVID-19 takes not only a physical but a psychological toll on recovery, which directly impacts how people are able to resume their lives,” he said.

More research is needed to understand the causes of long-haul COVID-19 and to develop effective treatment strategies.

In the meantime, clinicians are doing what they can to manage long-haulers’ symptoms and promote their recovery.

For example, treatments that help patients sleep better may reduce their fatigue and improve their overall well-being, Navis said.

Addressing potential mental health challenges is also important, she added.

“There can be depression, anxiety, and PTSD from having the illness,” she told Healthline.

“That might not be the primary issue causing all the symptoms,” she said, “but if it’s present, it absolutely could be a contributing factor, and it is something we can do something for.”

Navis has seen many of her patients’ long-haul symptoms get better over time.

“It can take time, but we are seeing a lot of people improve,” she said.

She hopes that as medical experts continue to treat long-haul COVID-19 patients, collaborate across specialties, and conduct research, improved treatment options will become available.

With many states currently reporting record-breaking rates of COVID-19, it’s likely that more support for long-haulers will be needed down the line.

“We must recognize that there will be a wave of patients with long COVID-19 entering our medical systems that will require continuing care and rehabilitation,” Glatter said.

“We must not only plan for this by developing centers of excellence, but allocate the necessary federal funds for research and care of these patients,” he added.