Which Long-COVID Symptoms Should You Worry About?

Guest post by Harry Whitaker, Ph.D.

The long-term effects of some diseases are well known, such as the obvious physical weakness of President Roosevelt’s polio. Another is the association between the Spanish Flu epidemic of 1918 and Parkinson’s Disease that struck affected individuals years later. Today, individuals who recover from pneumonia may experience a chronic cough (bronchiectasis) for years afterward and be plagued by obstructive pulmonary disease (COPD) long after they have recovered.

Since 2020, medical researchers have increasingly examined the residual effects of COVID-19. Perhaps to call more attention to pandemic dangers, reports have typically used terms such as post-COVID or long COVID syndrome, even though logically as of December 2021 no individual could have had this syndrome for more than two years.

Questionable studies

A literature review of long COVID papers published since August 2021 is sobering, and some of their conclusions are questionable. For instance, one study reported 205 symptoms (no patient had them all; some merely had one) while another report catalogued only 84 symptoms. In their rush to publish, authors neglected to discern whether patients truly had any of its laundry list of ailments before they categorically contracted COVID-19. Others failed to verify that study participants actually had COVID infection by PCR testing, for example, while yet others included patients who didn’t have COVID-19 by any accepted measure but merely had symptoms suggestive of COVID-19.

Shortcomings like these raise the possibility of the placebo effect, but equally concerning is the faulty logic of asking a patient whether they have ever had any of more than 200 symptoms. A Las Vegas casino would hardly give gamblers a hit in the face of such terrible odds.

A current review of long COVID

On the other hand, a current review of long COVID is sobering because the evidence is persuasive that it is real and florid. First, case statistics strongly suggest that women are more susceptible to it than men, and, like so many other things, probability and severity correlate with age—the older you are, the more at risk you are, and the more severe long COVID is likely to be.

The final conclusion is concerning. The virus initially causes a respiratory infection (which is why wearing a mask is advised). Long COVID, however, not only affects the lungs but also the brain, the stomach, the intestines, the kidneys, the heart, the sex organs, and the musculoskeletal system. The virus enters the body through the mouth, nose, or eyes. New mutations may now render it capable of crossing the blood-brain barrier and, via the circulatory system, reaching the entire body.

A survey of cases large enough to warrant statistical conclusions found the following symptoms compatible with long COVID syndrome, where fatigue was the most common and fever the least common:

• Fatigue
• Shortness of breath (dyspnea, chest pain, congestive heart failure)
• Insomnia
• Pulmonary embolism, congestive heart failure
• Difficulty walking
• Anxiety
• Depression
• Cognitive and memory impairment
• Cough
• Posttraumatic stress symptoms
• Muscle pain (myalgia)
• Joint pain (arthralgia)
• Loss of smell (anosmia)
• Heart palpitations
• Loss of taste (ageusia)
• Wheezing, coughing (airway constriction)
• Headache
• Throat pain (pharyngalgia)
• Nausea
• Diarrhea
• Vomiting
• Fever

The studies reviewed cannot accurately predict the chances that someone who contracts COVID-19 will come down with long COVID. Most studies currently place the odds at 50-50. That analysis could change when the effects of the latest Omicron variant are better understood.

However, the evidence so far indicates that vaccinated people are very unlikely to contract long COVID, just as they are less likely to contract COVID-19 itself no matter the variant.