Explainer: What is Long COVID?

Cosmos Magazine


Cosmos is a quarterly science magazine. We aim to inspire curiosity in ‘The Science of Everything’ and make the world of science accessible to everyone.

By Cosmos

Long COVID is still making headlines, and with the release of a House of Representatives standing committee inquiry into Long COVID and repeated COVID-19 infections, Australia is taking its first steps toward addressing the burden.

What is ‘Long COVID?’

Good question and there are several definitions globally. Two definitions are particularly prevalent. Organisations like the WHO and the UK’s National Institute for Health and Care Excellence agree that it’s the persistence of COVID-19 symptoms for three months after infection with the SARS-CoV-2 virus.

One of the recommendations to come out of the inquiry is for a definition to be agreed on for use across the country. That will help health authorities, researchers and care providers effectively work to the same standards and deliver consistent support.

Isn’t Long COVID like other illnesses?

SARS-CoV-2 is a virus and Long COVID (which is also called post-COVID syndrome) simply refers to the persistence of symptoms well after they should have gone away. If you think this sounds like other post-viral syndromes, you’re not far off the mark. In January, US-based researchers found it bears resemblance to Postural Orthostatic Tachycardia Syndrome – POTS – and chronic fatigue syndrome. Viral infection is posited as a trigger for both of these disorders, and both share symptoms with Long COVID.

So what are the symptoms of Long COVID?

There are, potentially, about 200 recognised symptoms associated with Long COVID. A person might experience fatigue and reduced activity, fever and generalised pain. Other symptoms include:

  • Breathlessness and cough.
  • Chest pain, tightness and heart palpitations.
  • Brain fog, headaches, disturbed sleep, impaired mobility, and neuropathic symptoms like pins and needles and numbness.
  • Abdominal pain, nausea, vomiting, weight loss and changes to appetite.

Long COVID symptoms aren’t just ‘all in the head’

How many people have Long COVID?

That same study from January suggested 1 in 10 people might get Long COVID after infection. It also estimated 65 million people around the world might be experiencing the illness.

In Australia and many other countries, no register of Long COVID cases exists, so the government can’t say exactly how many people have the syndrome, however good estimates suggest it’s a figure of around 5-10 percent of infected people.

But the story is a little more complex than that. For instance, the Florey Institute’s Professor Kevin Barnham notes that “approximately 80% of those infected with COVID-19 report neurological dysfunction, and 30% have persistent symptoms”.

Is Long COVID real? The numbers say yes

Your chances of getting Long COVID might increase based on several risk factors

Like being female, having existing health conditions like high blood pressure, or autoimmune issues like asthma or diabetes. Mental health conditions might also leave you more vulnerable, as could the severity of your COVID-19 infection.

Who is most likely to suffer from Long COVID?

Preventing Long COVID means avoiding COVID-19 in the first place

You can only get Long COVID if you are infected with the SARS-CoV-2 virus. Seems obvious enough. The parliamentary inquiry into Long COVID heard submissions from many organisations, researchers and clinicians regarding what best prevents infection and found that “mask-wearing, physical distancing, hygiene and … health precaution when visiting high-risk settings” is critical to prevention. Vaccination with approved vaccines may help to reduce the likelihood of Long COVID occurring as these have been shown to reduce the severity of COVID-19 and potential re-infection. The extent of this effectiveness is still being researched.

While in Australia 96% of people aged 16 and over have received the first double-dose vaccine protocol, fewer than three-quarters have had a third dose and just 45% have had a further dose. Presently, adults who have not had a booster shot or infection in the last six months are eligible for a booster, regardless of how many boosters have been received. Half of children aged 5-15 have had two doses.

US research points to antiviral drug for Long COVID prevention

What can be done if you get Long COVID?

Right now, identifying symptoms with your doctor is the first step, which might mean a care management plan or referral to a specialist, especially if another problem is triggered because of Long COVID – like the onset of an autoimmune problem.

When will we know more about Long COVID?

Australia’s health minister Mark Butler announced $50 million towards researching Long COVID on top of about $20 million already committed from various funding lines. The federal health department is also slated to develop a national response plan to Long COVID. The commitment of funding is good news, but that doesn’t help people who might be dealing with post-COVID symptoms today – or those who have suffered almost since the outbreak of the disease in early 2020.

“The [parliamentary] committee has acknowledged the difficulties so many people have had in getting assistance for Long COVID,” says Professor Andrew Baillie, a clinical psychologist from Sydney University.

“However the [inquiry] report could be stronger in actions to take now rather than calling for more reviews, for example of the Medicare chronic disease management plans; more research, to be conducted by the proposed Centre for Disease in Control in Australia, which is not yet established; and a national plan as announced by Minister Butler.

“These are all important but won’t deliver for people experiencing long covid for another year or so.”

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