PASC: “I no longer have COVID, but I am still not feeling too well”

What we know about long term recovery after COVID (PASC)

Many people complain of a long convalescence after COVID. They have negative swabs, and still they do not feel well. This is now a well recognized problem. About 44% of patients have a reduced quality of life for quite some time after the infection.

There are now reports showing that some of these symptoms can persist for a long time, and may still be present after 6 months. Somebody has symptoms in the recovery phase that they did not have during the acute phase of the illness. Sometimes, just knowing that this is a thing, and it is not just you, is already helpful.

There are things that can be done to improve your well being. Here is some advice regarding what to do if you have any of these symptoms.

  • Shortness of breath
    • If you are experiencing prolonged shortness of breath, it is definitely a good idea to see your doctor. There are multiple possible causes: you can be deconditioned because of prolonged inactivity; you could have some problem in your lungs or in your heart, that might or might not be related to COVID. This is not a symptom to neglect
  • Sleep difficulty, Anxiety, depression, post-traumatic stress disease
    • This kind of problems are very prevalent worldwide, since the start of the pandemic, and are not limited to who has had the infection. If you need help because of any of these symptoms, do not hesitate to contact your doctor. He will be able to guide you through therapeutic options, that range from a sleeping pill to a prolonged psychoterapy, according to your needs and preferences
  • Headaches
    • If you have a new or prolonged headache, please contact your doctor to choose the best painkiller (avoiding to damage your kidneys or stomach) and to evaluate if any test is needed.

For the following symptoms, you can find here some very reasonable advice regarding what you can do.

  • Coughing
  • Ongoing, sometimes debilitating, fatigue
  • Body aches and/or joint pain
  • Loss of taste and smell
  • Brain fog
    • Patients report being unusually forgetful, confused or unable to concentrate even enough to watch TV. This is happening to a variety of patients, including those who weren’t hospitalized.

There is a Facebook group of people with long term symptoms. It could be helpful to have a look, as long as you keep in mind that a single experience of a friend is not to be translated in a medical advice.

What we do not know yet:

  • How to predict who will have long term symptoms
  • What is the cause of the persistence of the symptoms when the virus is gone
  • If the long haulers should get the vaccine
  • How to predict the duration in the single person

This lack of knowledge is reflected in the content of the CDC and NHS webpages on long term effects.

For further reading:

Article Medical News & Perspectives 

Article The Lancet

Powerpoint WHO