I'm a Doctor and Here's What Happens After You Catch COVID
Have you just had a positive COVID test? Maybe you're wondering how long you are likely to feel unwell? How long do symptoms last? When will you feel completely back to normal? Read on and find out all you need to know, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
How Long After Becoming Infected Does it Take to Develop Symptoms?
It takes around 5 days from becoming infected with the COVID-19 virus, to the onset of symptoms. In fact, 97.5% of those who become infected, develop symptoms within 11 days, according to the Annals of Internal Medicine.
How Bad is Your COVID Infection?
- Mild infection. 80% of people who have COVID-19 have only a mild to moderate infection, which lasts around 2 weeks. COVID infection is said to be mild – or could be moderate – if you have symptoms such as cough, fever, and malaise, but no signs of pneumonia.
- Severe infection. 13.8% of those infected with COVID-19 have a severe infection, which can last 6 weeks. The infection is said to be severe if you have worrying symptoms, such as a fast respiratory rate — breathing at >30 breaths per minute – and a low oxygen saturation level of ≤ 93%. Those with severe infections are more likely to need hospital admission, and develop more complications, for example, secondary bacterial pneumonia, a pulmonary embolus (PE), or kidney failure.
- Critical infection. 6.1% have critical disease, defined as respiratory failure, septic shock, and multi-organ failure. Those with severe and critical infection appear more likely to have long term symptoms.
How Many People Get "Long COVID"?
New evidence has been emerging that a number of COVID patients continue to experience symptoms for weeks or months after the initial diagnosis. It seems around 1 in 20 continue to have symptoms long term.
One Italian study reported that after hospital discharge, by 60-days from the onset of the infection:
- 87.4% of people still had at least one symptom – most commonly breathlessness and fatigue.
- 13% were symptom-free.
- 32% reported one or two symptoms.
- 55% reported three or more symptoms.
Around two-thirds of patients said they had a reduced quality of life.
A research team at King's College, London, have been collecting information about COVID-19 symptoms using a specially designed mobile phone app. It is now becoming apparent from the use of this data, that although most people are only unwell with COVID for 14 days, around one in ten remains unwell for 3 weeks or longer.
How Long Are You Contagious with COVID?
One of the biggest problems with COVID-19 is that by the time you know you are infected, on average, you will have already infected 3 other people. The virus is highly contagious in the early stages – before you even know anything is wrong. Some people are "super spreaders" and inadvertently infect large numbers of people. This is why, mask-wearing—plus social distancing and hand washing—are vital to control the spread of infection. You can find out more about How to Not Catch COVID here.
Your Timeline of Infection
Information from the first patients infected with COVID-19 in Wuhan, China can be used to map out a timeline of infection. After becoming infected –
- Onset of symptoms to hospital admission – average 7 days
- Breathlessness occurs – average 8 days
- Acute respiratory distress syndrome – average 9 days
- ITU admission and mechanical ventilation – average – 10.5 days, according to a review in The Lancet
How Long Do COVID Patients Stay in the Hospital?
Data from ITU departments around the world shows that if you are admitted to hospital with COVID-19, your length of stay in hospital is generally between 4-21 days, apart from in China, where the length of stay can be as long as 53 days.
Do Patients Still Have Symptoms After Hospital Discharge?
After a hospital stay, most COVID patients are well enough to go home, but some patients will still have some unpleasant symptoms. Some of these symptoms relate to their medical care while in hospital, and will gradually recede, but some have symptoms related to their COVID-19 infection, and the duration of these symptoms is unknown. Those with persisting viral symptoms are said to be suffering from "long COVID."
How Do Patients Feel When They Leave ICU?
After a stay in the intensive care unit, patients may
- Feel weak — having spent days and weeks in bed, and often with little appetite.
- Have a sore throat — if they had to have an endotracheal tube in their airway. This can also make it hard to swallow. It can also affect your ability to speak as the tube is inserted in between your vocal cords. If you had a tracheostomy there will be a scar over your windpipe.
- Feel tired — after such a huge infectious insult your body needs a lot of rest and recuperation. This can last weeks or months.
- Have sore stiff muscles — This happens after being propped up in bed and unable to move or stretch properly.
- Have scars at different sites in your body — such as the hands, neck, or groin, where you had cannulas inserted to give you medicines.
- Feel anxious and depressed — This is natural, after being so ill and not knowing if you would pull through. Getting back into normal life is also challenging.
- Post Traumatic Stress Disorder (PTSD) — When you leave ITU you may get nightmares and flashbacks about your experiences. This may occur especially if you suffered from delirium, a confusion resulting from a severe illness, ever, strong medications and being in a bewildering environment. This may need professional help for recovery, for example, with cognitive behavioural therapy (CBT).
How Long Can "Long COVID" Last?
Long COVID is said to be present if you've had COVID-19 infection, but still have symptoms after 8 weeks. Dr. Tim Spectre and his colleagues at King's College Hospital have collected data about COVID symptoms using a specially designed app. From this, they have discovered that when infected with COVID –
- 1 in 7 had symptoms for 4 weeks
- 1 in 20 had symptoms for 8 weeks
- 1 in 50 had symptoms for 12 weeks or more.
- Many still have symptoms after 9 months or more.
They estimated the risk of Long COVID at around 1 in 20 of those who become infected.
Risk Factors for Long COVID Include…
- Older age – Long COVID affects 10% of 18-49 year-olds but this increases to 22% of those aged over 70.
- Obesity – Long COVID is slightly more common if you have a raised BMI.
- Sex – In younger age groups, long COVID is more common in women than men.
- Asthma – This appears to be linked.
- Symptoms – Having lots of symptoms early in the infection.
Dr. Spectre has suggested Long COVID can be divided into two groups. One group who have mostly long term respiratory symptoms with chronic cough, shortness of breath and tiredness. The second group has more organ-specific symptoms such as brain fog and other neurological symptoms, heart damage and kidney failure.
At the time of writing, 54 million people have been infected with the COVID-19 virus worldwide. If 1 in 20 develops Long COVID, this represents a huge new disease burden worldwide.
Final Thoughts From the Doctor
As I write this—on November 17th, 2020—there have been just over 11.5 million cases of COVID in the US and 252,000 deaths. If the chance of LONG COVID is 1 in 20 (5%), that's 565,000 people already, around the world, who still have symptoms, and we have no idea how long these will last.
If you have just tested positive to COVID-19, you have a 95% chance of being pretty much back to normal within 14 days. However, that unlucky 5% may well have symptoms for much longer.
What can you do to increase your chances of a mild COVID infection? Try and reduce your lifestyle factors – lose weight, take exercise, eat healthily, stop smoking. Get your body fit and your immune system will be ready for action.
And do everything you can to prevent getting—and spreading—COVID-19 in the first place until there's a vaccine available: Wear your face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, stay outdoors more than indoors. "We have seen what happens when you don't do that by the very unfortunate experiences that have become very public now in the United States. I mean, that's proof positive," says Fauci. And to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.
Dr. Deborah Lee is a medical writer for Dr Fox Online Pharmacy.