63 Signs You May Have Long COVID
A few months into the COVID-19 pandemic, health experts noticed that some people who battled the virus—mild, moderate, and severe infections included—weren't recovering from it. In fact, they reported lingering symptoms that increased in severity after their initial infection had cleared. For long haulers, "it is certainly clear that for around 10% of patients, symptoms can last long after the acute illness," F. Perry Wilson, a Yale Medicine physician and clinical researcher and associate professor of medicine at the Yale School of Medicine, explains to Eat This, Not That! Health. "Many people have described the symptoms as coming and going, often triggered by things like exercise or stress." Now, a new study published on MedRX sheds light onto Long COVID and the symptoms that it can include. The researchers surveyed 3,762 people from 56 countries, pinpointing the most commonly reported signs of the prolonged illness. Here are the most common symptoms, ranked from less common to the most common. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
You Might Have a New/Unexpected Anaphylaxis Reaction
Some long haulers report new or unexpected anaphylaxis reactions after an infection. The Mayo Clinic explains these are "severe, potentially life-threatening" allergic reactions that can occur within seconds or minutes of exposure to an allergen. "Symptoms include a skin rash, nausea, vomiting, difficulty breathing, and shock." If not treated promptly, usually with epinephrine, they can result in unconsciousness or death.
You Might Develop New Allergies
Similarly, some people report new allergies after COVID, specifically those associated with scent. According to one report from VeryWell Health, "COVID-19 can concoct new allergies in patients" to many substances–a signature perfume, soothing holiday candle, or even their own car. These allergies can result in "severe respiratory distress" with symptoms including shortness of breath, wheezing, headaches, and sore throats.
You Might Have Visibly Inflamed or Bulging Veins
Bulging veins are another symptom that long haulers have reported, which is likely due to the blood clotting tendencies of the virus. "COVID-19 can make blood cells more likely to clump up and form clots," the Mayo Clinic explains.
You Might Have Bradycardia
COVID long haulers report several heart-related symptoms. One of them is bradycardia. Per the Mayo Clinic, bradycardia is defined as a "slower-than-expected heart rate, generally beating fewer than 60 beats per minute."
You Might Have Dermatographia
There are many long term dermatological manifestations of COVID, and one is dermatographia. According to the Mayo Clinic, the condition is also known as skin writing. "When people who have dermatographia lightly scratch their skin, the scratches redden into a raised weal similar to hives," they explain. "These marks usually disappear within 30 minutes."
You Might Have Peeling Skin and Other Skin Issues
Other skin issues associated with long hauler symptoms include peeling skin. "The skin is potentially a visible window into inflammation that could be going on in the body," wrote Esther E. Freeman, MD, Ph.D., director of Global Health Dermatology at Massachusetts General Hospital, senior author of a study surrounding the skin manifestations experienced by 1,000 long COVID patients.
You Could Have Constipation
Gastrointestinal issues are common with long haulers, Dr. Wilson maintains. One of them is constipation. Of course, "if you have uncomfortable symptoms of constipation, the first step is ensure you are drinking enough fluids, and to increase your fiber intake. The fiber content of your diet by adding cereal grains, fruits and vegetables, or daily doses of a fiber supplement (for example, Metamucil or Citrucel)," advises Harvard Health.
You Might Develop Tinnitus
According to the Mayo Clinic, tinnitus is defined as "ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss." One study found that 40% of those who had COVID-19 symptoms experienced a worsening of their existing tinnitus, linking it to long COVID. "The findings of this study highlight the complexities associated with experiencing tinnitus and how both internal factors, such as increased anxiety and feelings of loneliness, and external factors, such as changes to daily routines, can have a significant effect on the condition," explained study author Eldre Beukes. "Poor treatment of tinnitus in the early stages often leads to much worse cases, and severe tinnitus can have a huge impact on mental health," added study co-author David Stockdale, chief executive of the British Tinnitus Association.
You Might Have Bladder Control Issues
Research has found that COVID-related inflammation impacts the urinary tract, and can result in urine cytokine elevation and cause COVID-19 associated cystitis, resulting in bladder dysfunction.
You Might Have Petechiae
Another dermatological sign of long COVID is petechiae. The Mayo Clinic describes them as "tiny round brown-purple spots due to bleeding under the skin" revealing that they can be in a small area due to minor trauma or "widespread due to blood-clotting disorder." One study maintains that this symptom could be the result of thrombocytopenia "not a common complication in COVID-19" or "due to an alternate etiology such as vasculitis."
You Might Have Hearing Loss and Other Ear/Hearing issues
According to case reports as well as this study, sudden onset sensorineural hearing loss (SSNHL)—often irreversible—has been reported by those identifying as long haulers.
You Could Faint
Many long haulers report fatigue, dizziness, and balance issues—all of which can increase the likelihood of fainting.
You Might Notice Tremors
Per the U.S. National Library of Medicine, a tremor is an involuntary, uncontrollable "rhythmic shaking movement" that occurs because of muscle contractions. As COVID can attack the neurological system, this could explain why some people experience them.
You Might Notice Skin Rashes
Skin rashes are another common dermatological manifestation of long COVID. "Rash-like morbilliform" lasted a median of seven days and four days, respectively, for patients with lab-confirmed COVID-19, with a maximum duration of 28 days, according to the authors of the MGH long COVID study.
You Might Have Vision Symptoms
Vision symptoms—including blurry vision—have been reported by many long COVID sufferers.
You Might Have Vibrating Sensations
One report on long COVID courtesy of the Atlantic found that many long haulers reported tingling or vibrating sensations when touching surfaces, likely due to the disease's effect on the brain and nervous system.
You Might Experience Lower Esophagus Burning or Refluxes
Those battling COVID-19 often report gastrointestinal issues. "Heartburn occurs when stomach acid backs up into the tube that carries food from your mouth to your stomach (esophagus)," the Mayo Clinic explains. For some, this symptom continues long after their initial infection.
You Might Have Menstrual/Period Issues
Many women have reported menstrual issues—such as irregular or skipped periods, blood clotting, or prolonged period-related symptoms—for months after a COVID-19 infection.
You Might Suffer Memory Issues
Since COVID-19 impacts the neurological system, memory issues often plague long haulers.
You Might Have Neuralgia (Nerve Pain)
Per the U.S. National Library of Medicine, "Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve." It can be caused by a variety of factors, including infections, such as herpes zoster (shingles), HIV/AIDS, Lyme disease, and syphilis, and, according to many long haulers, COVID-19.
You Might Slur Your Words or Speech
Slurring words and speech difficulties are usually a result of neurological damage, sometimes caused by a stroke. As COVID-19 wreaks havoc on the neurological system, this is likely why some long haulers still experience these issues months after their infection.
You Might Experience Hallucinations
One of the most curious symptoms reported by many long haulers is hallucinations, some of which are truly frightening. One woman felt a sponge was talking to her. Another thought an umbrella was a man. A third had homicidal thoughts about her children.
You Might Have COVID Toes
One of the most peculiar symptoms of long term COVID is pernio/chilblains, or redness and swelling of the feet and hands, which has come to be commonly known as "COVID toes." According to MGH's study, this symptom lasted a median of 15 days in patients with suspected COVID-19 and 10 days in lab-confirmed cases. "Notably, six patients with pernio/chilblains were long haulers with toe symptoms lasting at least 60 days, with two lab-confirmed patients with COVID toes lasting longer than 130 days," they wrote.
You Might Notice Speech/Language Issues
In addition to slurring words and speech, some long haulers report speech and language issues.
You Might Have "Other Eye Symptoms"
Eye symptoms—including blurry vision—can occur as a result of COVID related nerve damage or due to other symptoms related to the virus, including fever or headache.
You Might Develop Muscle Spasms
According to the Cleveland Clinic, muscle spasms, also known as muscle cramps, happen when a muscle involuntary and forcibly contracts. Dr. Wilson explains that they are "not terribly common" with long haulers "and can certainly be triggered by other conditions besides long-covid."
You Might Have "Other Temperature Issues"
Fluctuations in temperature are not uncommon amongst those battling long COVID.
You Might Notice a Change in "All Sensorimotor Symptoms"
The U.S. National Library of Medicine explains that sensorimotor polyneuropathy is a condition that causes a decreased ability to move or feel (sensation) because of nerve damage. It can be caused by autoimmune disorders or swelling/inflammation of the nerves. "Many patients with lingering covid symptoms report some alterations in nerve sensation," explains Dr. Wilson. "Often this takes the form of prolonged changes in smell or taste, but some have reported numbness or tingling in the hands or feet."
You Might Start—and Keep—Sneezing
Per the U.S. National Library of Medicine, a sneeze is a sudden, forceful, uncontrolled burst of air through the nose and mouth. Generally, it is caused by irritation to the mucous membranes of the nose or throat. This could be why months after an infection, COVID long haulers are still experiencing sneezing bouts.
You Could Have Vomiting
Vomiting is one of the many gastrointestinal complications reported by long haulers. It is likely the result of the gastrointestinal damage wreaked by the initial COVID-19 infection.
You May Experience "Brain Fog"
"This is a sense of feeling not 100% sharp, which can be hard for patients to describe," Dr. Wilson specifies. "They just don't feel on top of their mental game."
You Could Cough Up Blood
Coughing up blood can be due to a variety of health issues, explains Mount Sinai. Many of them—such as inflammation of the blood vessels in the lung (vasculitis), injury to the arteries of the lungs, pneumonia or other lung infections, or even simply irritation of the throat from violent coughing (small amounts of blood)—are likely connected to an initial COVID infection. "This is very uncommon and should absolutely be evaluated by a doctor," explains Dr. Wilson. "Coughing up blood is not a normal symptom and should be treated as a potential medical emergency if it develops suddenly."
You Might Feel Bone Ache or Burning
Bone aching or burning is another uncomfortable sensation tied to long hauler syndrome. "Diffuse aching, either in the muscles or bones has been reported," confirms Dr. Wilson.
You Might Cough With Mucus Production
While a dry cough is most commonly identified with COVID-19, some long haulers report more of a wet one that involves mucus. Edison Chiluisa, a 51-year-old hospital worker, recently revealed to the Washington Post that amongst his debilitating symptoms he "coughs up a thick mucus that is becoming worse despite a variety of treatments." Adds Dr. Wilson: "Lingering cough is common with all viral infections, and COVID seems to be no exception. Some patients are still coughing after they have tested negative."
You Might Have a Low Temperature
Temperature fluctuations—including low body temperature—are commonly reported by COVID long haulers.
You Could Have Acute (Sudden) Confusion/Disorientation
Another neurological symptom, acute or sudden confusion or disorientation is "a concerning symptom and should be evaluated by a medical professional ASAP."
You are Likely to Experience Post-Exertional Malaise
Feeling unusually exhausted after exerting any energy? Maybe that feeling—fatigue, or maybe a migraine—kicks in 24 hours after you exert yourself? It could be a symptom of long COVID. "This is one of the most common symptoms described by COVID long-haulers, who report that after exercise they can feel really run-down for a while," says Dr. Wilson.
You May Have Abdominal Pain
Gastrointestinal problems are a somewhat common symptom of COVID and likely explain why many long haulers report abdominal pain.
You Could Get Joint Pain
The Mayo Clinic explains that joint pain often arises as a result of inflammation. It has been established that inflammation is common in COVID-19 infections. "Inflammation attacks joint tissues, causing fluid in your joints, swelling, muscle damage, and more," explains Penn Medicine orthopedic surgeon, Christopher S. Travers, MD.
You Could Develop Heart Palpitations
Heart palpitations are "feelings of having a fast-beating, fluttering or pounding heart," explains the Mayo Clinic. "Stress, exercise, medication or, rarely, a medical condition can trigger them." Per one study published in JAMA Cardiology, out of 100 recovered COVID-19 patients, 78 reported "cardiac involvement" while 60% had ongoing myocardial inflammation. And, even those who initially suffered from mild to moderate infections, reported ongoing heart issues, such as palpitations.
You Might Have Nausea
Feeling uncomfortably ill is not uncommon for long haulers. "Some patients report gastrointestinal symptoms after COVID, like nausea and diarrhea," says Dr. Wilson.
You Could Develop Sleep Apnea
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts, according to the Mayo Clinic. "If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea," they explain. It is just one of a few sleep-related symptoms reported by COVID long haulers.
You Might Have Tachycardia
The Mayo Clinic explains that tachycardia, a form of arrhythmia, occurs when your heart beats over 100 beats per minute. It is one of the many heart-related symptoms that long haulers suffer from.
You Might Suffer From Insomnia
Sleep complications are not uncommon for long haulers. According to a survey of more than 1,500 people in the Survivor Corp Facebook group, half of patients recovering from COVID-19 reported difficulty sleeping as one of the lingering symptoms. Some experts believe that post-COVID insomnia could be the result of anxiety and stress created by the illness.
You Could Experience Dizziness or Balance Issues
Feeling dizzy or unbalanced is another neurological manifestation of the virus. "This may be due to the weakness many patients have after a tough bout with COVID, but any balance or persistent dizziness should be evaluated by a medical professional," Dr. Wilson says.
You Could Have a Runny Nose and Other Respiratory and Sinus Issues
Dr. Wilson confirms that runny noses and sinus issues are not uncommon with long haulers. "Lingering sinus congestion and runny nose have been reported weeks to months after a COVID infection," he says.
You Could Get Headaches and Related Symptoms
One case report focuses on a woman whose post COVID headache lasted for months after her initial infection. "New daily persistent headache (NDPH) is another chronic headache that can be triggered by viral diseases," the researchers explain.
You May Have Diarrhea
"A lot of patients with lingering symptoms report constipation or diarrhea that persists for a few days, then resolves, then returns again," says Dr. Wilson.
You Could Develop Other Sleeping Symptoms
It isn't uncommon for sleeping issues to occur as a result of health complications. Since COVID long haulers struggle with anxiety and stress as well as many other uncomfortable symptoms, it isn't surprising that they struggle with sleep.
You Might Feel a Pain/Burning in Chest
COVID-19 impacts the lungs and respiratory system, and according to some long haulers, continues to long after their initial infection. The Mayo Clinic explains that sudden, sharp chest pains—aka pleurisy—may indicate that the lung walls are inflamed. This sensation can signal pneumonia or other types of infection.
You Could Have a Rattling of Breath
"Chest congestion can be seen even after a patient is no longer infectious," Dr. Wilson explains. The University of Florida Health reports that there are several types of abnormal breath sounds, each unique in sound. These include rales, small clicking, bubbling, or rattling sounds in the lungs. "They are heard when a person breathes in (inhales). They are believed to occur when air opens closed air spaces. Rales can be further described as moist, dry, fine, or coarse," they explain. Others include wheezing, high-pitched sounds produced by narrow airways, rhonchi, snoring-like sounds that occur when air is blocked, and stridor, wheeze-like sounds that can be heard when a person breathes.
You are Likely to Experience Changes to Sense of Smell and Taste
"Some patients still haven't fully recovered their sense of smell months after they lost it during the initial infection," Dr. Wilson explains. "Many people might not recognize how serious this is, but without smell people may not eat as well, may inadvertently expose themselves to contaminated food, and, more broadly, life just feels less colorful. Though we don't often think about it, smell is hugely important for our well-being."
You Could Feel Muscle Aches
Achy muscles can be a sign that you are battling an infection, and also one that your body already has. "One of the more common long-hauler symptoms, muscle aches—particularly after exercise—can limit activity," says Dr. Wilson.
You Might Have a Loss of Appetite
Along with weight loss, loss of appetite does occur in long-haulers, explains Dr. Wilson. "Sme of this might be due to the loss of sense of smell that many patients report," he points out.
You May Have Breathing Difficulty (Normal O2 Saturation Level)
According to the Mayo Clinic, COVID-related pneumonia can permanently damage the tiny air sacs (alveoli) in the lungs. "The resulting scar tissue can lead to long-term breathing problems," they explain.
You May Have Chills/Flushing/Sweats
Temperature fluctuations, including chills, flushing, and sweats, are a common complaint amongst those suffering from long COVID.
You May Get a Sore Throat
According to the CDC, viruses and infections can cause sore throats. While many COVID sufferers report a sore or scratchy throat as an initial symptom of the virus, some claim that it lingers long after their initial infection.
You May Feel a Tightness of Chest
"Chest symptoms like cough, congestion, rattling, can persist in some patients," Dr. Wilson maintains.
You Could See an Elevated Temperature (98.8-100.4F)
While a fever over 100.4 is a trademark symptom of COVID-19 as well as long COVID, a simple spike in temperature (or low grade fever) is also common.
You are Extremely Likely to Have Fatigue
Extreme exhaustion or fatigue is one of the most debilitating symptoms of long COVID. "This is one of the most commonly reported symptoms and can be quite severe," reveals Dr. Wilson.
You Could Feel Shortness of Breath
"Shortness of breath, particularly with exercise (even climbing a flight of stairs) can be really debilitating," says Dr. Wilson. Per John Hopkins Medicine, shortness of breath is when you feel like you can't get enough air or your chest is tight. While this might be normal after a workout or period of exertion, post COVID shortness of breath can occur at any time—even when laying in bed or sitting on the couch.
You Might Have a Dry Cough
Dry cough is one of the defining symptoms of an initial COVID-19 infection, with many long haulers reporting that it does not quit. The American Lung Association points out that this could be a result of permanent damage to the lungs, which may in turn affect the ability of the body to function normally. However, they also point out that some long haulers experience symptoms such as a dry cough, "without apparent damage to vital organs."
You May Have a Fever
While a fever is a trademark symptom of an initial COVID-19 infection, many long haulers report a recurrent or persistent temperature spike over 100.4F. If you've experienced that or any of the symptoms mentioned here, seek medical attention or contact a Post-COVID care center. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.