How do I know if I have Long Covid?

Post-Acute sequelae of COVID-19, also known as Long Covid, describes a wide range of symptoms that people can experience after a COVID infection. There are over 200 documented symptoms, the most common include fatigue, headache, brain fog, breathing difficulty, heart rate variation, sleep disruption and more see our blog post on What is Long Covid for more background. 

Symptoms can range in severity from: 

• people who face debilitating symptoms that impact all aspects of their lives; 
• those who experienced sudden and unexpected health issues (e.g. with their heart or other organs) due to the impact COVID has had on their body; or 
• more mild symptoms among people who haven’t felt “quite right” since a COVID infection. 

Currently, Long Covid is either self-diagnosed or diagnosed in consultation with a clinician. The main criteria are a sudden development, or worsening, of symptoms consistent with Long Covid within 12 weeks of a COVID infection. 

Objective diagnosis criteria using blood samples and other common testing methods are under development, but not widely used. Existing evidence shows significant associations between high levels of persistent inflammatory measures and people who experience Long Covid symptoms. Other measures include elevated levels of lactate dehydrogenase (LDH), increased vascular endothelial growth factors (VEGF) and decreased levels of hemoglobin. However, further research is needed to find a more definitive set of core blood biomarkers to support diagnoses.  

Long Covid symptoms vary in severity 

The proportion of people impacted by Long Covid is at least 10% - 14%. Anecdotal feedback from researchers and the public suggests that figure could be much higher when people with mild symptoms are also taken into account.

Some people have experienced severe symptoms that make it difficult to work, attend school or even move around their house. Others can work or otherwise go about their day for part of the time, but feel they need frequent rests, have trouble exercising or limit the number of activities they can do in a day to help manage symptoms and avoid overtaxing their systems. For them, the link with a COVID infection is more clear. There was a sudden, and fairly extreme, change in their physical systems and abilities that developed after an infection. 

For those who are not sure if what they feel is Long Covid, research shows that the longer term impacts of a COVID infection can be felt in a range of ways, and accumulate with each COVID infection. This points to why there can be a spectrum of severity of symptoms and why an individual’s reaction to COVID can change over time. Evidence suggests there is cumulative damage in the body from COVID infections, even for people who feel like they “fully recovered” from a previous infection. For example, your risk of developing Long Covid increases with each subsequent infection. Also, the risk of someone developing an issue with one or more of their organ systems was higher among those who were reinfected, regardless of their vaccination status. As COVID continues to circulate in the population, and multiple reinfections are common, people will face an increased risk of serious complications during the acute COVID infection, and an increased risk of developing Long Covid after an infection. 

As the profile of the work Andrea and I are doing has grown, more people are reaching out to ask the question - I have been feeling unwell since my last COVID infection, do I have Long Covid? The short answer is yes, it could be. Long Covid is not an on-off switch and different people experience it in different ways. You can read more about Long Covid symptoms here to consider if your experience matches up with those commonly linked to Long Covid. For me, just knowing that the range of different symptoms I was experiencing were linked was a game changer. It let me focus on a smaller number of issues and dive into evidence about how to alleviate problems that were close to the root cause. I hope that knowledge is power for others too!   

Andrea and I are passionate about sharing the available evidence to increase awareness, and use that information to support those experiencing Long Covid to manage symptoms and feel more like themselves. Check back with our Blog for more content on Long Covid, relevant research, symptom management tips and more. 

We hope you found this helpful. New blog posts will be available regularly. Sign up below to get free symptom management tools and we’ll let you know when new posts are available. Make sure you don’t miss out!

Warmly,
Katie

Resources and references:

1. ThriveNinety Blog Post: What is Long Covid
   
2. Davis HE, McCorkell L, Vogel JM, Topol EJ. Author Correction: Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023 Jun;21(6):408. doi: 10.1038/s41579-023-00896-0. Erratum for: Nat Rev Microbiol. 2023 Mar;21(3):133-146. PMID: 37069455; PMCID: PMC10408714.
3. Mahdi, A., Zhao, A., Fredengren, E. et al. Dysregulations in hemostasis, metabolism, immune response, and angiogenesis in post-acute COVID-19 syndrome with and without postural orthostatic tachycardia syndrome: a multi-omic profiling study. Sci Rep 13, 20230 (2023). https://doi.org/10.1038/s41598-023-47539-1
4. pre-print SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels; Natalia Eberhardt, Maria Gabriela Noval, Ravneet Kaur, Swathy Sajja, Letizia Amadori, Dayasagar Das, Burak Cilhoroz, O’Jay Stewart, Dawn M. Fernandez, Roza Shamailova, Andrea Vasquez Guillen, Sonia Jangra, Michael Schotsaert, Michael Gildea, Jonathan D. Newman, Peter Faries, Thomas Maldonado, Caron Rockman, Amy Rapkiewicz, Kenneth A. Stapleford, Navneet Narula, Kathryn J. Moore, and Chiara Giannarelli, Version 1. bioRxiv. Preprint. 2023 Aug 15. doi: 10.1101/2023.08.14.553245
5. Xu, Sw., Ilyas, I. & Weng, Jp. Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies. Acta Pharmacol Sin 44, 695–709 (2023). https://doi.org/10.1038/s41401-022-00998-0
6. Bowe, B., Xie, Y. & Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 28, 2398–2405 (2022). https://doi.org/10.1038/s41591-022-02051-3
7. Lai YJ, Liu SH, Manachevakul S, Lee TA, Kuo CT, Bello D. Biomarkers in long COVID-19: A systematic review. Front Med (Lausanne). 2023 Jan 20;10:1085988. doi: 3389/fmed.2023.1085988. PMID: 36744129; PMCID: PMC9895110.
8. Bowe, B., Xie, Y. & Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 28, 2398–2405 (2022). https://doi.org/10.1038/s41591-022-02051-3
9. Luo S, Zheng Z, Bird SR, Plebanski M, Figueiredo B, Jessup R, Stelmach W, Robinson JA, Xenos S, Olasoji M, Wan DWL, Sheahan J, Itsiopoulos C. An Overview of Long COVID Support Services in Australia and International Clinical Guidelines, With a Proposed Care Model in a Global Context. Public Health Rev. 2023 Sep 22;44:1606084. doi: 10.3389/phrs.2023.1606084. PMID: 37811128; PMCID: PMC10556237.