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What to Know About the Evolving List of Long COVID Symptoms

Since the onset of the COVID-19 pandemic in 2020, millions of people have experienced persistent symptoms dubbed as “long COVID,” after their initial infection. Long COVID comes in two forms: long COVID disease and long COVID syndrome. A key criterion for both types is that symptoms last at least three months.

Long COVID disease usually affects older individuals who have had a severe initial infection that required hospitalization. It also usually involved organ damage. As for long COVID syndrome, those who deal with it may have only had a mild initial infection or even been asymptomatic.

Long COVID syndrome often impacts women in their 30s to 50s, does not result in organ damage, and does not have comorbidities. Long COVID syndrome usually fits the category of “invisible” illness with overlapping symptoms with conditions like fibromyalgia or chronic fatigue syndrome.

As studies and patient reports show more possible symptoms, keeping track of the list can be daunting, especially when certain health issues are listed under acronyms people are not familiar with.

Common Long COVID Symptoms

  • Tiredness that interferes with everyday activities
  • Chronic fatigue
  • Post-exertional symptom exacerbation (PESE)
  • Fever
  • Labored breathing
  • Shortness of breath
  • Cough
  • Chest pain
  • Heart palpitations
  • Headache
  • Sleep problems
  • Lightheadedness
  • Brain fog and other cognitive issues
  • Change in smell or taste
  • Depression or anxiety
  • Diarrhea
  • Stomach pain
  • Musculoskeletal pain
  • Changes in menstrual cycles

Diagnosing long COVID requires ruling out other medical conditions and a confirmed or likely initial COVID-19 infection regardless of symptomology. In the case of long COVID disease, the condition can exacerbate organ damage that you sustained during your initial infection like kidney damage. Even long COVID syndrome can lead to developing health conditions.

Understanding Acronyms of Potential Long COVID Symptoms

One aspect of long COVID that can lead to various medical issues is inflammation. It plays a key role in the “long COVID alphabet soup,” which is the number of acronyms medical providers and clinical studies discuss as potential side effects when dealing with long COVID.

Diagnostic methods to identify long COVID symptoms can include x-rays, CT scans, MRIs, medical imaging using contrast dye, ultrasound, and lab work.

Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS)

Myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), is a medical condition that can impact many aspects of one’s health. It usually interferes with their ability to perform daily tasks, from working out to spending extended time at a desk. Many individuals with ME/CFS experience post-exertional malaise (PEM) where they deal with excessive exhaustion from various tasks, including those they used to perform with no or fewer difficulties.

Common symptoms of ME/CFS include:

If you experience ME/CFS symptoms, your doctor usually reviews your family health history and your current symptoms. They need to rule out other medical conditions and can refer you to specialists such as a neurologist or a rheumatologist for additional evaluations.

Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome, also known as POTS, is a medical condition that impacts the autonomic nervous system, which regulates key functions, the sympathetic nervous system which handles the fight or flight response, and blood flow.

POTS symptoms are especially potent when standing up from a reclining position. Sitting or lying down can alleviate them. Different types of POTS exist, such as neuropathic POTS and low blood volume POTS.

Common POTS symptoms include:

  • High or low blood pressure
  • High or low heart rate
  • Chest pain
  • Dizziness and/or fainting
  • Chronic fatigue
  • Nausea
  • Temperature deregulation
  • Brain fog
  • Vision changes
  • Neck pain and/or headaches
  • Sleep disturbances
  • post-exertional malaise
  • Excessive sweating
  • Diarrhea and/or constipation

Doctors usually use a tilt table test to check how your vitals change as you gradually go from a horizontal to a vertical position.

Treatment for POTS can include:

  • Medication
  • Fluid and salt supplementation
  • Compression garments
  • A blood pressure monitor
  • Reclined exercises
  • Lifestyle changes to avoid exposure to specific triggers like alcohol or excessive heat

Cerebral Venous Sinus Thrombosis (CVST)

Cerebral venous sinus thrombosis or CVST happens when a blood clot develops in the brain’s venous sinuses, which keeps the blood from properly draining out of the brain and possibly result in a hemorrhage. CVST is a rare result of a stroke that can occur at any age.

CVST symptoms include:

  • Headache
  • Blurred vision
  • Fainting
  • Seizures
  • Loss of control over specific body parts

If diagnosed with CVST, you should begin treatment right away at a hospital. Your doctors can recommend fluids, antibiotics, anti-seizure medications, anticoagulants, and close monitoring of your brain activity and pressure.

Deep Vein Thrombosis (DVT)

Deep vein thrombosis or DVT means that a blood clot develops in one or more deep veins in your body. It usually occurs in the legs and may cause pain or swelling. Some people show no signs of DVT. Deep vein thrombosis can lead to severe health consequences if a blood clot travels to your lungs and cause a pulmonary embolism.

If you suspect DVT, you should see your primary care physician. When experiencing pulmonary embolism symptoms, you should get emergency medical attention.

Pulmonary Embolism (PE)

A pulmonary embolism is a potentially life-threatening health situation in which a blockage happens in a pulmonary artery. Its most common cause is a blood clot that traveled to your lungs. If you have additional risk factors such as cardiovascular conditions, a pulmonary embolism can be especially dangerous.

People can experience mild to severe symptoms such as:

  • Chest pain
  • Cough
  • Dizziness
  • Fever
  • Leg pain and/or swelling
  • Rapid or irregular heartbeat
  • Shortness of breath and labored breathing
  • Skin discoloration

Mast Cell Activation Syndrome (MCAS)

Mast cells are blood cells in your gastrointestinal tract, your skin, your airways, and your bone marrow. They support your immune system in dealing with infections. They also play a role in allergic reactions. Mast cell activation syndrome or MCAS is when your mast cells cause allergic reactions and other symptoms by releasing excessive chemicals into your body.

Common MCAS symptoms include:

  • Swelling
  • Itching
  • Abdominal pain
  • Chronic pain
  • Diarrhea or constipation
  • Dizziness or fainting
  • Drops in blood pressure
  • Fatigue
  • Headache
  • Nausea and vomiting
  • Rapid heartbeat
  • Sweating

If you experience such symptoms, you should contact your physician. They may test for histamine, tryptase, and/or prostaglandin levels. They usually ask if your allergic symptoms happen in two or more organs and are recurring. They can prescribe antihistamine medications and other solutions to block the chemicals your mast cells release.

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