Two weeks later, her husband got better and was cleared to return to his maintenance job. But not Kephart. The 47-year-old patient services coordinator in Sterling, Nebraska, has barely gotten off the couch in the past three months. Her exhaustion and fever remain unrelenting. And new symptoms have developed, including severe nausea. “I used to be so active, walking 20 miles a week, but now I can’t walk around my house without problems. It’s been such a long and frightening road,” she says. RELATED: From Nose to Toes, the List of COVID-19 Symptoms Keeps Growing
A Newly Identified Post-COVID-19 Woe
Kephart is part of a growing legion of COVID-19 patients whose illnesses have lingered months beyond the typical acute phase of a few weeks. Many have no underlying medical condition that would have flagged them for trouble, such as diabetes or heart disease. Their symptoms have stumped physicians and researchers, who are trying to figure out why some people are affected this way and when — or whether — they might recover. “Guidelines from the World Health Organization (WHO) say mild cases should recover in two weeks and severe cases in six. But we’re seeing patients with symptoms months after being diagnosed,” says Denyse Lutchmansingh, MD, a pulmonary and critical medicine physician at Yale Medicine in New Haven, Connecticut. Researchers are trying to get a clearer sense of the number of people who are affected this way. One early study by Italian researchers, published in July 2020 in the Journal of the American Medical Association, found that two months after falling ill, 88 percent of people who had been hospitalized for COVID-19 complained of at least one lingering symptom. More than one-half had three or more, which many said had impacted their quality of life. RELATED: Black Americans Have Been Hit Hardest By COVID-19 — Here’s Why
Symptoms Are Wide-Ranging
People with COVID-19 who have been hospitalized are more likely to experience permanent injuries, such as lung scarring (fibrosis) or liver, heart, or brain abnormalities, Dr. Lutchmansingh says. But even patients with moderate cases, like Kephart, can become “long haulers,” as they are calling themselves, with ongoing medical issues. Long haulers may experience a range of symptoms, from shortness of breath to muscle weakness, joint pain, ringing in their ears, mental fogginess, and word-recall issues. Fatigue is also a common complaint. Mara Gay, a 33-year-old New York Times editorial board member, detailed her problem with lingering pneumonia and exhaustion in an op-ed in The Times in May, a month after contracting the disease. In July she told a cable news host she is still often bone-tired. Even when people are mostly recovered, problems can linger. Three months ago Laura Queller, a 59-year-old resident of Westfield, New Jersey, contracted a moderate case of COVID-19, along with her husband and grown son and daughter. She got over the worst after two weeks and now mostly feels fine — until she tries to exercise. “For a long time, I couldn’t do it without getting light-headed and easily winded. Now I’m trying to do very mild, very gradual exercises as a way to slowly recover and get back into shape,” she says. Exercise has also sometimes proved problematic for her daughter, who recently experienced extreme dizziness after attempting a run. RELATED: Is It Safe To Go Back to the Gym?
Symptoms Come in Waves
New symptoms may turn up well after the acute phase is over, with problems coming and going in waves, Lutchmansingh says. For instance, it wasn’t until four weeks after contracting COVID-19 that Kephart lost her senses of taste and smell, symptoms of the disease. They have yet to return, making it hard for the once-passionate cook to gin up an appetite. “I used to love salad, but now it’s just this awful crunch,” she says. In addition to body aches that sometimes become extra painful, she says, “There are days when my arms and legs go numb like they’re asleep. And sometimes I just can’t get out of bed.” On occasion Kephart is so nauseated she can’t even sip water, a problem that landed her in the ER when it lasted several days. She is currently taking medication to bring down her heart rate, which frequently became elevated after she contracted COVID-19, requiring assessment with an electrocardiogram (EKG) and heart-rhythm monitor. Some days Kephart is fine, but then she succumbs again. “The longest I have felt okay is four days straight. Then I try cooking and laundry and I totally regret it,” she says. The lingering illness forced her to give up her job at a home healthcare company. RELATED: The Lasting Impact of COVID-19: How Will It Affect Our Mental Health?
Doctors Are Perplexed
Post-viral symptoms can occur with other diseases: People who have had chicken pox are prone to subsequent shingles, for example, and herpes patients have recurrent bouts. But the range of issues and the seriousness of some problems make COVID-19 different, Lutchmansingh says. Scientists have begun taking steps towards a better understanding. In June, the National Institutes of Health (NIH) launched a study to examine the long-term effects of COVID-19 in people who had been hospitalized with the disease. And Yale Medicine recently started a recovery clinic for people whose respiratory or other symptoms linger more than six weeks after their original infection. “We want to figure out what they’re experiencing and how we can best intervene,” Lutchmansingh says. She urges patients not to suffer in silence. “If you haven’t gotten over the disease, tell your primary care doctor and, if needed, get referred to a specialist in your area for additional evaluation,” Lutchmansingh says. When breathing difficulties are an ongoing issue, for instance, you may need to consult a pulmonologist. If your primary care physician doesn’t take your complaints seriously, find a different doctor, Lutchmansingh advises. Patients are also learning from one another. A Facebook group called Survivor Corps and a Slack channel, Body Politic, are becoming places for long haulers to share symptoms and techniques that have helped them feel better, such as using cold wraps for muscle aches. “Finding the Facebook group was life-saving,” Kephart says. “It’s disheartening that so many are suffering, but when I get a new symptom and see that others have it, I feel less alone.” RELATED: Can Taking a Vitamin D Supplement Help Protect Against COVID-19?
