Long COVID: Symptoms, Diagnosis, and Management

COVID-19

Hello, doctor.
I recently tested positive for COVID-19, and after completing my isolation, I've noticed that I experience more shortness of breath and difficulty breathing during exercise compared to before.
I would like to ask if I might be experiencing long COVID or other post-acute sequelae of SARS-CoV-2 infection.
Additionally, I would like to know how I can confirm if I have long COVID and what the subsequent management options are.
Thank you.

Shui, 20~29 year old female. Ask Date: 2022/07/20

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding long COVID, we primarily assess it based on clinical symptoms.
According to your description, it does seem to be caused by long COVID.
There are no specific treatment medications recommended for this condition.
It is advisable to maintain a regular routine, get plenty of rest, engage in moderate exercise, and have a balanced diet.
Most individuals will gradually improve.
Thank you for your inquiry.

Reply Date: 2022/07/20

More Info

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist for weeks or months after the initial COVID-19 infection has resolved. It can affect individuals regardless of the severity of their initial illness, including those who experienced mild or asymptomatic cases. The symptoms of Long COVID can vary widely and may include fatigue, shortness of breath, cognitive difficulties (often referred to as "brain fog"), joint pain, and sleep disturbances, among others.

In your case, experiencing increased shortness of breath and difficulty breathing during exercise after recovering from COVID-19 could indeed be indicative of Long COVID. This condition can lead to lingering respiratory issues, as the virus may have caused inflammation or damage to the lungs, even if the acute phase of the illness was mild.
To confirm whether you have Long COVID, it is essential to consult with a healthcare provider who can conduct a thorough evaluation. This may include:
1. Medical History Review: Discussing your symptoms, their onset, and duration with your physician. It’s important to provide details about your COVID-19 infection, including the severity of your symptoms and any treatments you received.

2. Physical Examination: A physical exam can help assess your overall health and identify any physical signs of respiratory distress or other issues.

3. Diagnostic Tests: Your doctor may recommend several tests to evaluate your lung function and overall health. These could include:
- Pulmonary Function Tests (PFTs): These tests measure how well your lungs are working and can help identify any restrictions or obstructions in airflow.

- Chest X-ray or CT Scan: Imaging studies can help visualize any structural changes in the lungs that may have occurred due to the infection.

- Blood Tests: These can help rule out other conditions that may be causing your symptoms and assess your immune response.

4. Referral to Specialists: Depending on your symptoms, your doctor may refer you to specialists such as a pulmonologist (lung specialist) or a rehabilitation specialist who focuses on post-COVID care.

Management of Long COVID is still an evolving field, but several strategies can help alleviate symptoms:
- Rehabilitation Programs: Many healthcare systems are developing rehabilitation programs specifically for individuals recovering from COVID-19. These programs often include physical therapy to help improve lung function and overall physical conditioning.

- Symptom Management: Depending on your specific symptoms, your doctor may recommend medications to help manage issues such as pain, fatigue, or respiratory difficulties.

- Lifestyle Modifications: Engaging in light physical activity as tolerated can help improve endurance and lung capacity. However, it’s crucial to listen to your body and avoid overexertion. Gradually increasing activity levels can be beneficial.

- Mental Health Support: Long COVID can also impact mental health, leading to anxiety or depression. Seeking support from mental health professionals can be an essential part of recovery.

- Monitoring: Regular follow-ups with your healthcare provider can help track your progress and adjust your treatment plan as needed.

In summary, if you suspect you have Long COVID, it is vital to seek medical advice for a comprehensive evaluation and tailored management plan. Early intervention can significantly improve outcomes and help you regain your pre-COVID level of health and activity. Remember, you are not alone in this, and many resources are available to support your recovery journey.

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