Long COVID

What Is Long COVID?

Many people recover fully within a few days or weeks after being infected with SARS-CoV-2, the virus that causes COVID-19. But others have symptoms that linger for weeks, months, or even years after their initial diagnosis. Some people seem to recover from COVID-19 but then see their symptoms return, or they develop new symptoms within a few months. Even people who had no symptoms when they were infected can develop symptoms later. Either mild or severe COVID-19 can lead to long-lasting symptoms.

Long COVID, long-haul COVID, post-COVID-19 condition, chronic COVID, and post-acute sequelae of SARS-CoV-2 (PASC) are all names for the health problems that some people experience within a few months of a COVID-19 diagnosis. Symptoms of long COVID may be the same or different than symptoms of COVID-19. Long COVID can also trigger other health conditions, such as diabetes or kidney disease.

What We Know About Long COVID

What causes long COVID?

Scientists don’t know for sure what causes long COVID, but research is providing some clues.

• SARS-CoV-2 particles may become active again, causing symptoms to reappear.

• Overactive immune cells may release high levels of inflammatory substances that can injure organs and tissues.

• The infection may cause the immune system to start making autoantibodies that attack a person’s own organs and tissues.

Symptoms may also be caused by a combination of these and other factors. Research into these factors is ongoing.

Why are long COVID symptoms so varied?

Scientists are uncovering risk factors for long COVID and reasons why symptoms vary from person to person. Some factors that may be important include:

• Female sex

• Older age

• Severity of initial COVID-19 illness

• Immune response to initial infection

• Not being fully vaccinated against COVID-19

• The SARS-CoV-2 variant that caused the initial infection

• Preexisting health conditions, such as diabetes, lung problems, autoimmune diseases, or obesity

Health inequities may also increase the risk of long COVID for some racial or ethnic minority groups and some people with disabilities.

Can children get long COVID?

Children and teenagers can get long COVID, whether they had COVID-19 symptoms or not.

Multisystem inflammatory syndrome in children (MIS-C) is a serious delayed complication of SARS-CoV-2 infection that may develop in children and young adults. The condition is caused by inflammation of body parts, including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal organs. Children ages 5 to 11 are most frequently affected by MIS-C.

How can I prevent long COVID?

The only known way to prevent long COVID is to avoid getting COVID-19. The Centers for Disease Control and Prevention (CDC) has steps you can take to protect yourself and others from getting COVID-19.

I have COVID-19. How can I reduce my chances of getting long COVID?

If you are not vaccinated, vaccination after you recover from COVID-19 may help to prevent long COVID. COVID-19 vaccination may also reduce the likelihood of MIS-C in young people ages 12 to 18.

People who test positive for COVID-19 can check with their health care providers about authorized treatments that may lower their risk of severe symptoms and hospitalization. Scientists are studying COVID-19 treatments to see whether they lower the risk of long-term symptoms.

What can I do if I have long COVID?

There is no specific treatment for long COVID yet. You and your health care provider can work together to create a personal care plan to manage your symptoms and improve your quality of life.

There are tools available to help people cope with long COVID and get the health and social support they need. There are also many support groups to help people with long COVID symptoms connect with each other. The National Institute of Mental Health offers tips for managing stress during pandemics.

How You Can Help Fight Long COVID

Long COVID Clinical Studies

NIH launched the Researching COVID to Enhance Recovery (RECOVER) Initiative in early 2021 to identify risk factors and causes of long COVID to help understand how it can be prevented or treated in the future. Your experiences — whether you have long-term COVID-19 symptoms, had COVID-19 and recovered, recently tested positive for COVID-19, or never had COVID-19 — are critical to helping scientists study these symptoms.

Reach out if you or someone you know might be interested in volunteering for a study. Compensation may be available. Pregnant people can participate, and children can also take part in some studies if they wish to and if they have the consent of a parent or guardian.

Participate in an Adult Long COVID Study

• NIH’s RECOVER Initiative includes several studies about the long-term, ongoing health effects that some people experience after COVID-19. Find a RECOVER study site near you.

• As part of RECOVER, researchers are enrolling participants from the Gestational Research Assessments of COVID-19 (GRAVID) Study, who had SARS-CoV-2 infection while pregnant. The researchers will monitor the health of the participants and their children for 4 years. The results may identify ways to reduce the risks of long COVID after pregnancy and to better treat its symptoms.

• NIH’s Longitudinal Study of COVID-19 Sequelae and Immunity (RECON_19) investigates long-term medical problems experienced by people after they have recovered from COVID-19. Close contacts of people with COVID-19 are also invited to participate, to see whether they became infected but did not have symptoms. The study is taking place in Bethesda, Maryland.

• The Cardiac Magnetic Resonance Tissue Characterization in COVID-19 Survivors study will look for long-term effects of COVID-19 on the hearts of people who had the disease. Up to 500 people can participate in this 3-year study, which is based in New York City.

• The Observational Study of Neurologic Function After COVID-19 Infection will examine the nervous systems (brain and nerves) of people who have had COVID-19 but still have neurological symptoms. Up to 200 people can participate in this study, which is taking place in Bethesda, Maryland.

Participate in a Pediatric Long COVID Study

• Researchers with the Long-Term Outcomes after the MUltisystem Inflammatory Syndrome In Children (MUSIC) Study, now a part of RECOVER, seek explanations for MIS-C and long-term outcomes for children infected with SARS-CoV-2. Learn how to participate.

• As part of RECOVER, the Pediatric COVID Outcomes Study (PECOS) is monitoring up to 1,000 children and young adults who previously tested positive for COVID-19. The study, which evaluates how COVID-19 affects participants’ physical and mental health for a total of 3 years, is taking place in Washington, D.C., and Bethesda, Maryland.

• Newborns, children, teens, and young adults up to age 25 may take part in the Understanding the Long-Term Impact of COVID on Children and Families study, which is taking place at 65 locations in the United States. If you or your child has COVID-19, long COVID, or MIS-C or may have been exposed to COVID-19, you may be eligible for the study.