Long COVID

What is Long COVID?

Long COVID can happen after someone is sick with COVID-19. It is a chronic disease, which means it lasts a long time, and/or can come and go over time. It is sometimes called “post-COVID syndrome”, “post–COVID-19 condition (PCC)” or “long-haul COVID”.

Long COVID is a serious public health concern that has affected millions of U.S. adults and children. Symptoms can range from mild to severe and last for at least three months. In some cases, Long COVID can cause disability.

Much is still unknown about Long COVID because it is a new condition. The SARS-CoV-2 virus that causes COVID-19 was first discovered in 2019. We continue to learn more as research continues.

Symptoms of Long COVID

Long COVID symptoms can last for months or years after COVID-19 infection. Symptoms can vary from person to person and may be difficult to recognize or diagnose.

According to the Centers for Disease Control and Prevention (CDC), there are over 200 symptoms of Long COVID. Symptoms may get worse after physical or mental effort. The most common symptoms include:

  • Tiredness that interferes with everyday life
  • Feeling generally unwell (in a way that may be hard to describe) after physical or mental effort   
  • Difficulty thinking or focusing, also called “brain fog”
  • Fever
  • Difficulty breathing
  • Coughing
  • Chest pain
  • Fast-beating heart (heart palpitations)
  • Change in smell and/or taste
  • Headaches
  • Sleep problems
  • Anxiety or depression
  • Dizziness when you stand up
  • Joint or muscle pain
  • Pins-and-needles feelings
  • Stomach pain
  • Diarrhea
  • Constipation 
  • Rash
  • Changes in menstrual cycles

Who can develop Long COVID?

Anyone who had COVID-19 can develop Long COVID, even if they did not have symptoms when they had COVID-19. People who get COVID-19 more than once risk getting Long COVID with each infection.

According to research published in June 2024, it is estimated that 6.4% of adults in Washington were experiencing Long COVID as of October 2023, with 117,000 estimated to have had significant activity limitations. This research also found that rates of Long COVID were highest in central and eastern Washington at this time. The percent of Washington adults with Long COVID is regularly estimated by the Household Pulse Survey.  

The CDC states that people who are more likely to have Long COVID include:

  • Women.
  • Older adults.
  • People with underlying health conditions.
  • Hispanic and Latino people.
  • People who were very ill or hospitalized with COVID-19.
  • People who did not get vaccinated against COVID-19. 

People that suffer from health inequities can have a higher risk of negative health impacts from Long COVID. Health inequity happens when a group of people have different health outcomes because of systemic (affects a whole system), avoidable and unjust reasons.  

According to the Office of the Assistant Secretary of Health (OASH), groups who have less access to healthcare or experience stigma (shame or guilt) from the healthcare system may be less likely to get a Long COVID diagnosis. 

You can read more about how OASH is addressing Long COVID disparities here.

Preventing Long COVID 

You can prevent Long COVID by not getting COVID-19. Staying up to date on COVID-19 vaccinations is your best defense against COVID-19.  

Vaccinated people who still get COVID-19 may be less likely to develop Long COVID than unvaccinated people. 

Other tools you can use to prevent COVID-19 infection include wearing a mask, improving air flow and filtration, frequently washing your hands with soap and water, cleaning frequently touched surfaces, physical distancing, and testing.  

If you have COVID-19, protect others from COVID-19 by following these guidelines. 

Protect yourself from Long COVID: Get Vaccinated (English) (PDF)

Learn about getting vaccinated for COVID-19

Diagnosing Long COVID

It can be difficult to diagnose Long COVID. Some symptoms can be difficult to understand. There are currently no lab tests or imaging studies to make the diagnosis of Long COVID. Medical tests can show normal results even if a patient has Long COVID. Long COVID can share symptoms or characteristics with other chronic conditions.

Some people who report Long COVID symptoms did not show COVID-19 symptoms. They did not get tested for COVID-19 when they were first ill. This makes it difficult to confirm they had COVID-19 and can complicate a diagnosis. It can be helpful to get tested for COVID-19 when you first feel ill to assist in your Long COVID diagnosis later, if needed.

Healthcare Appointment Checklist for Long COVID (CDC) (English)

New and Preexisting Health Conditions

Long COVID can affect many organ systems. Patients can present with one or more diagnosable conditions, such as: autoimmune conditions and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).  

This means people who have had COVID-19 may develop new health concerns, such as diabetes or heart conditions. Preexisting health conditions such as diabetes and heart disease can also become worse after COVID-19 illness.

Living with Long COVID

Much is still unknown about how to diagnose and treat Long COVID. Having Long COVID or supporting someone with Long COVID can feel confusing. Long COVID can show different symptoms from person to person. Symptoms may be manageable for some and cause disability in others.

Remember you are not alone. According to the Centers for Disease Control and Prevention (CDC), about 1 in 4 adults with Long COVID report that it limits their daily activities.  Joining a support group can help ease feelings of isolation.

Learn more:

Ask for accommodations. An accommodation is a change made for someone or something. Symptoms may make it difficult or impossible for people to do things they were able to do before they were ill. Work and school tasks can be difficult to manage. Employers and schools may be responsible for making reasonable accommodations for your symptoms.

Learn more: 

Manage your energy. A common symptom is feeling tired often, especially after mental or physical exertion. Be mindful about saving your energy and taking frequent breaks throughout the day.

Learn more about the 4 P’s of managing your energy with Long COVID here: 120-066 - Long-COVID "4 P's" poster - 8.5x11 - June 2023 (wa.gov) (English)

Long COVID and Disability Rights

Long COVID can cause physical and mental impairments and is considered a disability under the Americans with Disabilities Act (ADA). People with long COVID are legally protected from disability discrimination. They may be entitled to reasonable modifications from businesses, state, and local governments to accommodate long COVID-related limitations.

Guidance on “Long COVID” as a Disability Under the ADA (English)

Long COVID and Pregnancy

Pregnant or recently pregnant people are more likely to become severely ill from COVID-19. COVID-19 can cause complications that affect the pregnancy and the developing baby. It is safe and recommended for people who are pregnant or chest feeding to be vaccinated against COVID-19.

Pregnant people can develop Long COVID. Studies are still being done about the effects of Long COVID during and after pregnancy.

Long COVID and Youth

Youth can also become ill from long COVID. Youth experiencing long COVID symptoms such as fatigue and difficulty concentrating might struggle to participate in school and other activities. Young children may have difficulty communicating their symptoms.

Children with long COVID may be eligible for special education, protections or related services under 2 Federal laws.

Getting youth vaccinated against COVID-19 is the best way to prevent long COVID in youth. Getting youth vaccinated against COVID-19 is the best way to prevent Long COVID in youth. Learn more about COVID-19 vaccines here.

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