Long COVID is a challenging problem for both patients and clinicians. Like much of this pandemic, our understanding about the long-term effects of COVID-19 is evolving and incomplete. Unfortunately, a number of patients who have recovered from COVID-19 will continue with symptoms that last more than two months after recovery.
Typical symptoms of long COVID include fatigue, brain fog, anxiety, shortness of breath, chest tightness and cough. About one third of patients will experience more than one of these symptoms, and between 10 and 70-percent of patients recovering from COVID will experience multiple symptoms.
Jon Blaschke, M.D., a cardiologist with the INTEGRIS Heart Hospital, says it is common for hospitalized patients with COVID-19 to have clotting issues including clotting in the lungs, heart attacks, strokes and rhythm disturbances. He says inflammation of the heart is seen as well. “However, after the acute phase of COVID, longer-term, serious cardiovascular problems seem to be infrequent.”
He adds, “We do not have information on risk for vascular events long-term, but most patients who have recovered from COVID have no heart issues or residual vascular problems from the virus even though they may have persistent symptoms.”
But he warns certain symptoms should never be ignored. Patients who are experiencing chest pain, shortness of breath (especially with activity), new or severe fatigue, or swelling should be evaluated by a physician. Red flags to look for include episodes of passing out, or symptoms that are worse with activity.
* In general, patients who are still having symptoms after recovery from COVID should start with an evaluation with a primary care provider. Initial evaluation often includes an EKG and a chest x-ray. In many instances this is enough to provide reassurance.
* Most patients with known cardiac injury (atrial fibrillation, abnormal heart enzymes, inflammation of the heart) from COVID warrant subspecialty evaluation and follow-up. These are generally seen in patients with severe illness (requiring hospitalization), and in general, these patients are already established with a cardiologist.
* Patients who had abnormal chest x-rays or were hospitalized warrant follow-up at a minimum with their primary provider, and most need follow-up x-rays or CT scans. Lung function testing may also be indicated.
In conclusion, Blaschke has this advice, “The single thing I tell all of my patients is the best way to prevent both serious illness including hospitalization and death from COVID, and effects from long-haul COVID is to get immunized and boosted. This applies to both the acute illness and to long COVID. We know that fully vaccinated patients are 23 times less likely to be hospitalized or to die from COVID when compared to those who are not immunized.”
He continues, “The health care community is united and the data is clear, we are counting on our patients to do their part to protect themselves, their families and us, so that we can be there for them, if the need arises.”
