It has been estimated that up to 20 million Americans are still affected by long COVID, a suite of symptoms that can linger for weeks, months or longer after the initial infection. Most people recover from COVID within a couple of weeks, but some people (10-30%) retain viral remnants for much longer with difficult symptoms to go with them. The lingering symptoms are thought to come from three sources: damage to the body’s cells from the virus, damage from being intubated and other treatments associated with acute hospital care, or just re-infection that can recur over and over after you have “recovered.” One of the most debilitating lingering symptom is a sense of fatigue or malaise that can make it hard to be productive or think clearly. Anxiety, depression, insomnia, brain fog are reported along with more obvious symptoms like continued loss or taste or smell with loss of appetite, shortness of breath from lung damage, kidney injury, or cardiovascular problems like blood clots.  Children are more likely to experience fatigue, difficulties sleeping and concentration problems that resolves within a couple of months. Long COVID is more likely to be experienced by women – this trend has been studied in America, as well as across Asia and Europe.

Last August when Utah experienced the worst air quality in the world due to wildfires and wind, Cole Checketts of Woods Cross felt lousy with mild symptoms that he thought were just due to the smoke in the air. Being a mechanic, he relies on his sense of smell to diagnose problems under the hood. The smell of burning coolant, for example, can indicate a small leak even before the fluid starts collecting under the car. One of his mechanics asked him to check out a strange smell, and he could smell nothing. Total loss of smell lasted for a couple of weeks and then he started to smell a little bit. The returning sense only picked up unpleasant smells. “Everything smelled like burning mucous.” 

Even now, 10 months later, Checketts said, “I was eating watermelon and it smelled like wet, molding grass.” On Father’s Day, he could hardly taste his celebratory burger. He is hoping that his sense of smell will eventually return, but is unsure if treatment will be helpful since it is not even understood how smell/taste is lost due to COVID, whether it is damaged cells or a messed-up brain issue. He has also experienced “brain fog” since having COVID. “I have always had a decent vocabulary, but now I see an object in front of me and can’t remember the word for it and names of people are especially hard,” said Checketts.

Like other viruses, including the ones that causes cold sores or mono, the body can store reservoirs of a virus that can allow the virus to persist. COVID reservoirs have been found in the intestines, breast tissue, appendix, and lungs months or even years after the initial infection. The goal is a truce between the virus and the immune system. Treatment should be more holistic or comprehensive targeting immune health and general well-being. Getting a vaccination can reduce the chances of getting long COVID especially past the four-month mark. President Biden has empowered the secretary of Health and Human Services to create a plan for long COVID and the National Institute of Health has started a study called RECOVER to understand, prevent and treat long COVID. Hopefully, effective treatments are on the horizon, but compassion and understanding are needed presently for those still struggling with lingering effects of the pandemic.λ