You can feel tired and exhausted for months after your initial infection

August 19, 2022 / Infectious Disease

You had COVID-19 a few weeks — or even months — ago. But you’re still dealing with the symptoms of the infection, like fatigue and shortness of breath.

You could be part of a group of individuals who experience long-term effects from COVID-19. Whether you call it long COVID, long-haul COVID or chronic COVID, the terms all mean the same thing: You’re still not 100%.

And when you’re feeling tired or fatigued all the time, as well as feeling breathlessness, it can be frustrating.

So, how do you know if you have long COVID-19 and what can you do to feel better?

Pulmonologist and critical care specialist Michael Ghobrial, MD, explains how fatigue and shortness of breath can linger in those who’ve had COVID-19.  

What is long COVID?

There’s no universal clinical definition of “long COVID,” but the Centers for Disease Control and Prevention (CDC) says that “some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as post-COVID conditions (PCC) or long COVID.”

While research is ongoing to understand these symptoms and how they impact individuals, we do know a few things:

• Anyone who has had COVID-19 can experience post-COVID conditions, even those who had mild symptoms or no symptoms at all.
• But long COVID is often found in those who had a severe case of COVID-19.
• Those who aren’t vaccinated and then become infected have a higher risk of long COVID.
• You can possibly test negative or not know you were infected with COVID-19 and still experience long COVID symptoms.

In fact, one study shows that 1 in 8 people who had COVID-19 will experience symptoms up to three months after they were infected.

“In general, females, those with comorbidities or severe COVID-19 infection, as well as the African American population, have been shown to have more persistence symptoms as compared to other groups,” says Dr. Ghobrial.

It’s also possible that you can develop long COVID if you’re reinfected for a second or third time with COVID-19.

Fatigue in long COVID

Sure, we all get tired from time to time. But when you’re experiencing fatigue, you’re overly tired to the point where it affects how you function. You may have trouble getting up in the morning and making it through the day. Your work and personal life can start to suffer, too.

Fatigue can be one of the most common symptoms reported in those with long COVID.

In fact, a recent study shows that almost 70% of people who initially had COVID-19 reported that they’re still experiencing fatigue three to 12 months after the initial infection.

So, how do you decipher between run-of-the-mill tiredness or something more? With long COVID, it’s feeling more tired than staying up too late or feeling exhausted after a grueling workout.

“It’s a feeling that people have reported that they haven’t felt before,” says Dr. Ghobrial. “It’s a different experience, a different feeling.”

How to treat fatigue in long COVID

Dr. Ghobrial says that it’s key to speak to a healthcare provider about any lingering fatigue you may have.

It’s also important to work with your doctor to pinpoint the reason for your fatigue, but there are lifestyle changes you can make to help manage those feelings of tiredness like:

• Focusing on quality sleep.
• Limiting alcohol.
• Eating a healthy diet.
• Managing your stress.
• Exercising often.
• Maintaining a healthy weight.
• Taking breaks throughout the day.

Breathlessness in long COVID

Known as dyspnea, shortness of breath is a tight feeling in your chest. It can be difficult to take deep breaths. While most people try to “catch their breath” after exercising or running, if you have long COVID, you may get winded or breathless just by walking around or going up a flight of stairs.

When you’re feeling short of breath after having COVID-19, it may also mean that your respiratory system may have been damaged during your infection. Testing like X-rays or CT scans can show any abnormalities.

“There is a recent study that shows that people who have self-reported symptoms despite normal imaging are more likely to experience depression and anxiety,” says Dr. Ghobrial. “It’s the role of the doctor to help educate and alleviate their concerns.”

There’s also a concern about shortness of breath and the stress it can put on your heart and cardiovascular system.

“Your heart will have to overwork to compensate for your shortness of breath,” explains Dr. Ghobrial. “If you’re hyperventilating, or breathing faster than the normal breathing, your expected heart rate and expected blood pressure will be higher than someone who’s just breathing normally. And this increased heart rate and blood pressure could be stressful for someone who already has a cardiovascular abnormality.”

How to treat breathlessness in long COVID

If you’re dealing with shortness of breath or other respiratory illnesses six to eight weeks beyond your initial COVID-19 infection, you should see a specialist for your symptoms.

“Your doctor can refer you to specific exercise programs designed for pulmonary function improvement or physical therapists who are specifically trained to help patients perform breathing exercises,” says Dr. Ghobrial.

Other ways to help with your lung function include:

• Exercise.
• Medication.
• Oxygen therapy.

When to seek treatment

If you think you have long COVID, don’t hesitate to talk to a doctor.

“You really need to be seen, be heard and report your symptoms,” stresses Dr. Ghobrial.

But he cautions that there are significant wait times for people who want to be seen by specialists for long COVID. Some clinics across the country have started multidisciplinary visits where you can be seen by a variety of specialties and receive any testing you may need.

Also, know that it can be tricky to pinpoint how exactly COVID-19 has affected you and your body.

“There hasn’t been any data yet today to show that one test or certain biomarkers can identify symptoms,” says Dr. Ghobrial. “So, oftentimes, we describe and explain what the tests show and talk to patients about the main one to three symptoms that are bothering them.”

And remember, there’s hope. It may take some time to see improvement, but your doctor can work with you on finding a solution that brings you relief.

“During follow-ups, people have said their long COVID symptoms are getting better and they’re able to perform their day-to-day activities,” reassures Dr. Ghobrial. “Their improvement is not on a day-to-day basis. It’s more on a week-to-week or month-to-month basis where they’re noticing that they’re feeling better.”