As one of three doctors at John Hopkins Medical Center that runs the post-COVID clinic, Panagis Galiatsatos, M.D. understands more than most the effects that long-term COVID symptoms can have on people’s lives. Numerous conversations with patients about ongoing symptoms make him well poised to answer some of the most pressing questions we have about the long-term effects of COVID-19. Here is what you need to know.

Q: Are certain age groups at higher risk of post-COVID?

I have personally seen that post-COVID seems to hit the younger age groups more severely. Fatigue, cognitive impairment and just overall not feeling like themselves happen across the board.

Q: What are the most common long-term symptoms?

One of the things I try to prepare patients for is that it is very common to have symptoms after a bad infectious disease, especially if it hits the lungs. So, when a patient comes in, I ask them “could your symptoms be a part of healing?” The most common symptom that signifies healing is a lingering cough because coughing is your lung’s way of sweeping out dead cells. In the case of COVID-19, this cough could last for as long as six months after the viral infection, especially if the patient contracted Omicron because it is more airway dependent than the original strain.

Shortness of breath is another common healing symptom because, as your lungs heal, they aren’t going to be functioning at 100% yet. However, be sure to talk with your doctor to make sure that there is not something else going on as these symptoms, accompanied by others may signal something more serious.

Outside of the lungs, I commonly see fatigue in many of my patients. Once again, this can be a part of the healing process but, if it doesn’t self-resolve within three months, it may signal something bigger. Other possible symptoms range from cognitive impairment to loss of smell and taste.

Though none of these may seem life-threatening, if any symptom is impacting your quality of life, you should speak with your healthcare provider.

Q: What symptoms may signal something more serious?

As a lung doctor, coughing or breathlessness that lingers beyond three months catches my attention. My biggest concern is seeing symptoms that may suggest post COVID-19 interstitial lung disease because that can be life threatening if not well managed. If caught early treatment can help stop the progression of the disease and prevent permanent lung scarring.

We know the virus can cause quite a depletion of certain immune cells, like lymphocytes, which can create some level of an autoimmune phenomenon. We see this with other viruses as well, which is why I encourage patients to have a conversation with their healthcare provider about any symptoms they are experiencing so we can determine if medication, like steroids, may help the healing process.

Q: What can patients do at home to manage their symptoms?

Especially for the lungs, exercise promotes healing because it increases blood flow which brings more healing cells into the lungs. The lungs are very good at realizing if certain parts are damaged or can’t be healed, they are going to make sure that the healthier parts can compensate, and exercise helps that. Talk to your doctor about whether your exercise should be monitored, perhaps with pulmonary rehabilitation to make sure that your heart rate and oxygen levels are OK. If your doctor decides that is not necessary, you can do your exercise at home. Exercise can be a simple as trying to speed up your morning routine or taking a few short walks.

Other things that I often suggest depend on the symptoms that you are experiencing. For example, for loss of smell, there is great data from research over 20 years ago that says that smelling lavender oil daily helps reignite the blood flow and potentially allows the olfactory nerves to kick back in. Or if you are struggling with fatigue, a physical therapist may have a suggestion about low-impact activities that can help you get your energy back.

The number one focus should be on not getting COVID-19 in the first place. The vaccine helps convert COVID-19 into something milder, but it won’t completely prevent post-COVID symptoms. So, you should continue to protect yourself as best you can by masking and maintaining good hygiene practices, especially if there is a surge in your area.

Learn more about what to expect post-COVID on our website.

Disclaimer: The information in this article was medically reviewed and accurate at the time of posting. Because knowledge and understanding of COVID-19 is constantly evolving, data or insights may have changed. The most recent posts are listed on the EACH Breath blog landing page. You may also visit our COVID-19 section for updated disease information and contact our Lung HelpLine at 1-800-LUNGUSA for COVID-19 questions.

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