​​If You Feel Certain Aches and Pains, You May Have "Long COVID," Say Physicians
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As we approach the holiday season, doctors continue to warn of a surge. “We expect to see and are already starting to see a rise in cases now,” Thomas Gut, DO, Associate Chair of Medicine at Staten Island University Hospital tells us. “The easing of restrictions and reduced use of masks will allow for easier transmission of the virus through the air. Thankfully, the severity of the virus has reduced as the virus has evolved further.” Although there has been an uptick in COVID cases in some areas, the death rate is dropping. NBC reports, “According to NBC News data, Covid deaths have fallen consistently since Aug. 31, when the seven-day average of daily Covid deaths was at 571. A month later, on Sept. 30, the number fell to 475. By Halloween, 365 were dying per day, on average, from Covid.” While deaths from COVID have declined, the virus is still worrisome.  

Dr. Mark Fischer, Regional Medical Director at  International SOS tells us, “COVID is less deadly compared to previous years due to vaccines, boosters and treatments. However, COVID is still a major concern in the U.S. as the CDC still reports thousands of deaths per week. It’s imperative that those who are unvaccinated get their vaccines and that people keep up with their boosters to continue to see the decrease.”

Long COVID is another concern of the virus health officials have. The Centers for Disease Control and Prevention states, “New data from the Household Pulse Survey show that more than 40% of adults in the United States reported having COVID-19 in the past, and nearly one in five of those (19%) are currently still having symptoms of ‘long COVID.’ Eat This, Not That! Health spoke with experts who share what to know about long COVID and signs that indicate you could have it. Please consult your physician for medical advice. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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Dr. Jaclyn Leong, Co-Director UCI Health COVID Recovery Clinic tells us, “Long COVID symptoms vary and do not have a set of specific diagnostic criteria right now, therefore, making it challenging to identify. If you have been infected with COVID before then there is the possibility of having this disease.” Dr. Jacob Hascalovici MD, PhD and Clearing Chief Medical Officer says, “People should know that long COVID can have a lingering impact and that it can be difficult to tell which symptoms are signs of long COVID and which might be due to different causes.” 

The Mayo Clinic states, “Post-COVID-19 syndrome involves a variety of new, returning or ongoing symptoms that people experience more than four weeks after getting COVID-19. In some people, post-COVID-19 syndrome lasts months or years or causes disability. Research suggests that between one month and one year after having COVID-19, 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19. Among people age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19.”

Sick young woman lying in the bed covered with blanketSick young woman lying in the bed covered with blanket
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Although many people equate COVID to the flu, it’s not. Dr. Leong explains, “COVID-19 and the flu have similarities and differences. COVID-19 and the flu can result in severe illness and complications in those with increased risk such as older adults, with underlying medical conditions. The differences are that COVID-19 seems to cause more severe illness in some people and severe COVID-19 infection can result in hospitalization and death in healthy people.  

Furthermore, most people who get the flu will recover on their own or may have secondary complications such as bacterial infection. Complications following a COVID-19 infection include increased risk of blood clots, multisystem inflammatory syndrome, or post-covid conditions that may last from months to years. These complications with COVID-19 may even occur in patients that have no symptoms or are asymptomatic from their acute infection.”  

Thoughtful girl sitting on sill embracing knees looking at window, sad depressed teenager spending time alone at home, young upset pensive woman feeling lonely or frustrated thinking about problemsThoughtful girl sitting on sill embracing knees looking at window, sad depressed teenager spending time alone at home, young upset pensive woman feeling lonely or frustrated thinking about problems
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According to Dr. Hascalovici, “Anxiety, depression, stress, and similar conditions related to mental health can increase the chances a person will experience long COVID. Unfortunately, having COVID could predispose people to depression for about a year after the infection, and depression that isn’t characteristic for you, especially if it accompanies fatigue, can be a sign of long COVID.”

The Harvard Gazette reports, “Psychological distress, including depression, anxiety, worry, perceived stress, and loneliness, before COVID-19 infection was associated with an increased risk of long COVID, according to researchers at Harvard T.H. Chan School of Public Health. The increased risk was independent of smoking, asthma, and other health behaviors or physical health conditions.

“We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID,” said Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School who led the study. “Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension.”

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Dr. Hascalovici says, “Muscle pain (myalgia) can mean you might be a long hauler. The COVID infection can damage muscle fibers, affect your immune system, or contribute to clots that impede blood flow through the muscles. This can all add up to persistent muscle pain that may be constant or may ebb and flow. The pain may last for a few extra weeks or may linger for months. If you’re feeling it, light exercise and activity, coupled with low inflammation eating and a visit to your physician could help decrease the pain and soreness.”

An article posted on the National Library of Medicine states, “Myalgia is a common symptom in patients with viral infections such as novel coronavirus disease 2019 (COVID-19) and influenza. Myalgia reflects generalized inflammation and cytokine response and can be the onset symptom of 36% of patients with COVID-19. Back pain in COVID-19 may usually indicate pneumonia. Why is the common myalgia caused by COVID-19 longer and more severe than myalgia of other viral infections? Myalgia and fatigue in patients with COVID-19 may be longer in duration than other viral infections and may be unresponsive to conventional painkillers. According to our observation, when viral load is reduced with virus treatment, muscle pain may decrease. In addition to the classic mechanisms of myalgia known in viral infections, COVID-19 can cause musculoskeletal pain with completely different mechanisms.”

Woman in pain sitting on a bed.Woman in pain sitting on a bed.
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Dr. Leong says, “Continued symptoms, returning or new symptoms such as chronic fatigue, cough, shortness of breath, or chest pain is an indication of long COVID. If symptoms after acute COVID have not gone away after 4 weeks such as cough, shortness of breath, or chest pain this may indicate that you may have Long COVID. Patients that do not have long COVID typically resolve their acute symptoms and do not have lingering or returning symptoms after acute COVID-19. Also, if you’ve had an asymptomatic infection of COVID, then later develop new symptoms that seemingly appear spontaneously, maybe due to long COVID. 

It is common that our long COVID patients will have normal blood tests and imaging. Diagnostics may return normal, but the symptoms are still there. This does not mean the symptoms are not real or there isn’t real pathophysiology occurring. As we learn more about Long COVID, we may in the near future have diagnostic tests and treatment for helping us alleviate this illness.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

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