What Are the Most Common Long COVID Symptoms?
Fatigue is the most common, affecting 47% of Long COVID patients. This comprehensive review of 27 studies found that shortness of breath (32%), muscle pain (25%), and joint pain (20%) were also highly prevalent. About 1 in 5 people have symptoms for 5 weeks or more, and 1 in 10 experience them beyond 12 weeks.
This review from the Journal of the Royal Society of Medicine analyzed the current evidence on Long COVID symptoms, complications, and management. The findings reveal that persistent symptoms occur regardless of how severe the initial COVID-19 infection was.
The 10 Most Common Long COVID Symptoms
Researchers pooled data from 27 studies and found these symptoms most often:
- Fatigue: 47% (95% CI 31-63)
- Shortness of breath: 32% (95% CI 18-47)
- Muscle pain: 25% (95% CI 13-37)
- Joint pain: 20% (95% CI 13-27)
- Headache: 18% (95% CI 9-27)
- Cough: 18% (95% CI 12-25)
- Chest pain: 15% (95% CI 9-20)
- Altered smell: 14% (95% CI 11-18)
- Altered taste: 7% (95% CI 4-10)
- Diarrhea: 6% (95% CI 4-9)
Other common symptoms included cognitive impairment (“brain fog”), memory loss, sleep disorders, palpitations, and sore throat.
Dr. Kumar’s Take
This review provides the most comprehensive picture of Long COVID symptoms I’ve seen. The 47% fatigue rate is striking. Nearly half of Long COVID patients struggle with tiredness that doesn’t go away with rest.
What’s particularly important is that these symptoms occur regardless of how sick you were initially. Even people with mild COVID-19 can develop persistent symptoms. One study found that 59% of patients with mild disease still had symptoms at 8-12 weeks.
The review also found two main symptom clusters: one with fatigue, headache, and upper respiratory complaints, and another with multi-system problems including ongoing fever and stomach issues.
Who Is at Higher Risk?
Several factors increased the risk of developing persistent symptoms:
- Older age
- Female gender
- Hospital admission at symptom onset
- Initial shortness of breath or chest pain
- Abnormal lung sounds during exam
- More symptoms during acute phase
- Pre-existing conditions, particularly asthma
- Need for oxygen therapy
- Pre-existing high blood pressure
- Chronic lung conditions
Having more than five symptoms in the first week of infection was significantly linked to developing Long COVID, regardless of age or gender.
Impact on Daily Life
Long COVID affects more than just physical health:
Employment:
- 40% unable to return to work within 8 weeks of hospital discharge
- One study found 70% still unable to work at 3 months
- Those who did return often needed reduced hours or changed duties
Quality of Life:
- Significant reductions in quality of life scores
- Patients with ongoing symptoms had overall quality of life scores of 43% compared to 67% in those without symptoms
Mental Health:
- 23% had anxiety or depression at 6-month follow-up
- A quarter of patients in one study had moderate-to-severe PTSD symptoms
- Women had higher odds of PTSD than men
Complications Beyond Symptoms
Long COVID can cause measurable problems in several organ systems:
- Lungs: 53% had decreased lung function capacity in one study at 30 days
- Heart: 78% had abnormal cardiac MRI findings at 2-3 months
- Brain: MRI scans showed possible disruption to brain structure at 3 months
- Kidneys: One-third of patients with acute kidney injury did not fully recover
Treatment and Management
Current treatment focuses on multidisciplinary care:
- Long-term monitoring of ongoing symptoms
- Physical rehabilitation, especially pulmonary rehabilitation
- Mental health support
- Management of pre-existing conditions
- Social services support for those unable to work
Treatment options remain limited because the underlying mechanisms of Long COVID are not yet fully understood.
Practical Takeaways
- Fatigue is the most common Long COVID symptom, affecting nearly half of patients
- Symptoms can persist regardless of initial illness severity
- Multiple symptoms in the first week may predict Long COVID development
- Physical rehabilitation may help improve breathing and exercise capacity
- Mental health support may be needed, especially for women
- Employment impacts are significant and may require accommodations
Related Studies and Research
- Athletic performance study
- Hyperbaric oxygen addresses pathophysiology of long COVID: Clinical review
- Ardenne Institute Official: Oxygen Multistep Therapy
- EWOT for exercise-induced low blood oxygen (88% improved)
FAQs
How long do Long COVID symptoms last?
About 1 in 5 people have symptoms for 5 weeks or more. About 1 in 10 have symptoms lasting 12 weeks or more. Some people experience symptoms for 6 months or longer.
Can you get Long COVID from a mild infection?
Yes. Studies show that persistent symptoms can develop regardless of how severe the initial infection was. Even people who had mild COVID-19 managed at home can develop Long COVID.
Is there a test for Long COVID?
Currently there is no single test. Diagnosis is based on having symptoms that persist beyond 4-12 weeks after COVID-19 infection without an alternative explanation.
Bottom Line
This comprehensive review of 27 studies reveals that Long COVID affects a significant proportion of COVID-19 survivors. Fatigue tops the list at 47%, followed by shortness of breath, muscle pain, and joint pain. Symptoms can persist for months regardless of initial illness severity, and impact quality of life, mental health, and employment. Risk factors include older age, female gender, and having multiple symptoms during acute infection. While treatment options remain limited, multidisciplinary care involving physical rehabilitation, mental health support, and symptom monitoring is recommended.
