I had COVID-19… am I okay?

COVID-19 is a virus, and like a great many other viruses, the damage that it does is due to the body’s reaction to it: inflammation. The symptoms well-known to the general population – shortness of breath, fatigue, loss of sense of taste or smell – are all the result of the body’s inflammatory responses to the virus. After the initial inflammation subsides, hopefully your symptoms do as well.

Yet some symptoms may linger as a result of damaged tissues. While most of the symptoms will resolve within the following month, some patients have experienced effect that have lingered for several week or months. The most common lingering symptom is simple fatigue, similar to what one may experience in the week or two after a bad bout of the flu. 

However, persistent fatigue may also be due to inflammatory damage to either the heart or lungs. Some patients after COVID have had damage to the small membranes in the lung that allow the normal transfer of oxygen into the blood. This might be mild enough to only cause fatigue, or severe enough to cause ongoing shortness of breath, particularly with any exertion. Also, inflammatory damage to the heart may lead to a decrease in its ability to pump blood to the rest of the body, either because of weakened heart muscle (known as “cardiomyopathy”), or due to an abnormal rhythm, like atrial fibrillation. Acute or worsening shortness of breath in post-COVID patients may also be due to recurrent pneumonia, or blood clots forming in inflamed blood vessels and moving into the lungs.

It is widely known by the public that COVID-19 may cause a loss of taste or smell. This is due to inflammation of the small nerve fibers that provide these senses; these small nerves may be damaged, or even destroyed, and may take months to regenerate or regain full function. This indicates that the virus has infected the central nervous system, including the brain and spinal cord. In the short run, it too may lead to chronic fatigue, unexplained, transient pains, or simply “brain fog.” In rare cases, it has led to strokes, seizures, or even partial temporary paralysis. It is also hypothesized that the effects of the virus may increase the chances of getting early onset Parkinson’s or Alzheimer’s disease, though this has yet to be proven.

A more common complaint following a severe battle with COVID-19 is lingering depression, or anxiety, or difficulties with memory or concentration. This is likely to be more pronounced in anyone that has had any significant hospital stay, particularly with a critical illness of any nature. Survivors of a serious illness are likely to feel run down, or even have a significantly altered mood for days to weeks after they return home. As with any illness, a prompt return to normal activities and daily routine is the desired goal, and within the limits of the individual and good judgement, will help the patient to recover more quickly. The inability to resume one’s normal living after more than a month following COVID-19 infection should prompt the individual to seek reevaluation from their primary physician. This would include a history, physical, basic lab work, and probably an EKG and follow-up chest x-ray. Taking zinc, vitamin D, and vitamin C regularly in addition to any prescribed medications in the post-infection month should also help your recovery.

What you do NOT need to do is get re-tested for COVID-19 if you have just had a confirmed case (a negative result would be meaningless, and you would not do anything different for a positive result). The most important thing to do, as with an early COVID-19 infection, is to see your primary physician early on to evaluate and monitor any symptoms, being reassured that most cases of COVID-19 resolve completely.

Dr. Patrick Conrad is the Weems Memorial Hospital emergency room director, responsible for operations and management of emergency room physicians and staff in providing acute, emergency, and critical care.