Most people who develop coronavirus disease 19 (COVID-19) recover within 2–6 weeks, but some experience lasting symptoms. Others with severe COVID-19 may develop complications, require rehabilitation after a hospital stay, or both.
In addition to the physical impact of COVID-19, people may also experience changes in their mental health.
Below, we describe the long-term effects of COVID-19 on physical and mental health and explore the resources available for help.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.
Because COVID-19 is a new disease, scientists are unsure about the effects months or years after the initial illness.
Researchers have theorized that the virus responsible for COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may cause similar effects to other coronaviruses, such as those that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
According to a 2020 study, around 30% of people who recovered from severe SARS or MERS had long-term lung abnormalities. A 2009 study found that 40% of people who survived SARS still experienced chronic fatigue about 3.5 years later, on average.
But while SARS, MERS, and COVID-19 are caused by viruses from the same family, there are key differences among them, as the 2020 study highlights. For this reason, looking to the other two diseases does not provide a reliable way to predict COVID-19’s long-term effects.
Research into the impact of COVID-19 is ongoing. Initiatives such as the COVID Symptom Study are tracking peoples’ symptoms and the long-term consequences of the disease via a mobile app.
Most people who develop COVID-19 experience a mild or moderate illness that improves on its own. However, some people who have had a mild or moderate illness go on to develop lasting symptoms that can be severe — even after they have recovered from the initial infection.
When these symptoms are prolonged, people sometimes refer to the issue as “long COVID” or to the people who have it as “long-haulers.”
People with mild or moderate COVID-19 often go on to report:
- extreme fatigue
- muscle weakness
- a low-grade fever
- trouble concentrating
- lapses in memory
- mood changes
- trouble sleeping
- a sensation of pins and needles
- a loss of taste and smell
- a sore throat
- difficulties swallowing
- skin rashes
- shortness of breath
- chest pain
- heart palpitations
- the new onset of diabetes or high blood pressure
These symptoms may last for weeks or months after the body has cleared the virus.
It seems that anyone, including young people and those with no preexisting health conditions, can develop long COVID. Citing a telephone survey, the World Health Organization (WHO) observe that 20% of people aged 18–34 reported prolonged symptoms.
Around 10–15% of people who develop COVID-19 experience severe symptoms, and approximately 5% become critically ill. People with severe symptoms can also experience long COVID.
In addition, people with a more severe form of the illness may be more likely to experience complications. As the WHO note, the complications can involve damage to:
- The lungs: An August 2020 study found that people with severe COVID-19 are often discharged with signs of pulmonary fibrosis, a type of lung damage. In some people, it can cause long-term breathing difficulties.
- The heart: According to a June 2020 review, 20–30% of people hospitalized with COVID-19 have signs that the illness has affected their heart muscle. The researchers speculate that in some people, COVID-19 may also cause myocarditis, inflammation of this muscle.
- The nervous system: An April 2020 study with 214 participants found that people with severe COVID-19 were more likely to experience neurological manifestations, such as dizziness, nerve pain, and impaired consciousness.
Currently, doctors are not sure how these complications will affect people in the long term.
People who spend time in the hospital and require mechanical ventilation may also experience other difficulties. A July 2020 study lists the following complications of ventilator treatment:
- chipped teeth
- lacerated lips, tongue, or throat
- injured vocal cords
- collapsed lung
- heart rhythm problems
People who leave the hospital after having COVID-19 need ongoing support and rehabilitation to help them recover.
The COVID-19 pandemic has affected mental health on a large scale. According to an August 2020 review, many people felt an increase in stress, anxiety, depression, and sleep disturbances in response to the pandemic.
Some factors that can contribute to mental health difficulties during the pandemic include:
- isolation and loneliness
- difficulty working or the loss of employment
- financial struggles
- severe or lasting illness
- preexisting mental or physical health conditions
- emergency medical treatment
- grief and bereavement
Research also shows that people can experience severe stress while using a ventilator, due to their dependence on the machine to breathe. Some people also develop depressive disorders after ventilator treatment.
During the COVID-19 pandemic, many people have found it difficult to access treatment for their ongoing symptoms.
Below are just a few of the factors that have prevented people from accessing necessary medical care:
- Lack of awareness: Early in the pandemic, doctors were not aware that COVID-19 could cause lasting symptoms. Early guidance indicated that for most people, the illness would be short-term.
- Lack of information: Scientists are not yet sure what causes long COVID or how best to manage it. This can mean that even when doctors are aware of the potential long-term impact, they may not know how to provide treatment.
- False-negative test results: According to an article in BMJ, false negatives are common among people with COVID-19. This, coupled with a lack of access to testing in some areas, means that many people with long COVID do not receive medical attention. For this reason, the article’s authors recommend that doctors do not require positive test results in order to diagnose chronic COVID-19 symptoms.
More resources may now be available for support. These include:
Numerous healthcare centers in the United States and elsewhere have set up post-COVID clinics to help people recover from the illness.
Many of these clinics aim to help people who have spent time in the hospital. They focus on helping people with breathing and rebuilding muscle strength and also provide psychological care for people with anxiety or depression. Examples of these clinics include:
- The Post-COVID Assessment and Recovery Clinic at Penn Medicine, in Philadelphia, PA
- The Center for Post-COVID Care, part of the Mount Sinai Health System, in New York City
- The COVID-19 Follow-up Clinic at the University of California, San Francisco
An increasing number of providers are also establishing clinics for long COVID.
If a person cannot reach a clinic in person, they may be able to request a phone or video appointment.
Apps and online tools
Some health organizations have developed online tools to provide people with information and guidance as they recover from COVID-19. Two examples include:
- the Your COVID Recovery portal from the United Kingdom’s National Health Service
- the Mental Health and COVID-19 Information and Resources portal from Mental Health America
A person may also be able to access therapy and other mental health support online, via an app, or over the phone.
Online support groups can help people understand that they are not alone and provide a platform for talking through experiences. Some support groups have been involved in efforts to research long COVID.
Some examples of these groups include:
Many people with lasting COVID-19 symptoms report episodes of extreme fatigue, and some have expressed concern that COVID-19 may cause chronic fatigue syndrome (CFS).
CFS, or myalgic encephalomyelitis, is a long-term condition that can follow a viral illness, causing symptoms such as:
- severe physical fatigue
- mental fatigue, sometimes called “brain fog”
- difficulty sleeping
- muscle pain
- symptoms that get worse after exercise, called post-exertional malaise
While many people with long COVID experience these or similar symptoms, it is unclear whether long COVID is — or could lead to — CFS.
Some researchers view long COVID as a separate phenomenon, calling it post-COVID-19 syndrome or a post-viral syndrome.
In a letter to the editor of the journal Medical Hypotheses, scientists emphasize the importance of studying and finding treatments for post-COVID-19 syndrome.
Anyone experiencing new or persistent symptoms following recovery from COVID-19 should contact a doctor, by phone, if possible.
The doctor can assess the symptoms and, if needed, perform diagnostic tests to check for complications. They can also to help monitor and manage the symptoms over time.
If a person experiences severe or rapidly worsening symptoms, they should seek emergency medical help. Some of these concerning symptoms include:
- chest pain or pressure
- difficulty breathing
- a change in the color of the lips —which may appear blue in people with lighter skin or grey or white in people with darker skin
- an inability to stay awake
- an inability to keep liquids down
- rapid weight loss or gain
For anyone struggling with anxiety, grief, or depression, a doctor, a therapist, or another mental health professional can help.
Most people who develop COVID-19 experience mild symptoms and recover without treatment. However, as SARS-CoV-2 is a new virus, researchers are still learning about the long-term effects of the disease that it can cause.
Currently, doctors know that COVID-19 can cause lasting symptoms. Some call this issue long COVID or post-COVID-19 syndrome. When it is severe, COVID-19 can also cause lasting organ damage.
These and other experiences related to the pandemic can be traumatic, affecting a person’s mental health.
As scientists gather more data, they become better equipped to find effective treatments and management strategies.
To protect oneself and others, it is crucial to follow the COVID-19 prevention guidelines from the Centers for Disease Control and Prevention (CDC).