February 19, 2021

UW Health Expert Offers Latest Information on COVID-19 'Long Haulers'

Madison, Wisconsin - COVID-19 "long haulers" is the informal term used for people who have recovered from COVID-19 but have one or more chronic symptoms that continue for many months.

The scientific term is "post-acute COVID-19 syndrome," and health experts are continually learning more about it.

Dr. Aurora Pop-Vicas, infectious disease specialist, is focused on this phenomenon at UW Health and can share what experts know so far.

Who is most likely to get post-acute COVID-19 syndrome?

From what we know so far, there are two main categories of "long haulers."

  • First, patients who have been hospitalized for weeks or months in the ICU often have greatly impaired function after being on prolonged life support. Some of these patients could also be recovering from severe complications caused by the virus, such as strokes, blood clots, cardiovascular disease, or other related organ damage.

  • Second, some patients who had only mild COVID-19 illness, not requiring hospitalization or other critical medical treatments, have developed either new or recurrent symptoms persisting for months after the initial infection. Many are young, previously healthy individuals. Research is currently underway to determine the risk factors that may predispose someone to this syndrome.

What are the most common symptoms of post-acute COVID-19 syndrome?

  • The most common post-COVID-19 symptom consistently reported in the studies to date is fatigue or generalized muscle weakness.

  • Shortness of breath, palpitations, sleeping difficulties, anxiety, depression, joint pain, chest pain, altered smell or taste, headaches, cognitive difficulties (brain fog) are also common. Not surprisingly, these symptoms significantly impair quality of life and can make normal activities very challenging.

How common is post-acute COVID-19 syndrome?

  • In studies of patients who required hospitalization for COVID-19, up to 75 percent reported at least one symptom persisting six months after infection.

  • Additionally, one in five still showed evidence of decreased lung function six months later, even if they did not require oxygen during their hospitalization.

  • The syndrome is less common in patients who had mild COVID-19 infection and did not require hospitalization. According to reports from large population-based studies, approximately 10-20% of these patients go on to develop "long-haul COVID."

Why does post-acute COVID-19 syndrome happen?

  • Research into the reasons behind post-acute COVID-19 syndrome are ongoing.

  • Some believe it is due to an over-reactive immune response to the virus, or the result of persistent inflammation after the initial infection.


  • A treatment specific to these "long haulers" has not yet been identified. Pending more research, treatment would be determined based on the patient's individual symptoms and condition.

  • Management includes a multidisciplinary approach, relying on what we have learned from similar syndromes.

  • In previous, related syndromes, most patients eventually returned to normal, with holistic support, rest, symptomatic treatment and progressive activity increases, as tolerated.

  • Patients with new or worsening COVID-19 symptoms should undergo a comprehensive medical evaluation to rule out anything serious or life-threatening, be referred to specialty clinics, if appropriate and formulate an individualized rehabilitation plan.


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