SEATTLE — Countless people continue to report lingering symptoms long after recovering from a bout with COVID-19. Dubbed “long COVID,” this troubling malady can manifest in a number of ways, including persistent trouble breathing, unshakable brain fog, and ongoing aches and pains, just to name a few of the most common ailments. Now, new research is finally shedding some light on the subject of what long COVID really is.

Scientists at the University of Washington School of Medicine report long COVID is not just one single condition after all and should not be treated as such. The study also notes that long COVID symptoms often change over time, with many patients frequently reporting both headaches and fatigue.

Researchers assessed persistent symptoms experienced by patients with COVID-19 at both three and six-month intervals. In total, this project encompassed 5,963 patients (4,504 tested positive for COVID-19, 1,459 tested negative). Many patients (about 2,000) came from King County through the University of Washington School of Medicine.

The four major symptom categories among people who tested positive for COVID-19 were:

  • Minimal symptoms (72% of cases)
  • Tiredness, headache, and muscle/joint aches (17% of cases)
  • Tiredness, headache and muscle/joint aches in addition to loss of taste and smell (5%)
  • Symptoms across multiple systems (6%)
Woman feeling sick on couch with COVID or flu symptoms
(© Paolese –

This study is especially noteworthy and clinically significant because it displays how long-term symptoms tied to COVID-19 change over time, notes senior author Kari Stephens, the Helen D. Cohen Endowed Professor and research section head in the Department of Family Medicine and an adjunct professor in the Department of Biomedical Informatics and Medical Education at the University of Washington School of Medicine.

Several prior studies centered on long COVID chose to focus primarily on the individual symptoms while failing to consider clusters or patterns of symptoms. Many of those projects didn’t even have comparison groups and relied on data captured by providers during clinic visits, as opposed to directly from the patients themselves.

“This study also gives providers information about how long-term outcomes for COVID may look and present in patients over time,” Stephens says in a university release. “This study will help us understand how we need to treat long COVID over time, in very specific ways for each patient depending on how their symptoms present.”

This project was unique in the sense that people were able to report symptoms directly, regardless of whether or not they received formal medical care.

“While it is becoming increasingly clear that long COVID is not a singular condition, having data showing several distinct, symptom-defined phenotypes is a strong step towards developing evidence-driven approaches to treat the millions of people who continue to experience lingering symptoms,” explains lead author Michael Gottlieb, vice chair of research for emergency medicine at Rush University Medical Center.

All in all, researchers conclude this work will help determine funding and policy support for future long COVID programs.

“We don’t want to forget about long COVID as we all go back to ‘normal,’” Dr. Stephens adds. “New long COVID cases are occurring every day.”

Currently, the CDC estimates that 11 percent of people who contracted COVID-19 are currently experiencing long COVID symptoms. The close to 6,000 participants examined for this study began self-reporting symptom data via detailed surveys starting around December 2020, and were then tracked for up to 18 months. This part of the project ended in September 2022.

The study is published in Open Forum Infectious Diseases.

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