As the last vestiges of the pandemic are fading away, many North Carolinians are still living with lingering aftereffects of a COVID-19 infection.

About one in six state residents have experienced long COVID, according to the Centers for Disease Control and Prevention.

Here’s an updated guide to the condition:

Do you have long COVID?

There’s no test that will definitively tell a physician whether you have long COVID or not.

“A lot of our testing is just based on excluding other things that could cause the same symptoms,” said Dr. Louise King, co-director of UNC Long COVID Recovery Clinic.

Doctors often try to exclude conditions like anemia and thyroid disorders to determine whether the patient’s symptoms are truly related to their COVID infection, she said.

Although earlier COVID variants tended to cause longer-term respiratory complications, newer Omicron variants make fatigue the most common symptom of long COVID, King said.

Other common symptoms include:

  • Brain fog

  • Headaches

  • Shortness of breath

  • Joint pain

Patients must experience these symptoms for at least a month before they could be considered part of long COVID, according to the definition set by the CDC.

Why do patients develop long COVID?

Experts still don’t know exactly why some people have lingering symptoms months afterCOVID infections.

There are three major theories in the scientific community, King said:

  • Viral particles from the initial COVID infection stay in the body long after the initial infection has passed.

  • The COVID-19 infection causes long-lasting inflammation in the body.

  • The initial infection causes the body’s immune system to start attacking itself.

The most likely explanation involves a combination of all of these theories, King said.

What long COVID treatments are available?

Because researchers still don’t know what causes long COVID, treatments are largely targeted at reducing symptoms, rather than treating root causes.

Many patients benefit from learning strategies to manage their energy levels, said Christie Palagonia, a physical therapist and program director at the WakeMed Pulmonary Rehab.

Therapists like Palagonia often teach patients to try and mitigate their symptoms, whether that be with breathing exercises or by restructuring their schedules.

Though there isn’t a “magic pill,” some patients may benefit from medications that target specific long COVID symptoms like anxiety and depression.

Luckily, most people recover from long COVID, especially between the first and third month of having the condition, King said.

Triangle resources to help cope

If a person suspects they have long COVID, they should schedule an appointment with their primary care provider, who can perform some preliminary tests, King said.

If those tests suggest that long COVID is likely, appointments with a physical therapist might be in order, King said. There are also Triangle clinics focused on treating long COVID, like the UNC Long COVID Recovery Clinic, though these programs often have long waitlists.

WakeMed Spiritual Care also offers a virtual peer support group for patients with long COVID. Those interested can contact Sara Robb- Scott for more information at [email protected].

Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

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