A Keck Medicine of USC physician shares facts about the lingering condition — and how a multidisciplinary clinic for long COVID is helping patients recover.
Patients who can’t shake the effects of COVID-19 — a condition known as “long COVID” — are not alone. One in 5 people continue to experience symptoms for weeks or even months after they have shed the COVID-19 virus, according to recent survey data from the Centers for Disease Control and Prevention.
“Researchers and clinicians have come a long way in understanding and treating long COVID,” she says. In March 2022, Keck Medicine opened the COVID Recovery Clinic — a multidisciplinary program led by a core team of clinicians specializing in primary care, pulmonology and physical therapy.
“One of my big goals is to help patients return to a more functioning life,” says Dr. McAuley, who answered some common questions about long COVID.
What are the symptoms of long COVID and how is it diagnosed?
Patients who are still experiencing symptoms more than 12 weeks after their initial illness may be diagnosed with post-acute sequelae of COVID-19 — also called long COVID or chronic COVID.
In some cases, symptoms may go away temporarily before reappearing later.
Long COVID symptoms can include:
- Chronic fatigue
- Shortness of breath
- Chest pain or heart palpitations
- Headaches and dizziness
- Difficulty concentrating or thinking, also known as brain fog
- Muscle aches or pains after physical activity
- Change in taste or smell
- Pins-and-needles sensation
- Stomach pain and diarrhea
- Depression or anxiety
A patient may be diagnosed with long COVID if there is no other explanation for their lingering symptoms, Dr. McAuley says.
“Providers do a full workup to make sure a patient’s issues aren’t coming from a different problem,” Dr. McAuley says. “For example, recurring headaches after an infection isn’t necessarily long COVID. It could be that the patient has a migraine disorder that began prior to having COVID. Providers analyze every option to ensure we diagnose people correctly.”
At Keck Medicine, the COVID Recovery Clinic’s core team works together — simultaneously seeing a patient in one visit, if needed — to create a detailed workup while partnering with a nurse navigator to form an integrated, personalized treatment plan.
Who can get long COVID?
A person previously infected with the COVID-19 virus is at risk for developing long COVID. The severity of their original infection is a key factor, as well as preexisting health conditions like heart disease, diabetes and chronic lung issues.
“The conditions that will predispose someone to having a more severe case of COVID could also predispose them toward having long COVID,” Dr. McAuley says. “If someone has more serious symptoms or ends up in the hospital, they are more likely to have a prolonged recovery.”
Long COVID affects women more often than men, Dr. McAuley says, and the patient’s age can also play a role.
“Older adults are more at risk compared to younger populations,” Dr. McAuley says. “But even in pediatric patients, we’ve seen that the older the child gets, the more likely they are to get long COVID.”
“It has to do with the immune system functioning appropriately,” Dr. McAuley says. “When you’ve been vaccinated, your body already knows what the virus looks like and has antibodies ready to address it.”
Is long COVID curable and what are my treatment options?
Long COVID is treatable, Dr. McAuley says, and research shows it’s possible to erase symptoms entirely. A large study from Scotland, published in Nature Communications in October 2022, found that more than half of long COVID patients fully recovered from symptoms within 18 months.
“The symptoms usually dictate the treatment,” she says. “My clinical opinion is that long COVID could actually be several different conditions, which is why we can’t treat them all the same way.”
At Keck Medicine, the primary treatments for long COVID include nonmedication strategies, such as occupational and physical therapy, and, sometimes, speech therapy. “A lot of things are technique-based and focus on helping patients cope with symptoms,” Dr. McAuley says.
Dr. McAuley talks about a patient with chronic headaches, as an example. “We would treat that case the same as any chronic headache disorder. There are certain medications that are shown to be helpful with that.”
But, she says, “it’s trickier when patients have prolonged shortness of breath, and yet, all their testing is normal. For some patients, we have them use an inhaler and see if that helps.”
How long does long COVID last?
There isn’t an established standard for how long a patient will experience long COVID, and the recovery time varies by individual. Dr. McAuley says Keck Medicine has seen patients fully recover in a few weeks, but she has also cared for some patients for two years.
She is hopeful that the COVID Recovery Clinic model can be replicated to help other long COVID patients find answers and relief.
“One of my goals is to find different ways of managing these patients so that primary care doctors could provide similar care, especially in areas where patients may not have access to a clinic like ours,” Dr. McAuley says.