Long-COVID

or

Post-acute sequelae of COVID (PASC)

WHAT IS long-covid or PASC?

Long-COVID is an emerging condition and is not well-understood. Long-COVID refers to lingering symptoms following the initial COVID-19 infection that are not explained by any alternative diagnosis. 10-20% of individuals who have recovered from COVID-19 infections will experience symptoms of long-COVID. Symptoms of long-COVID typically occur about 4 weeks to 3 months from the initial COVID-19 infection. In order to get a diagnosis of long-COVID, these symptoms need to last for at least 2 months. Individuals living with long-COVID and who are not currently experiencing an active COVID-19 infection are not infectious to others.

These symptoms can be novel, meaning they were not experienced during the acute infection, or ongoing. These symptoms can last weeks, months, or even years after the individual is first infected. These symptoms can occur in anyone that has had COVID-19 regardless of severity (mild, moderate, severe), whether they were hospitalized, or whether they were put on a ventilator. Females are more likely than males to experience long-COVID.

Long-COVID can be severely debilitating. Symptoms of long-COVID can result in inability to complete occupational requirements or day-to-day tasks of daily living. “Brain fog” after COVID, which is one of the most common long-COVID symptoms, resembles cancer-therapy-related cognitive impairments. Individuals with long-COVID who experience post-exertional malaise (PEM) or post-exertional symptom exacerbation (PESE) can experiences “crashes” that can last for hours to days. These “crashes” can be triggered by physical exertion, cognitive exertion, stress, dehydration, weather changes, consuming larger meals, alcohol consumption, and hormonal changes, such as during the premenstrual period.

WHAT ARE THE SYMPTOMS OF long-covid or pasc?

Individuals with long-COVID may experience any combination of the following symptoms:

  • "Brain fog"

  • Word finding problems

  • Difficulty with memory

  • Difficulty with attention

  • Difficulty with problem solving

  • Difficulty with executive function

  • Cognitive fatigue

  • Difficulty with communicating

  • Difficulty processing written information

  • Difficulty comprehending speech

  • Difficulty communicating via writing

  • Slurring words/speech

  • Speaking unrecognizable words

  • "Brain fog"

  • Word finding problems

  • Difficulty with memory

  • Difficulty with attention

  • Difficulty with problem solving

  • Difficulty with executive function

  • Cognitive fatigue

  • Vocal fatigue

  • Vocal quality changes

    • Breathiness

    • Hoarseness

  • Difficulty projecting the voice

  • Pain or discomfort while speaking

  • Vocal tract discomfort or sore throat

  • Difficulty breathing

  • Shortness of breath

  • Chest pain or tightness

  • Rapid breathing

  • Inducible laryngeal obstruction or paradoxical vocal fold motion

  • Chronic cough

WHAT can be done about long-covid or pasc?

  • Difficulty with communicating

  • Difficulty processing written information

  • Difficulty comprehending speech

  • Difficulty communicating via writing

  • Slurring words/speech

  • Speaking unrecognizable words

  • Anxiety, depression, or PTSD

  • Emotional lability

  • Irritability

  • Impulsivity/disinhibition

  • Difficulty swallowing or dysphagia

  • Loss of appetite

  • Change in taste

  • Change in smell

  • Gastrointestinal pain and problems

  • Nausea

  • Autonomic dysfunction

  • Headaches

  • Fatigue

  • Post-exertional malaise (PEM)

  • Vocal fatigue

  • Vocal quality changes

    • Breathiness

    • Hoarseness

  • Difficulty projecting the voice

  • Pain or discomfort while speaking

  • Vocal tract discomfort or sore throat

  • Post-exertional symptom exacerbation (PESE)

  • Neuropathies

  • Racing or pounding heart

  • Increased resting heart rate

  • Dizziness on standing

  • Postural Orthostatic Tachycardia Syndrome (POTS)

  • Tinnitus and/or earaches

  • Joint and/or muscle pain

  • Sleep problems

  • Vision impairment

  • Hair loss

  • Changes in menstrual cycle

There are treatment options for symptoms of long-COVID. Speech-language pathologists at Empowered Voice Rehabilitation LLC can assist in evaluation, management, and treatment of the following long-COVID symptoms:

  • Difficulty breathing

  • Shortness of breath

  • Chest pain or tightness

  • Rapid breathing

  • Inducible laryngeal obstruction or paradoxical vocal fold motion

  • Chronic cough

Additional treatment for other long-COVID symptoms may be provided by other members of the multi-disciplinary team. If you suspect that you may have long- COVID or have received a long-COVID diagnosis, seek out providers that are familiar with the diagnosis. Treatment techniques for long-COVID differ from treatment techniques used for other diagnoses. Ask you primary care physician for referrals to appropriate providers to manage your symptoms. There are ways to improve your quality of life after a long-COVID diagnosis.

Experiencing Long-COVID and need help?