By Angel V. Rodis, MD—Program Director, Critical Care
Lead Physician, Virtua Pulmonology 

Since the COVID-19 pandemic first arrived in the U.S., health care experts have learned a lot about the condition, its symptoms, and how to manage them. As more people recover from COVID-19, experts are also learning that some people—including those who had a mild case of COVID-19 and those who were on a ventilator for weeks—are experiencing long-term, post-COVID symptoms. 

Mild cases may cause long-term symptoms

Approximately 85 percent of people with COVID-19 have mild symptoms. People with mild symptoms typically recover well and can manage their symptoms at home, sometimes with the help of their primary care provider. However, even after having a mild illness, some people are experiencing shortness of breath or a persistent cough that lasts for weeks or months. 

These symptoms also could be the result of an undiagnosed COVID-19 infection—especially if you developed them soon after the pandemic’s appearance in the U.S. before testing was available. 

Unfortunately, even though antibody testing is available, it may not be sufficient to conclude that a COVID-19 infection is the cause of your persistent symptoms. Health experts don’t yet know how long COVID-19 antibodies last in the body, and if you’re tested long after your initial infection, a negative result may not be conclusive. 

If you’re experiencing prolonged lung symptoms that you think may be COVID-19 related, it’s best to see your primary care provider (PCP). Your PCP will perform an exam and may order additional tests to rule out non-COVID causes of your symptoms, such as allergies, asthma, or bronchitis. 

If your PCP can’t identify an apparent cause for your symptoms—or if treatment is ineffective or testing reveals abnormal results—your doctor will refer you to a pulmonologist for further evaluation. 

Lingering symptoms after moderate-to-severe infection

Approximately 15 percent of patients with COVID-19 have moderate or severe symptoms that need to be treated in the hospital. Researchers are trying to figure out what causes some people to develop severe COVID-19 symptoms, while others experience only mild illness. 

People in this group may experience complications such as pneumonia or acute respiratory distress syndrome (ARDS). ARDS occurs when fluid fills the lungs and prevents normal breathing, reducing the amount of oxygen in the bloodstream and depriving organs of oxygen. Patients who experience severe symptoms usually require treatment in the intensive care unit (ICU). Although some patients may be able to receive respiratory support using high-flow oxygen, patients with ARDS typically need to be on a ventilator for days or weeks to help them breathe.  

The most common long-term symptoms in people who have been hospitalized are shortness of breath and fatigue. However, patients also have developed blood clots that could lead to pulmonary embolism (blood clot in the lung), stroke, problems with their trachea because of intubation, or cognitive difficulties as a side effect of treatment with medications or a ventilator. 

Expert pulmonology treatment

After patients with COVID-19 are discharged from the hospital, they need follow-up care from a pulmonologist to monitor their condition and manage lingering symptoms. Virtua offers a comprehensive Lung Wellness Program that connects patients with services, including specialty care from pulmonologists, thoracic surgeons, and cardiothoracic surgeons. 

Virtua patients who were hospitalized for COVID-19 treatment receive a wearable device after discharge that remotely monitors their blood oxygen levels, pulse, respiration rate, and body temperature. Monitoring these vital signs allows Virtua medical experts to intervene quickly if a patient experiences worsening symptoms. 

Treatment of lung symptoms primarily focuses on symptom relief, allowing the patient to feel better until the inflammation goes down and the lungs recover. Asthma medications such as bronchodilators or inhaled steroids often are used to relieve symptoms of wheezing, shortness of breath, and coughing. 

In some cases, these patients also require rehabilitation to help them regain their strength after hospitalization or ventilator use for an extended period. 

Recovery takes time

How quickly patients recover after COVID-19 depends on the severity of their symptoms, their age, and whether they have any other medical conditions that increase their risk for complications. 

If a patient had COVID-19 and developed pneumonia, full recovery could take 3-6 weeks. Recovery may take longer for patients who needed to be on a ventilator, especially if they’re older or have other lung conditions such as chronic obstructive pulmonary disease (COPD) or asthma. 

Although most patients see improvement in their breathing over time, and many experience a complete recovery, some patients may not see their breathing return to what was normal for them before having COVID-19. That’s because COVID-19 can cause permanent scarring or damage in the lungs. 

Prevention is key

As with COVID-19 care, there’s still a lot to learn about long-term COVID-19 management and recovery. The good news is that health care experts are already seeing some patients make a full recovery after spending weeks on a ventilator. 

But, until health care experts can understand COVID-19 more fully, the best thing that people can do is prevent COVID-19 infection in the first place and adjust their lifestyle to reduce their risk for developing more serious COVID-19 complications. 

Quitting smoking, maintaining a healthy weight, and managing chronic health conditions—especially those that affect the lungs—can make a significant difference. People who have preexisting lung conditions should take COVID-19 seriously and take steps to protect themselves as much as possible. 

It’s also crucial for members of the community to wear masks, practice social distancing, wash hands, and follow public health recommendations—including young and healthy people who may mistakenly believe that COVID-19 doesn’t pose significant health risks for them. 

To learn more about COVID-19 care at Virtua and find out about enhanced patient safety measures, call 888-847-8823 or check out our COVID-19 Updates.