Why Are Asymptomatic COVID-19 Patients Experiencing Long-Haul Symptoms?

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It is now well known that some people who contract severe cases of COVID-19 are likely to experience long-term symptoms months after the virus has cleared their body. Fatigue, headaches, brain fog, loss of smell and taste, muscle aches, shortness of breath, chronic cough and heart damage are reported in COVID-19 long-haulers.  

But now, research is showing that even those who have mild or asymptomatic COVID-19 infections (meaning they had little or no symptoms) can experience these long-haul symptoms of COVID-19. They feel fine while the virus is active in their body, but begin experiencing symptoms months after they’ve tested negative.

COVID-19 behaves so differently from person to person,” says Dennis Cunningham, M.D., medical director of infection control and prevention at Henry Ford Health System. “Some people get moderately sick right away and then the infection clears and they’re fine. Others get severely sick and have symptoms for months after, and still others have little or no symptoms while they have COVID-19 and then experience symptoms after the virus has cleared the body.”

Why do long-haul symptoms occur?

COVID-19 isn’t the only virus that can cause long-haul symptoms. Many viruses can cause post-viral symptoms, which occurs when the immune system has gone into overdrive to fight off a virus, causing inflammation and damage to other organs like the heart, brain and kidneys.

“With COVID-19, while some long-haul symptoms may be due to post-viral syndrome, other long-haul symptoms might be due to the virus itself,” says Dr. Cunningham. “COVID-19 directly affects the lungs, so that’s why shortness of breath and chest pains are common long-haul symptoms. It also affects the olfactory nerves, which detect smells. The olfactory nerves are connected to the brain, and because of that, COVID-19 could also directly affect the brain. There’s still more to learn about this virus.”

Why can asymptomatic people get long-haul symptoms?

It’s not entirely known why asymptomatic people can have long-haul symptoms. But even if you don’t experience noticeable side effects, it doesn’t mean COVID-19 isn’t taxing on your body: your immune system could still be going into overdrive and the virus could still be causing damage throughout your body.

Are long-haul symptoms more common based upon age or gender?

 Long-haul symptoms seem to slightly discriminate by age and gender: while men are more likely to experience severe cases of COVID-19, middle-aged women ages 40 to 60 are more likely to experience long-haul symptoms. One theory as to why this is that autoimmune conditions are more common in middle-aged women. And when your immune system goes into overdrive and damages other organs, it’s more likely that you’ll experience long-term symptoms.

“The best protection against experiencing long-haul symptoms is getting vaccinated,” says Dr. Cunningham. “Not only will getting vaccinated help prevent you from getting the virus, but in the unlikely case that you do get it, it will prevent you from having a case of COVID-19 that’s severe or that will leave you with lingering symptoms. There are also reports that some unvaccinated patients with COVID-19 long-haul symptoms may have symptom relief after vaccination.”

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Dr. Dennis Cunningham is the medical director of infection control and prevention at Henry Ford Health System.  

 

Categories: FeelWell