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Why does COVID-19 make some people sick for months?

Why does COVID-19 make some people sick for months?

This article was published on
June 7, 2020

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Because the COVID-19 virus is new, we still don't know why some people might become sick longer than others—but we do know that people infected with COVID-19 who have severe symptoms tend to have symptoms for longer than those with mild cases. Differences in immune responses, including lower levels of antibody production, can impact how long patients remain sick with COVID-19. COVID-19 can impact many organs, which might help explain why the virus can cause symptoms that continue over a longer period of time in some patients. Akiko Iwasaki, a Yale immunology doctor, believes some potential reasons the virus lasts longer in some patients is because the virus might remain in one of the organs that is not tested by nasal swabs; that non-living parts of the virus can still cause your immune system to overreact like the virus is still alive and reproducing in your body when it isn't really doing that; and the virus might not be present in your body any longer, but your immune system is stuck in the state of fighting it off. Additionally, after becoming infected with different viruses, your body can take a while to heal. So even if you don't have the virus anymore, you may continue coughing and not be able to breathe as well as you normally do, since your throat and lungs have yet to fully heal and recover. Currently, the majority of patients infected with COVID-19 have symptoms for several days - 6 weeks.

Because the COVID-19 virus is new, we still don't know why some people might become sick longer than others—but we do know that people infected with COVID-19 who have severe symptoms tend to have symptoms for longer than those with mild cases. Differences in immune responses, including lower levels of antibody production, can impact how long patients remain sick with COVID-19. COVID-19 can impact many organs, which might help explain why the virus can cause symptoms that continue over a longer period of time in some patients. Akiko Iwasaki, a Yale immunology doctor, believes some potential reasons the virus lasts longer in some patients is because the virus might remain in one of the organs that is not tested by nasal swabs; that non-living parts of the virus can still cause your immune system to overreact like the virus is still alive and reproducing in your body when it isn't really doing that; and the virus might not be present in your body any longer, but your immune system is stuck in the state of fighting it off. Additionally, after becoming infected with different viruses, your body can take a while to heal. So even if you don't have the virus anymore, you may continue coughing and not be able to breathe as well as you normally do, since your throat and lungs have yet to fully heal and recover. Currently, the majority of patients infected with COVID-19 have symptoms for several days - 6 weeks.

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What our experts say

Because the COVID-19 virus is new, we still don't know why some people might become sick longer than others—but we do know that people infected with COVID-19 who have severe symptoms tend to have symptoms for longer than those with mild cases.

Differences in immune responses, including lower levels of antibody production, can impact how long patients remain sick with COVID-19. COVID-19 can impact many organs, which might help explain why the virus can cause symptoms that continue over a longer period of time in some patients. Akiko Iwasaki, a Yale immunology doctor, believes some potential reasons the virus lasts longer in some patients is because the virus might remain in one of the organs that is not tested by nasal swabs; that non-living parts of the virus can still cause your immune system to overreact like the virus is still alive and reproducing in your body when it isn't really doing that; and the virus might not be present in your body any longer, but your immune system is stuck in the state of fighting it off.

Additionally, after becoming infected with different viruses, your body can take a while to heal. So even if you don't have the virus anymore, you may continue coughing and not be able to breathe as well as you normally do, since your throat and lungs have yet to fully heal and recover.

Currently, the majority of patients infected with COVID-19 have symptoms for several days - 6 weeks.

Because the COVID-19 virus is new, we still don't know why some people might become sick longer than others—but we do know that people infected with COVID-19 who have severe symptoms tend to have symptoms for longer than those with mild cases.

Differences in immune responses, including lower levels of antibody production, can impact how long patients remain sick with COVID-19. COVID-19 can impact many organs, which might help explain why the virus can cause symptoms that continue over a longer period of time in some patients. Akiko Iwasaki, a Yale immunology doctor, believes some potential reasons the virus lasts longer in some patients is because the virus might remain in one of the organs that is not tested by nasal swabs; that non-living parts of the virus can still cause your immune system to overreact like the virus is still alive and reproducing in your body when it isn't really doing that; and the virus might not be present in your body any longer, but your immune system is stuck in the state of fighting it off.

Additionally, after becoming infected with different viruses, your body can take a while to heal. So even if you don't have the virus anymore, you may continue coughing and not be able to breathe as well as you normally do, since your throat and lungs have yet to fully heal and recover.

Currently, the majority of patients infected with COVID-19 have symptoms for several days - 6 weeks.

Context and background

COVID-19 has been shown to have varying effects on different individuals, including symptoms and secondary health effects. This range of outcomes makes it difficult to know the estimate length of impact COVID-19 might have on an individual. One example of a secondary outcome is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — a long-term reappearance of symptoms — clusters of which have followed many infectious outbreaks. Increased data and corresponding analysis will help to provide more empirical evidence on how long COVID-19 adversely impacts individuals, what symptoms are most prevalent, and what secondary outcomes are most common.

COVID-19 has been shown to have varying effects on different individuals, including symptoms and secondary health effects. This range of outcomes makes it difficult to know the estimate length of impact COVID-19 might have on an individual. One example of a secondary outcome is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — a long-term reappearance of symptoms — clusters of which have followed many infectious outbreaks. Increased data and corresponding analysis will help to provide more empirical evidence on how long COVID-19 adversely impacts individuals, what symptoms are most prevalent, and what secondary outcomes are most common.

Resources

  1. Clinical Questions about COVID-19: Questions and Answers (U.S. CDC)
  2. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) (U.S. CDC)
  3. COVID-19 and Multiorgan Response (CPC)
  4. Coronavirus disease (COVID-19) outbreak (WHO)
  5. COVID-19 Can Last for Several Months (The Atlantic)
  6. Researchers warn covid-19 could cause debilitating long-term illness in some patients (Washington Post)
  7. A woman says she's had 8 positive coronavirus tests in 50 days. How long can it really take to recover? (CBS News)
  8. Clearance and persistence of SARS‐CoV‐2 RNA in patients with COVID‐19 (Journal of Medical Virology)
  1. Clinical Questions about COVID-19: Questions and Answers (U.S. CDC)
  2. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) (U.S. CDC)
  3. COVID-19 and Multiorgan Response (CPC)
  4. Coronavirus disease (COVID-19) outbreak (WHO)
  5. COVID-19 Can Last for Several Months (The Atlantic)
  6. Researchers warn covid-19 could cause debilitating long-term illness in some patients (Washington Post)
  7. A woman says she's had 8 positive coronavirus tests in 50 days. How long can it really take to recover? (CBS News)
  8. Clearance and persistence of SARS‐CoV‐2 RNA in patients with COVID‐19 (Journal of Medical Virology)

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