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New Study Shows 4 Categories of Long COVID Symptoms To Watch Out for—Do These Signs Sound Familiar?

By Kaitlin Vogel,


If these sound familiar, it's time to call your doctor.

While long COVID affects everyone differently, there is a new study that reveals four major types of symptoms.

Researchers found symptoms fall under the following categories:

  • Heart, kidney and circulatory problems
  • Respiratory issues, anxiety , sleep disorders and chest pains
  • Musculoskeletal and nervous system issues, including arthritis
  • Digestive and respiratory issues

Interestingly, results also indicated which long COVID symptoms were most prevalent: The heart, kidney and circulatory system subtype affected most people (34%) followed by respiratory, anxiety and sleep issues (33%). Musculoskeletal and nervous system issues and digestive problems were much less prevalent, according to researchers.

Another finding worth noting: Two-thirds of the people affected by respiratory issues, sleep disorders, anxiety and chest pain were women.

Why Most People Are Affected by Heart, Kidney and Circulatory Symptoms

It's no surprise that the heart, kidney and circulatory system subtype was found to be the most common in this study, Dr. William Li, MD and author of Eat to Beat Your Diet: Burn Fat, Heal Your Metabolism, and Live Longer , explains. Infection by the coronavirus that causes COVID-19, SARS-CoV-2, is known to infect the lining of blood vessels.

“This was work my colleagues and I published in the New England Journal of Medicine early in the pandemic, when we made the discovery that COVID is a vascular disease that affects your circulation,” says Dr. Li. “COVID damages the lining of blood vessels, damages the circulation, and this causes heart, kidney and other organs to be compromised.”

One of the cardinal signs of circulatory damage is blood clots. Tiny clots that can form anywhere you have blood vessels are now suspected to cause many of the symptoms of COVID and may still be occurring in patients with long COVID.

Other underlying causes of long COVID are attributed to chronic smoldering inflammation as well as signs of autoimmune reactions. The heart, kidneys and circulation are vulnerable to these insults as well, Dr. Li adds.

Related: This Easy 15-Minute Practice May Treat Side Effects of Long COVID

What Could Be the Reason Behind the Different Symptoms Between Men and Women?

The reason for the gender differences is unclear. It is known that the bodies of men and women function differently, including the powerful effects of sex hormones, and this may contribute to the cluster differences, Dr. Li explains.

This study was observational, based on patients who were infected by the ancestral virus causing COVID, and in 2020, the capture of clinical data was not consistent, so further studies are needed to define sex differences as well as whether this pattern is still present now that Omicron and its subvariants have become the dominant—and less severe—versions of the virus that causes COVID. It’s clear that the disease “COVID” in 2023 is not the same as COVID-19, which rained death and destruction on so much of the world, Dr. Li states.

Related: New Research Says These 4 Factors Might Mean You're More Likely to Get Long COVID

“These three symptom clusters lump together symptoms of post-viral chronic fatigue syndrome and fibromyalgia (CFS/FMS),” says Jacob Teitelbaum, MD . “The hallmark symptoms of CFS/FMS are fatigue, musculoskeletal pain, cognitive dysfunction, palpitations, numbness and tingling, shortness of breath with associated anxiety and insomnia . This symptom mix represents the key PASC group.”

Chronic fatigue syndrome and fibromyalgia reflect immune dysfunction. And, as is seen in numerous immune diseases such as lupus, arthritis, multiple sclerosis and CFS/FMS, about 75% of those affected are women.

A woman’s immune system is very different than a man’s, Dr. Teitelbaum adds. A woman must be able to carry a baby for nine months without rejecting it as a foreign body. Also, a large percentage of the immune system genes are on the X chromosome. Women have two X chromosomes, while men only have one. It is suspected that this is why women are far more prone to immune and autoimmune conditions in general.

Treatment Options for Long COVID

The diagnosis of long COVID remains murky. This condition, also known as PASC (Post-Acute Sequalae of COVID-19), is made of more than 200 different signs and symptoms which are not always present in every individual, though some are more common than others, Dr. Li explains.

Intensive research is underway to define the spectrum of long COVID, which can be disabling. At the moment, the treatment is mostly supportive, meaning attempts to provide symptom relief rather than a cure. There are a number of experimental treatments also being tested, in individual patients as well as in clinical trials.

However, as medical research uncovers the underlying pathology behind long COVID, more specific treatments will be developed. For example, specific therapies may be directed toward healing the circulation, dampening inflammation or halting autoimmunity.

There may also be dietary factors that can help reduce inflammation and autoimmunity and help to heal the circulatory damage of COVID infection.

The big goal is to find ways to prevent long COVID to begin with. Some progress has been made, Dr. Li adds. For example, it was recently reported that the diabetes medication called metformin reduced the development of long COVID by 42%.

Next up: Is There Treatment for Long COVID? Here’s Everything You Need To Know if You’re Still Experiencing Symptoms


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