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Keys to understanding long COVID

By: Lillee Gelinas, DNP, RN, CPPS, FAAN

Unlock the mystery to a clinical challenge.

Do you know someone with long COVID? I do. As a result, I’m trying to understand it as much as possible, so I can be compassionate and helpful. Because nurses are patient-centered and holistic, we’re naturally drawn to learn more about this latest clinical conundrum. The healthcare system overall wants to learn, too. Long COVID clinics are springing up all over the United States, as healthcare tries to come to grips with this challenging group of symptoms—some patients with long COVID report over 200 symptoms affecting various organ systems.

The Centers for Disease Control and Prevention describes long COVID (also known as post-COVID conditions, long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID) as a range of new, returning, or ongoing health problems experienced 4 or more weeks after first being infected with SARS-CoV-2.

Because there’s still much we don’t know about the condition, the best treatment remains a mystery. Our understanding of evidence-based treatments for long-COVID remains incomplete, so guidance will change over time as research sheds more light on the condition. I want to share what I’ve learned so far.

According to the Mayo Clinic in Jacksonville, Florida, patients with long COVID are placed into three categories:

  1. Patients with COVID-19 who don’t recover completely and have ongoing symptoms because of direct cell damage from the virus.
  2. Patients with symptoms related to chronic hospitalization.
  3. Patients with symptoms that appear after recovery.

My colleague falls into the third category, which is scary. Despite vaccinations and boosters, several of my family members and work colleagues were sick from COVID-19, so we wonder if one day we’ll fall into that third category, too.

The National Institutes of Health has divided long COVID into the following symptom clusters, and is trying to understand what drives illness within each.

  • Viral persistence: The virus stays in the body.
  • Autonomic dysfunction: Changes in the ability to regulate heart rate, body temperature, breathing, digestion, and sensation.
  • Sleep disturbances: Changes in sleep patterns or the ability to sleep.
  • Cognitive dysfunction: Trouble thinking clearly or brain fog.
  • Exercise intolerance/fatigue: Changes in a person’s activity or energy level.

As more data and clinical experiences become known, American Nurse Journal will keep you up to date. Long COVID is on my personal and professional radar screen for many reasons, but none more important than the health and well-being of me, my family, and my colleagues.

Let me know if you have perspectives or experiences with long COVID. In the spirit of “all teach, all learn,” we need to share all we can. Collectively, nursing solutions have been key to addressing healthcare issues in the past, and we can do it again now. I hope that, in the near future, long COVID will no longer be a mystery but a disease state we can treat confidently.



Lillee Gelinas, DNP, RN, CPPS, FAAN


American Nurse Journal. 2023; 18(6). Doi: 10.51256/ANJ062304

Let Us Know What You Think

2 Comments. Leave new

  • martha langdon
    June 22, 2023 11:15 am

    Feedback on long covid symptoms. I had Covid the last of February into the first of March of this year. Although I was 65 at the time, I had no underlying chronic physical illnesses and was working full time in an ICU. I had plenty of energy and did not feel my chronological age. Covid changed my life. I have a laundry list of physical problems that have either just recently dissipated or are still on-going. I am now 66 years old and feel every day of those 66 years. It has been a very disheartening and has caused me to seriously think about retiring. However, there are people with a lot worse aftereffects then I have. I can empathize with them completely.

  • Jackie Riley
    June 21, 2023 11:23 am

    Feedback on long covid symptoms. Since having covid in 2020 I have tingling in my upper and lower extremities as well as muscle spasms in my face and legs. I have sought help and finally met a natural path that suggested NAC supplement which thank goodness helped. I have been taking now for over a year with great results. I have tried to stop supplement to see if symptoms were gone but no, shortly after stopping my symptoms returned. I am very thankful to my physician for having a solution even if it just managing the symptoms at least I feel more normal.


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