Cleared COVID-19 but not the symptoms? You are not alone.

Just when we think we’re emerging from the pandemic, COVID-19 bites back.

A large study of the national health care databases of the U.S. Department of Veterans Affairs suggested getting reinfected with COVID-19 can increase the risk of death, hospitalization and new health conditions compared with the initial infection.

The Centers for Disease Control and Prevention recently reported that 1 in 5 people have long COVID. The CDC defines “long COVID” as persistent symptoms or “organ dysfunction” lasting three or more months that people didn’t experience before COVID-19.

Dr. Christopher Udovich, medical director of Silver Cross Hospital in New Lenox, said people who had severe COVID-19 often experience lingering symptoms such as shortness of breath and vague chest pain.

However, doctors are surprised to find those same symptoms in patients who were asymptomatic or had mild disease.

But then, long COVID still is poorly understood.

“We don’t know enough yet,” Udovich said.

Dr. Salah Lababidy, a pulmonologist with Midwest Respiratory and director of the Silver Cross Sleep Center, said the focus in 2020 was to save lives. Two years later, it’s apparent COVID-19 also may cause long-term damage in survivors.

“These patients have real symptoms,” Lababidy said. “You just can’t say, ‘You have post-COVID.’ ”

Lababidy believes new variants that escape immunity are especially concerning for the elderly, people with underlying risk factors, people with previous infections or people with long COVID symptoms.

“We don’t know what will happen to them,” Lababidy said

Unfortunately, doctors can’t test for long COVID like they test for strep or the flu, Udovich said.

So when people come into the clinic with chest pains or shortness of breath, doctors must run tests, sometimes many tests, to determine the cause, which might not be COVID-19-related, Udovich said.

Patients might have congestive heart failure, kidney failure, anemia or chronic obstructive pulmonary disease, Udovich said.

“Long COVID is almost a disease of exclusion,” Udovich said. “You’ve got to make sure something more serious isn’t going on.”

Rehabilitation often is helpful for respiratory symptoms, Lababidy said. In the meantime, patients with long COVID might lose their jobs if they aren’t feeling well enough to work, he said. Long COVID isn’t limited to physical symptoms, either, he said.

Anxiety and depression can persist, especially for patients hospitalized with severe COVID-19, those who required oxygen and those who were “near death” on ventilators, Lababidy said.

“It’s like [post-traumatic stress disorder] for them,” Lababidy said.

Still, except for cough and blood clots, it’s difficult to absolutely determine in hospitalized patients whether their new health conditions are related to a past COVID-19 infection, said Dr. Jonathan Pinsky, an infectious disease specialist at Edward Health, who added that he mostly sees patients infected and hospitalized for the first time.

Moreover, a person’s risk of reinfection has many variables: impaired immune system, not vaccinated or current on vaccines, amount of exposure and whether people are following mitigations, he said.

“It’s something that’s really hard to determine on a case-by-case basis,” Pinsky said. “That’s where population studies are needed.”

Assuming multiple reinfections may lead to long-term health issues means people should heed Will County’s high transmission rate, especially because many people who use home COVID-19 tests don’t report the results, Pinsky said. But the elderly or those with debilitating conditions can’t handle the fever, cough and diarrhea, Pinsky said.

Pinksy’s also seeing far less respiratory failure and intensive care patients than two years ago.

“The reasons for this are vaccines and immunity,” Pinsky said.

He believes the vaccines still will prevent severe illness and death with the new variants. But don’t shrug off mitigations because “you can still get pretty sick,” he said.

So wear a face mask in public, he said.

“If not for your own health, then for the health of others,” Pinsky said.

The CDC said symptoms possibly associated with long COVID include:

· Fatigue

· Fever

· Cough

· Shortness of breath

· Chest pain

· Palpitations

· Brain fog

· Lightheadedness

· Diarrhea

· Joint or muscle pain

· Rash

· Depression

· Anxiety

· Menstrual irregularities

· Prickling or tingling