Post-acute COVID-19 syndrome causes months of symptoms after recovery

Kaisha Jantsch

For most people, COVID-19 is fleeting.

While their battles with the virus itself can be enduring, after they get better they typically stay better — recovered individuals don’t often continue to display symptoms of illness.

But some do. 

These people, called long haulers, make a full recovery from COVID-19, yet continue to feel sick for months on end. For them, even a brief moment of contact with a COVID-positive person can cause long-term suffering. 

That’s what happened to Kathy Doutt, 60, a support clerk at Heritage Valley Health System who lives in Ohioville.

Doutt’s story

In late November, Doutt tested positive for COVID-19 after interacting with someone who was sick. 

At first, she was asymptomatic and didn’t realize she might be ill until her husband, who also tested positive, started exhibiting symptoms. When her symptoms appeared, they were mild: loss of taste and smell, a bit of congestion, dry mouth, fatigue — nothing major. Doutt made a full recovery and returned to work. 

On her second day back, though, she noticed a sharp change in her health.  

“I felt this feeling coming over me like I was getting lightheaded, and I asked my coworker to get me some water,” Doutt said. “I knew something wasn’t right. I went into the restroom…and when I came out…I had to call out for help.” 

She was flushed and sweaty, but cold at the same time. 

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“My teeth were chattering and my blood pressure went up and my heart felt like it was racing out of my chest,” Doutt said, so an ambulance was called.

The paramedics took her to a hospital where they performed a number of tests that all showed she was healthy, but in the weeks the followed the fits continued. Doutt became so weak that she couldn’t get out of bed and was forced to take a leave of absence from work. Eventually, doctors diagnosed her with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), also known as Post-Acute COVID-19 Syndrome or long COVID. 

Though her health has improved some, she’s still suffering months later and doctors now fear the syndrome may have evolved into Postural Orthostatic Tachycardia Syndrome and Dysautonomia (POTS), called post-COVID POTS when triggered by the virus. Doutt’s scheduled for a tilt table test to get a definitive diagnosis. 

Though the National Institute of Health is now studying post-COVID POTS, not much is known about it. However, area doctors and researchers are starting to get better at identifying and treating PASC because Doutt is far from being the only local long hauler. 

What is Post-acute COVID-19 Syndrome and who gets it? 

“We are seeing more and more cases now that more and more people are being infected (by coronavirus),” said Dr. Tariq Cheema, the division director of Pulmonary, Critical Case, Sleep and Allergy for Allegheny Health Network.

He said that between 15% and 20% of people who recover from COVID-19 will develop PASC and, like Doutt, their experience with COVID-19 doesn’t have to have been severe for them to get it. 

“Interestingly, we’re…seeing the people who were asymptomatic, but they got COVID, developing this syndrome a few weeks later,” he said, noting that, despite that trend, those who had more serious cases see long-term effects more often. 

What those effects are varies. 

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The most common symptoms include fatigue, brain fogginess and the inability to concentrate, but people who get long COVID can also experience depression, Post-Traumatic Stress Disorder, insomnia, the continued inability to smell and taste and blood clotting. In severe cases, the disease attacks the heart and lungs. 

“As a pulmonologist, the biggest concern we’re seeing are the people who are developing scar tissue in their lungs, and it’s a pretty rapid onset,” Cheema said. “You also see cases where the heart muscle is affected and you get heart failure.”

How is it treated? 

So, how can doctors prevent that? And how do they treat patients with less severe but still chronic issues? 

The answer? It depends. 

“We’re learning as we go to see what is the best way of dealing with this,” Cheema said. 

At AHN, doctors and administrators have established a Post-acute COVID Syndrome clinic to learn about long haulers, and give them specialized, targeted treatment. That can be therapy for those suffering from depression and PTSD, consultations with cardiologists for those who have developed a heart issue or discussions with neurologists for those dealing with migraines and neurological effects. 

“The first thing…is to identify the issues,” Cheema said. “There’s so many out there that are not being seen by anyone, and people are struggling at home.” 

Though she has sought medical attention for her PASC, Doutt is still one of those people. 

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After several unsuccessful and costly trips to the emergency room, she now works through episodes on her own at home. 

“All I can do is lay down, drink fluids…and monitor my blood pressure and heart rate,” Doutt said. “I basically have to ride it out.” 

She’s been prescribed medication to help manage her blood pressure, but she said most of the battle is mental. 

“A positive state of mind is very important for this condition,” Doutt said, noting that she maintains positivity through faith and friends.  

Still, medical treatment is important to her. That’s why she is getting vaccinated. 

Can the vaccine help? 

“…When my family doctor told me…he read about COVID long-haulers having symptoms lessen or go away after being vaccinated, I (knew I) had to do it,” Doutt said. 

And it does seem to help. 

“There’s a good percentage of people who report this like they’ve been cured,” Cheema said. 

But he’s skeptical. All of the reports on how vaccines impact PACS are anecdotal, and while they offer hope, they don’t offer answers. 

“Is it the vaccine that’s helping, or does the vaccine just create an overwhelming sense of wellbeing? We don’t know that yet,” Cheema said. “At this point, we wouldn’t be able to explain that from a vaccine. It hasn’t been proven.”

His advice? Avoid the struggles of PASC altogether — don’t get COVID-19. 

Can it be avoided? 

“The best treatment is always prevention,” Cheema said, reminding people to follow all guidelines, wear masks, hand wash, socially distance and get vaccinated. 

Doutt agreed. 

“Wearing a mask is the least thing you could do to help prevent the spread of COVID,” she said. “It’s not a way to control you. It’s a way to help stop this madness.”

However, it’s not the way to stop it. The vaccine is. 

Why get the vaccine? 

“The first thing that I think people need to understand is that, even if you’ve had COVID, you need to get vaccinated,” Cheema said.

That’s because even people who have already had the virus can contract it again or contract one of the new variants including the more infectious U.K. variant, known as B.1.1.7. The Centers for Disease Control and Prevention reported recently that this more virulent variant is now the dominant one in the nation.

“The only way we get out of this is if we all get vaccinated,” Cheema said. “Because if we don’t, and we don’t have herd immunity, then everything is in vain.”

He had a message for those concerned about side effects. 

“The worst side effect of COVID is death,” Cheema said. “Do the right thing, get vaccinated.”

Kaisha Jantsch is a staff reporter for The Beaver County Times and can be reached at Follow her on Twitter at @JantschKaisha. 

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