How to Identify and Treat the 4 Types of Long COVID

A recent study supported by the Researching COVID to Enhance Recovery (RECOVER) Initiative has identified 4 types of Long COVID, based on the clusters of symptoms that patients develop. Long COVID can affect nearly every part of the body, and it can have a significant impact on a person’s quality of life. However, not all symptoms of Long COVID are the same. This article will explain what these types are, how they differ from each other, and how they can be treated.

4 Types of Long COVID and How they Differ

Type 1: Heart, Kidney, and Circulatory Problems

This type of Long COVID is characterized by problems with the heart, kidneys, and blood vessels. Patients with this type may experience chest pain, shortness of breath, high blood pressure, swelling in the legs, and kidney damage. They are more likely to have had severe COVID-19, requiring hospitalization or intensive care. They may also have a higher risk of developing cardiovascular diseases in the future.

Treatment for Type 1

Patients with this type of Long COVID may need to take medications to control their blood pressure, reduce inflammation, and prevent blood clots. They may also benefit from regular monitoring of their heart and kidney function, as well as lifestyle changes such as quitting smoking, eating a healthy diet, and exercising moderately.

Type 2: Lung Conditions, Sleep Disorders, and Anxiety

This type of Long COVID is characterized by problems with the lungs, sleep, and mental health. Patients with this type may experience coughing, wheezing, difficulty breathing, insomnia, nightmares, and anxiety. They are more likely to have had mild or moderate COVID-19, without requiring hospitalization. They may also have a higher risk of developing chronic obstructive pulmonary disease (COPD) or asthma in the future.

Treatment for Type 2

Patients with this type of Long COVID may need to take medications to improve their lung function, such as bronchodilators, corticosteroids, or antibiotics. They may also benefit from pulmonary rehabilitation, which involves breathing exercises, education, and counseling. For their sleep problems, they may need to practice good sleep hygiene, such as avoiding caffeine, alcohol, and screens before bed, and following a regular sleep schedule. For their anxiety, they may need to seek psychological support, such as cognitive behavioral therapy (CBT), mindfulness, or medication.

Type 3: Muscle Pain, Connective Tissue Disorders, and Nervous System Disorders

This type of Long COVID is characterized by problems with the muscles, joints, and nerves. Patients with this type may experience muscle pain, weakness, fatigue, joint pain, stiffness, and nerve pain. They are more likely to have had autoimmune diseases, such as rheumatoid arthritis or lupus, before getting COVID-19. They may also have a higher risk of developing fibromyalgia or chronic fatigue syndrome in the future.

Treatment for Type 3

Patients with this type of Long COVID may need to take medications to relieve their pain and inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, or anticonvulsants. They may also benefit from physical therapy, which involves stretching, strengthening, and massage. For their nerve problems, they may need to undergo nerve stimulation, such as transcutaneous electrical nerve stimulation (TENS) or acupuncture.

Type 4: Digestive and Respiratory Problems

This type of Long COVID is characterized by problems with the digestive system and the upper respiratory tract. Patients with this type may experience nausea, vomiting, diarrhea, abdominal pain, loss of appetite, sore throat, nasal congestion, and loss of smell or taste. They are more likely to have had gastrointestinal or respiratory infections, such as gastritis or sinusitis, before getting COVID-19. They may also have a higher risk of developing irritable bowel syndrome (IBS) or chronic rhinosinusitis in the future.

Treatment for Type 4

Patients with this type of Long COVID may need to take medications to treat their digestive or respiratory symptoms, such as antacids, antiemetics, antidiarrheals, antibiotics, or antihistamines. They may also benefit from dietary changes, such as avoiding spicy, fatty, or acidic foods, and drinking plenty of fluids. For their loss of smell or taste, they may need to undergo smell or taste training, which involves exposing themselves to different odors or flavors regularly.

More Information on Long COVID

If you want to learn more about Long COVID, you can visit the following websites:

RECOVER: Researching COVID to Enhance Recovery – This study was supported by the RECOVER Initiative. To help doctors and researchers better understand Long COVID, find a clinical study site near you.

Long COVID as a Disability – The U.S. Department of Health and Human Services provides information on resources for people with symptoms of Long COVID that cause physical or mental impairment.

Sources

  • Zhang, H., Zang, C., Xu, Z., Zhang, Y., Xu, J., Bian, J., Morozyuk, D., Khullar, D., Zhang, Y., Nordvig, A. S., Schenck, E. J., Shenkman, E. A., Rothman, R. L., Block, J. P., Lyman, K., Weiner, M. G., Carton, T. W., Wang, F., & Kaushal, R. (2023). Data-driven identification of post-acute SARS-CoV-2 infection subphenotypes. Nature Medicine, 29, 226–235.

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