Long COVID

Some people who get COVID-19 may experience symptoms after the initial illness goes away. Sometimes these kinds of symptoms become a syndrome called Long COVID. SAMHSA is partnering with the U.S. Department of Health & Human Services and other federal agencies, medical associations, patient organizations, researchers, and others to assess and address the impacts of Long COVID on behavioral health (mental health and substance use disorders). Additional information and resources are below.

What is Long COVID?

Definitions of Long COVID continue to evolve and vary, but Long COVID is defined by the Centers for Disease Control and Prevention as "a chronic condition that occurs after SARS-CoV-2 infection and is present for at least 3 months." A National Academies of Science, Engineering, and Medicine (NASEM) report defines Long COVID as "an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems."

Long COVID, also referred to as Post-COVID Conditions, manifests in multiple ways. Studies such as what is summarized within the NASEM report estimate over 200 symptoms associated with Long COVID. Common symptoms include fatigue, difficulty concentrating or "brain fog," shortness of breath or difficulty breathing, chest pain, heart palpitations, cough, joint or muscle pain, depression, anxiety, and many more side effects.

Long COVID Prevalence

Early population estimates from the CDC indicate that in 2022, around seven percent of the U.S. adult population reported having Long COVID. Other studies suggest around 10 percent (PDF | 1.7 MB) of those with COVID-19 may experience post-COVID complications. As research is still emerging, estimates of the prevalence of Long COVID may continue to shift.

Long COVID and Behavioral Health

Long COVID can have a significant impact on behavioral health. Some of the most common mental health-related symptoms associated with Long COVID include fatigue, sleep disturbances, depression, anxiety, psychosis, cognitive impairment, obsessive-compulsive disorder, and posttraumatic stress disorder. Long COVID also can aggravate pre-existing conditions or contribute to new mental health or substance use disorders.

Though the effects of the COVID-19 pandemic have contributed to behavioral health challenges for many people, evidence has also shown that:

The behavioral health symptoms associated with Long COVID are real and can sometimes be very debilitating. They are not made up.

Patients with Long COVID often face stigma and discrimination, in addition to their sometimes debilitating symptoms. For instance, employers, friends and family - and even health care providers - may doubt that their symptoms are genuine. And this can result in delayed diagnosis and not receiving the appropriate care or treatment.

Testing and Diagnosis

As Long COVID is not a single distinct illness and may be comprised of multiple symptoms or conditions and the medical community is still not completely sure what causes the symptoms, there is not a specific test that can determine if someone has Long COVID. A healthcare provider can make a Long COVID diagnosis based on a comprehensive picture that includes an individual's health history, previous diagnosis of COVID-19, laboratory tests and imaging and physical evaluations. If you think you may have Long COVID, talk to your healthcare provider.

What SAMHSA is Doing

Because of the burden that Long COVID can have on behavioral health, SAMHSA has taken a leadership role alongside other federal partners, including the HHS Office of Long COVID Research and Practice, to strengthen support to those impacted by Long COVID. Efforts include hosting technical expert meetings, a Policy to Action Initiative meeting, presentations to large professional organizations, and producing publications on the impacts of Long COVID on behavioral health, as well as guidance for primary care physicians on identifying and managing patients' behavioral health symptoms. As the field rapidly changes and the need is vast, SAMHSA continues to identify and start new projects to support this work.

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