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Page 9 Long COVID or Post-COVID Conditions are real Updated June 17, 2022 at cdc.gov DEFINITION Post-COVID Conditions Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as post-COVID conditions (PCC) or long COVID. People call post-COVID conditions by many names, including: long COVID, long-haul COVID, post-acute COVID- 19, post-acute sequelae of SARS CoV-2 infection (PASC), long-term effects of COVID, and chronic COVID. What You Need to Know Post-COVID conditions can include a wide range of ongoing health problems; these conditions can last weeks, months, or years. Post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions, even people who had mild illness or no symp- toms from COVID-19. People who are not vaccinated against COVID-19 and become infected may also be at higher risk of developing post-COVID conditions compared to people who were vaccinated and had breakthrough infections. There is no single test for post-COVID conditions. While most people with post- COVID conditions have evidence of infection or COVID-19 illness, in some cases, a person with post-COVID conditions may not have tested positive for the virus or known they were infected. CDC and partners are working to understand more about who experiences post- COVID conditions and why, including whether groups disproportionately impact- ed by COVID-19 are at higher risk. As of July 2021, “long COVID,” also known as post-COVID conditions, can be considered a disability under the Americans with Disabilities Act (ADA). Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557. U.S. Department of Health Human Services Office for Civil Rights and U.S. Department of Justice Human Services Civil Rights Division Disability Rights Section—Although many people with COVID-19 get better within weeks, some people continue to experience symptoms that can last months after first being infected, or may have new or recurring symptoms at a later time.1 This can happen to anyone who has had COVID-19, even if the initial illness was mild. People with this condition are sometimes called “long-haulers.” This condition is known as “long COVID.”2 In light of the rise of long COVID as a persistent and significant health issue, the Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice have joined together to provide this guidance. This guidance explains that long COVID can be a disability under Titles II (state and local government) and III (public accommodations) of the Americans with Disabilities Act (ADA),3 Section 504 of the Rehabilitation Act of 1973 (Section 504),4 and Section 1557 of the Patient Protection and Affordable Care Act (Section 1557).5 Each of these federal laws protects people with disabilities from discrimination.6 This guidance also provides resources for additional information and best practices. This document focuses solely on long COVID, and does not address when COVID-19 may meet the legal definition of disability. The civil rights protections and responsibilities of these federal laws apply even during emergencies.7 They cannot be waived. About Long COVID or Post-COVID Conditions Post-COVID conditions are a wide range of new, returning, or ongoing health problems that people experience after first being infected with the virus that causes COVID-19. Most people with COVID-19 get better within a few days to a few weeks after infection, so at least four weeks after infection is the start of when post- COVID conditions could first be identified. Anyone who was infected can experi- ence post-COVID conditions. Most people with post-COVID conditions experi- enced symptoms days after their SARS CoV-2 infection when they knew they had COVID-19, but some people with post-COVID conditions did not notice when they first had an infection. There is no test to diagnose post-COVID conditions, and people may have a wide variety of symptoms that could come from other health problems. This can make it difficult for healthcare providers to recognize post-COVID conditions. Your health- care provider considers a diagnosis of post-COVID conditions based on your health history, including if you had a diagnosis of COVID-19 either by a positive test or by symptoms or exposure, as well as doing a health examination. Symptoms People with post-COVID conditions (or long COVID) may experience many symptoms. People with post-COVID conditions can have a wide range of symptoms that can last more than four weeks or even months after infection. Sometimes the symptoms can even go away or come back again. Post-COVID conditions may not affect everyone the same way. People with post- COVID conditions may experience health problems from different types and combi- nations of symptoms happening over different lengths of time. Most patients’ symp- toms slowly improve with time. However, for some people, post-COVID conditions may last months, and potentially years, after COVID-19 illness and may sometimes result in disability. People who experience post-COVID conditions most commonly report: General symptoms —Tiredness or fatigue that interferes with daily life —Symptoms that get worse after physical or mental effort (also known as “post- exertional malaise”) —Fever Respiratory and heart symptoms —Difficulty breathing or shortness of breath —Cough —Chest pain —Fast-beating or pounding heart (also known as heart palpitations) Neurological symptoms —Difficulty thinking or concentrating (sometimes referred to as “brain fog”) —Headache —Sleep problems —Dizziness when you stand up (light- headedness) —Pins-and-needles feelings —Change in smell or taste —Depression or anxiety Digestive symptoms —Diarrhea —Stomach pain Other symptoms —Joint or muscle pain —Rash —Changes in menstrual cycles Symptoms that are hard to explain and manage Some people with post-COVID conditions have symptoms that are not explained by tests. People with post-COVID conditions may develop or continue to have symptoms that are hard to explain and manage. Clinical evaluations and results of routine blood tests, chest x-rays, and electrocardiograms may be normal. The symptoms are similar to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and other poorly understood chronic illnesses that may occur after other infections. People with these unexplained symp- toms may be misunderstood by their healthcare providers, which can result in a long time for them to get a diagnosis and receive appropriate care or treatment. Health conditions Some people experience new health conditions after COVID-19 illness. Some people, especially those with severe COVID-19, experience multiorgan effects or autoimmune conditions with symptoms lasting weeks or months after COVID-19 illness. Multiorgan effects can involve many-body systems, including the heart, lung, kidney, skin, and brain. As a result of these effects, people who have had COVID-19 may be more likely to develop new health conditions such as diabetes, heart condi- tions, or neurological conditions compared with people who have not had COVID- 19. Content on this page taken from cdc.gov/2019-ncov/longtermeffects