Chronic Covid-19 Syndrome: Long-Tail Recovery Risks Emerge

Dubbed by a growing number of doctors as chronic Covid-19 syndrome or long-tail recovery, the endless battle many so-called “recovered” coronavirus patients are fighting is emerging as the real hidden risk—one being downplayed or, worse, ignored by many young and otherwise healthy people. New emerging information is now building a significant case that chronic health issues—not death—represents the real and material risk for individuals in this pandemic.

We recently published a comprehensive article identifying the highly concerning trend regarding chronic Covid-19 health issues. It has quickly become one of our most popular and viewed articles. Our intent was to highlight emerging information—both empirical and anecdotal—that was pointing to a real and largely unrecognized problem: Recovery from Covid-19 does not mean healthy.

Since its publishing, information has continued to emerge at an exponentially increasing rate. As a result, we wanted to follow up on that article and disclose the new data that has come to the surface—especially given that medical experts have had more time to study recovered patients. That information is raising alarms across the healthcare industry—even warranting the development of new labels like “long-tail Covid-19 risk” and “chronic Covid-19 syndrome.”

So, let’s dig into this information and discover why we argue that the chronic issues related to Covid-19 are not only a clear and present danger for younger (20-40) and, otherwise, healthy people—it is a far greater risk than most are willing to acknowledge or accept.

Chronic Covid-19 Syndrome: The Emerging Picture & Basic Facts

Doctors in Israel are now reporting chronic issues with “recovered” patients—a trend that his surged recently. These issues include freak pains, lungs function that won’t return to normal, loss of taste and smell, and a range of incapacitating psychological issues.

Prof. Gabriel Izbicki of Jerusalem’s Shaare Zedek Medical Center notes, “What we are seeing is very frightening. More than half the patients, weeks after testing negative, are still symptomatic.”

Israeli Doctors Report that Half of "Recovered" Covid-19 Patients Still Suffer Weeks, Even Months, Later.

In addition to the unexplained pains, doctors find that the majority of “recovered” patients suffer from “general weakness… shortness of breath, sustained cough, and other complex breathing and pulmonary issues.

Even more concerning is the fact that Izbicki concedes that there appears to be no explanation for why some patients are struggling to recover, adding, “There is no correlation between seriousness of disease during hospitalization and extent of symptoms afterwards.”

Many of the patients report that they feel worse since “recovering,” again, noting extreme fatigue and lethargy, as well as breathing and heart problems. They contend that these chronic post-recovery symptoms have devastated their quality of life—making it difficult to perform even moderate physical activity, let alone resume normal activities.

In particular, doctors around the globe are noting a spike in patients reporting phantom pains–a concerning neurological development. These pains target all areas of the body–including areas not directly impacted by the virus.

Many of these “recovered” Covid-19 patients report that, on a scale of 1 to 10, the pains can hit an excruciating level of 10—though they can also manifest themselves as a burning sensation, tingling, or just hard-to-place sense that a limb does not feel normal.

Eran Schenker, director of the Bnei Brak clinic run by Maccabi Healthcare Services, warns that the freak pains are being seen in all patients—young and old alike. He adds, “Painkillers block the pain but don’t relieve the source, but we don’t know how to address the source and you can’t be on painkillers the rest of your life.”

Dan Oyero, Maccabi’s deputy director of medicine in central Israel, said that “the overarching issue doctors are dealing with is the far-reaching change in people’s lives,” adding:

“The most distressing thing is that people compare how they feel now compared to how they were a few weeks ago before they were infected, and they say they just can’t do the things they used to do.”

Dr. Bruce Farber, chief of infectious diseases at Northwell Health, New York State’s largest health system, states, “Covid is a totally different animal. You see [chronic symptoms] with very few respiratory diseases. Even with influenza for the most part, you live or die.”

And Avindra Nath, clinical director of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, warns people (especially younger folks) that “it’s a pretty bad infection even in mild cases.”

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In fact, doctors are now beginning to refer to the condition as a long-tail or chronic case of Covid-19. They have no idea how many suffer from it, what the cause is (why some develop it), or how long it will last—months, years, or even the rest of their lives.

“Recovered” Doesn’t Mean Healthy—Patient Stories Continue to Grow

Doctors report many patients have been sick with coronavirus for more than 60 days... but they aren't sure why.

On March 15th, Montano, a 32-year-old female became symptomatic with a Covid-19 infection.

The Washington Post reports that, over the course of the following weeks and months, she “developed a fever, cough, stomach problems, and lost her sense of taste and smell like other sufferers of the novel coronavirus. Unlike most of them, though, her symptoms never went away. They kept coming and going in waves like a roller coaster that has kept her bed-bound for 89 days straight — through school shutdowns, shelter-in-place orders, protests over those restrictions, and now, state reopenings.”

And then there is Cara Schiavo, who became symptomatic on March 7th. However, after a so-called recovery, the “former high school athlete who was kickboxing or going to the gym every day before covid-19, said she has had barely enough energy to get out of bed for more than two months.” She adds, “I feel like I’m living in a nightmare. I have literally cried, saying, ‘I just want to be back to myself.'”

And back in Israel, there’s the case of a female patient who was diagnosed in March. While she later tested negative (i.e., technically “recovered”), she is still suffering from severe fatigue and anxiety—adding that she can only walk for a few minutes at a time.

On top of that, her husband—who also was infected by and “recovered” from the coronavirus—is in even worse condition months later.

These stories only represent the tip of a massive iceberg of people around the world struggling to return to normal health and activities—months after being considered “recovered” by the medical system.

Experts Reveal Coronavirus May Trigger Other Chronic Illnesses

Neil Stone, a specialist in tropical and infectious diseases at University College London Hospitals, recently tweeted that the “wide array of covid phenomena which we don’t yet understand … may one day come to be known as Post Covid Syndrome.”

Dr. Neil Stone suggests that chronic health problems in "recovered" coronavirus patients may ultimately be called Post Covid Syndrome at some point.

Daniel Kuritzkes, the chief of the division of infectious diseases at Brigham and Women’s Hospital in Boston, notes that post-viral fatigue syndrome, for instance, is sometimes found in patients who’ve had mononucleosis, adding that another such possibility is that patients with relapsing symptoms may be experiencing an inflammatory syndrome similar to Kawasaki disease, which has recently been linked to cases of Covid-19 in children and young adults.

Furthermore, some experts are also growing increasingly concerned that Covid-19 may trigger ME/CFS.

A large and growing body of research shows that long-term illness and disability can be triggered by viral infections, including postural orthostatic tachycardia syndrome (POTS), myasthenia gravis, multiple sclerosis, Guillain-Barré syndrome, type I diabetes, and ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).

In fact, it has been noted that “SARS-CoV-2 would not be the first coronavirus to result in documented ME/CFS. Studies have shown that long-lasting disabling symptoms commonly occur in people who contracted two other coronaviruses that cause SARS and Middle East Respiratory Syndrome (MERS). In one study, 27% of SARS survivors were found to meet CFS criteria several years after developing SARS.”

Dr. Marc Lipsitch, Infectious Diseases and Epidemiology professor at Harvard University, has warned that in the wake of Covid-19 “it is likely that there will soon be a flood of new ME/CFS patients that medical systems around the world are woefully unprepared to treat.”

What’s the Cause or Source of Chronic Covid-19 Health Issues?

The jury is still out on exactly what is causing so many “recovered” patients to battle debilitating chronic health issues following their Covid-19 infection. However, it appears that there are four possible explanations emerging from the medical community.

First, some experts have suggested that the virus may be capable of reactivating.

According to Bernard P. Chang, an emergency physician and psychologist at Columbia University in New York City, “viral reactivation is the concept that a latent or ‘not active’ virus that is already within your system ‘awakens’ or switches to an active phase and begins causing symptoms in patients.”

Fiona Lowenstein, writing for Vox, notes that viral reactivation is well known in other illnesses, such as herpes, which remains dormant in between outbreaks. But it’s not a proven (or disproven) aspect of the new coronavirus.

Doctors don't know why many Covid-19 patients' symptoms keep relapsing.

This reactivation process also occurs with the varicella-zoster virus that is responsible for shingles—the same virus that causes chickenpox.

After you recover from chickenpox, the virus can lie dormant in your central nervous system for years—to be reactivated down the road.

However, not everyone who had chickenpox gets shingles—and most who do are older and/or have weakened immune systems (though the exact reason for reactivation remains elusive to researchers).

Given the fact that Covid-19 has an affinity for ACE-2 receptors in our brains and central nervous system, it is within the realm of possibility that it could also—like varicella-zoster—lie dormant there until it is reactivated by a trigger (potentially when we are older and/or develop a weakened immune system).

In other words, whatever may be triggering this chronic condition or syndrome in so many folks now could potentially trigger the same (or worse) reaction in anyone at some point in their future. That should concern everyone.

However, as we stated, no one knows (1) if this virus can go latent (e.g., in the CNS or spleen) and then be reactivated later by a trigger or, if it can, (2) if this has anything to do with the chronic health issues being experienced by so many “recovered” coronavirus patients. It’s a theory at this point—a potentially concerning one, but no more or no less than a theory.

Second, some experts believe these chronic issues are the result of reinfection.

However, while studies suggest that many (especially asymptomatic or mild cases) do not develop immunity and any immunity to Covid that is achieved is short-lived (anywhere from 3 to 12 months), it does not appear—in our opinion—from the growing volume of chronic cases that these failed “recoveries” are the result of “reinfections.”

We simply haven’t seen any empirical evidence to support that hypothesis. To learn more about the immunity issue, we encourage you to read our article Study Finds High Initial Covid-19 Infection Rate: Herd Immunity Close?

This then leaves us with two other possibilities.

Third, it may simply be the normal course for Covid-19. Or, as Jeremy Faust, an ER doctor and colleague of Kuritzkes at Brigham and Women’s Hospital in Boston, puts it, “Some may simply have coronavirus symptoms that come and go, but slowly improve over time, like a pendulum running out of energy.”

However, for many cases, that seems like an awfully energetic pendulum? The duration of these chronic issues, combined with the fact that they do not appear to improve over time (at least not yet), casts quite a bit of doubt on this theory.

While we may find this may be (and seems to be) the “normal” course of the virus for a great many people, that doesn’t equate to the course of a typical viral flu. These Covid-19 cases suggest that pendulum does not run out of energy in a reasonable length of time (like the flu) and is chronic in nature.

Finally, theory number four is that this could represent chronic post-viral syndromes, such as we addressed above.

Having researched this issue extensively, it seems that the most likely theory is that this is either an ongoing, chronic condition that arises for unknown reasons in some patients (a variation on the “common course” theory) or it is a chronic post-viral syndrome—either a new one (unique to Covid) or an existing syndrome that is triggered by Covid.


Regardless of what the source or pathway for these chronic health issues is, the fact is becoming well established that “recovered” does not mean healthy.

This is especially concerning for younger—otherwise healthy—individuals. This is the group that is being most impacted by the new wave of coronavirus infections in the US. Based on the growing wealth of knowledge, it is highly likely that a significant and material percentage of these folks will suffer from chronic health issues—issues that have proven to be lifestyle altering.

Whether we call this developing reality “long-tail Covid” cases or “chronic Covid-19 syndrome,” the truth is that you do NOT want to get this virus if at all possible.

Death is not the issue. Rather, debilitating chronic health problems are—issues that can (and do) impact anyone (regardless of age or health), issues that no one knows how long they will last, and issues that no one knows if they will get worse.

Finally, we have no idea if similar types of problems can emerge down the road for others who appear to have recovered without issue. It is entirely possible that this virus can lie dormant in the CNS (or other locations like the spleen, which has been shown to be an important target of the virus and potential hiding spot for it), only to reactivate later with devastating consequences.

There is still so much we do not know about the wicked and sneaky virus. Why on earth would you want to get it???

It’s time for everyone to develop a healthy level of respect for Covid-19 and behave accordingly. As we always say, you should be skewing the risk-reward curve as far as you can in your advantage—not the other way around.

Thriving in a hostile environment is all about respect (healthy fear)—not irrational fear. While we are never in ultimate control of our lives (God is) nor able to mitigate all risk, God does expect us to do our part—meaning, manifest a reasonable degree of personal responsibility and concern for others. As such, we encourage you to where a mask and practice social distancing.

As always, hope for the best, prepare for the worst, and—in all things—pray!

To learn more about this, we recommend reading part one of the unfolding story… Recovered Doesn’t Mean Healthy: The Untold Truth about Covid-19.

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Doug is a passionate servant of Christ and holds an MBA, BBA (Summa Cum Laude), and AAcc from Liberty University, as well as an additional two years of study at Bible college. He has over 20-years of corporate finance, accounting, and operations management experience—spanning the public, private and nonprofit sectors. He is proud to have served his country as a member of the 82nd Airborne Division and his local communities as a firefighter/EMT and reserve peace officer—experience that has provided him with a unique skill-set when it comes to emergency medicine, firearms, crisis management, and wilderness survival. Doug enjoys playing the drums, prepping, and spending time with family—especially in the Outer Banks of NC.