How long will prolonged cough, tiredness and shortness of breath last in long-COVID/post-COVID syndrome patients?

When considering persistent symptoms following an acute COVID-19 illness it is important to rule our other causes before assigning them as part of a post-COVID syndrome. A differential diagnosis of prolonged cough should be undertaken to rule out other potential causes such as chronic cough, asthma or an underlying malignancy.

Data on the duration of specific symptoms in long-COVID/post-COVID syndrome are limited and may be related to the underlying aetiology. For example, symptoms associated with depression, changes in activity or fitness levels or underlying organ damage may be more prolonged than post-viral persistent symptoms. However, there are limited data on the associated of specific post-COVID symptoms and the underlying causation. Further research is needed in this area.

Cough, fatigue and shortness of breath are more prevalent and persistent among people who were hospitalised with acute COVID-19 illness. At 8 months follow up (Nguyen et al 2022; >1000 patients). Fatigue was reported in 61% of patients, shortness of breath with activity in 48% of patients, shortness of breath at rest in 7% of patients and cough in 2% of patients. At 12 months follow-up (Becker et al 2021; 90 patients) fatigue was reported in 46% and shortness of breath 21%.

For those patients who do not require hospitalisation, fatigue and shortness of breath may persist beyond 6 months for some while cough will likely have resolved by 6 months for most patients. Across 5 studies of mainly outpatients >6 months follow-up (Nguyen et al 2022; >2000 patients): Fatigue was reported in 25–34% of patients, shortness of breath in 13–22% of patients and cough in 2–13% of patients.