Phillip Levy, MD, MPH on Long COVID: Managing Symptoms and Navigating Uncertainty

Long COVID remains challenging to treat, with options primarily focused on managing symptoms rather than providing a cure. Phillip Levy, MD, MPH, a specialist on this condition, explains that many patients receive supportive care, such as inhalers for breathing issues, though some may still experience persistent lung damage seen in scans, like fibrosis or parenchymal damage. Unfortunately, there are few options to reverse this damage; at best, symptoms might gradually improve over time. Those with long-term loss of smell or taste can try olfactory training to stimulate nerve recovery, though results vary.

In an interview with The Educated Patient,Levy, a professor in the Department of Emergency Medicine at Wayne State University and associate vice president for Translational Science in the Office of the Vice President for Research, explains that for many, the lingering symptoms of Long COVID—such as shortness of breath, brain fog and fatigue—significantly disrupt daily life, impacting their ability to engage in normal activities.

This can lead to emotional distress, especially when patients can no longer perform tasks they once found easy, like walking several blocks or running. Levy emphasizes that a lack of effective treatment options can intensify feelings of helplessness, further compounded by skepticism from some healthcare providers who may not recognize Long COVID symptoms, making patients feel dismissed and invalidated. For those struggling with validation from doctors, simply receiving a diagnosis can bring some mental relief, allowing them to focus on recovery.

Long COVID may also result in long-term complications due to microclots that cause organ damage, like mini-strokes or kidney issues, potentially worsening conditions like diabetes or hypertension. Patients may not always connect these issues to prior COVID-19 infections, making proper diagnosis essential for long-term care.

As Levy notes, COVID-19 isn’t going away. With new variants, the risk of reinfection remains, emphasizing the need for prevention. Vaccination continues to be the best tool available, especially for high-risk groups, including older adults and those with pre-existing health conditions. The latest vaccines, tailored to current variants, are recommended for everyone but are especially crucial for those more susceptible to Long COVID. Levy highlights that the choice of vaccine is less important than ensuring at-risk individuals stay protected through vaccination.

The uncertainty around Long COVID, coupled with limited treatment options, creates significant physical and emotional challenges. Prevention through vaccination remains the best approach to avoiding Long COVID and its potentially life-altering effects.