Long COVID living in pregnancy

Overview

Long COVID is when symptoms of COVID-19 last for weeks or months after the initial infection. When this happens during pregnancy, it can be especially challenging because you are also caring for your growing baby. The symptoms can come and go, and they affect each person differently.

It is not extremely common, but many pregnant women report having Long COVID symptoms after a COVID-19 infection. The exact number is not known, but studies suggest it may affect up to 1 in 4 women who had COVID-19 during pregnancy.

Long COVID can affect any pregnant woman who had COVID-19, even if her initial illness was mild. Women who had severe COVID-19 or who have other health conditions may be at higher risk.

Symptoms

Common symptoms

• Extreme tiredness or fatigue
• Shortness of breath or difficulty breathing
• Brain fog, trouble concentrating, or memory problems
• Chest pain or tightness
• Joint or muscle pain
• Loss of taste or smell that does not go away
• Headaches that are different from before
• Fast or pounding heartbeat (palpitations)
• Dizziness when standing up

Causes

Main causes

• Long COVID happens after an infection with the SARS-CoV-2 virus (the virus that causes COVID-19). It is not fully understood why some people get Long COVID, but it may involve the immune system, inflammation, or damage from the virus.

Risk factors

• Having severe COVID-19 during pregnancy
• Having other health conditions such as diabetes, high blood pressure, or obesity
• Being older than 35
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If you have severe shortness of breath that gets worse

Book a routine appointment if:

• If you have ongoing tiredness or brain fog that affects your daily life
• If you have new or worsening symptoms that concern you
• During your regular pregnancy check-ups, mention any Long COVID symptoms you are experiencing

Diagnosis

There is no single test for Long COVID. Your doctor will ask about your symptoms, when they started, and how they affect you. They will also check if there are other causes for your symptoms, especially during pregnancy.

Tests that may be done

• Blood tests to check for inflammation, anaemia, or other conditions
• Pulse oximetry to measure oxygen levels in your blood
• Breathing tests (spirometry) if you have lung symptoms
• An electrocardiogram (ECG) if you have chest pain or palpitations

What to expect at your appointment

Your doctor will work with you to understand your symptoms and rule out other problems. They may refer you to a specialist clinic for Long COVID, especially one that understands pregnancy. The process can take time, so be patient and keep a diary of your symptoms.

Treatment

There is no specific cure for Long COVID, but treatment focuses on managing symptoms and helping you recover. Your doctor will create a plan that is safe for you and your baby. This often involves a team of healthcare providers including your midwife, GP, and sometimes a specialist.

Self-care at home

• Rest when you feel tired and avoid pushing yourself too hard (pacing)
• Keep a symptom diary to track what makes you feel better or worse
• Do gentle movements like walking or stretching if you feel able
• Stay well hydrated and eat a balanced diet
• Ask for help with household tasks or childcare so you can rest

Medical treatments

Your doctor may recommend treatments to help with specific symptoms, such as breathing exercises for shortness of breath, or talking therapies for anxiety or depression. They will always choose options that are safe during pregnancy. Do not take any over-the-counter medicines without checking with your midwife or doctor.

When is surgery considered?

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Living with this condition

Living with Long COVID during pregnancy can be hard because you may feel very tired or unwell while also preparing for your baby. It helps to set small, realistic goals and to ask for support from family and friends. Remember that you are not alone, and many women go through this.

Lifestyle tips

• Pacing your activities: break tasks into small steps and rest between them
• Getting enough sleep: try to go to bed and wake up at the same time each day
• Managing stress: try deep breathing, meditation, or talking to a counsellor
• Avoiding triggers: if certain activities make your symptoms worse, avoid them or do them less often

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, whole grains, and protein. Drink enough water. Gentle exercise like walking or prenatal yoga may help, but only if you feel up to it. Always check with your doctor before starting any new exercise program during pregnancy.

Mental health and emotional wellbeing

Long COVID can make you feel anxious, depressed, or frustrated. It is normal to feel this way when your body is not recovering as quickly as you hoped. Talk to your midwife or doctor about how you are feeling. They can connect you with mental health support, including counselling or support groups.

Prevention

The best way to prevent Long COVID is to avoid getting COVID-19 in the first place. This includes getting vaccinated and following public health advice such as wearing a mask in crowded places and washing your hands regularly.

Vaccines

COVID-19 vaccines are recommended during pregnancy. They can reduce your risk of getting COVID-19 and may also lower the chance of developing Long COVID if you do get infected. Speak to your doctor or midwife about the best timing for vaccination.

Screening programmes

There is no specific screening test for Long COVID. However, if you have had COVID-19 during pregnancy, your healthcare team may monitor you more closely for symptoms.

Complications

If left untreated

• Persistent symptoms may affect your quality of life and ability to care for yourself or your baby
• Long COVID may increase the risk of pregnancy complications such as pre-eclampsia or preterm birth (more research is needed)
• Untreated mental health symptoms like depression can affect your well-being and bonding with your baby

Long-term outlook

Most women with Long COVID during pregnancy do improve over time. Recovery can take weeks or months, but with rest, support, and proper care, many feel much better. Your healthcare team will work with you to manage your symptoms safely for you and your baby. There is hope, and you are not alone.

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