Some coronavirus patients still have symptoms months after they are first infected, challenging the narrative that most people will survive the disease and move on.

Why it matters: As cases soar in the U.S., thousands more people will not only be hospitalized or die, but also will keep feeling the effects of the infection months from now.

Where it stands: Six months into the pandemic, we’re still figuring out how the virus works, how it kills people and the implications for the people who survive it.

Long-term symptoms range from neurological issues like “brain fogs” to an elevated heart rate.

• One study of Italian patients, published in JAMA, evaluated patients’ symptoms several weeks after they’d been discharged from the hospital and tested negative for the virus. It found that only 12.6% of them were free of any coronavirus-related symptoms.
• Common symptoms among recovered patients include fatigue, difficulty breathing, joint and chest pain, cough and headache.
• Many of these patients are “younger and had previously been healthy, with Covid cases initially considered mild to moderate. But months later they are still sick, and some are getting worse,” the Wall Street Journal reports.

What they’re saying: David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York City, told the WSJ that he thinks most patients with long-term symptoms are developing dysautonomia, a neurological condition that occurs when the autonomic nervous system is out of balance.

• It’s not clear whether the condition is a result of an overactive immune system, the virus itself, or is a post-viral syndrome, Putrino said.
• Another explanation is chronic fatigue syndrome, which some scientists theorize can be caused by stressful events.

The bottom line: “I’ve been very concerned by friends and family who just aren’t taking this seriously because they think you’re either asymptomatic or dead,” Hannah Davis, a patient who in June had been suffering from the virus for more than 70 days, told The Atlantic’s Ed Yong. “This middle ground has been hellish.”