What is “medium COVID”?

Apr 15, 2022

A new term – medium COVID –  has emerged that may add further nuance to Long COVID diagnoses. As the pandemic has progressed, scientists have realized that Long COVID, which was developed in the early stages of the pandemic to broadly encompass the experience of lingering COVID symptoms past the point of what could be considered the acute infection, may be a more complicated diagnosis than originally expected.

Questions remain as to when exactly a physician should start attributing acute COVID symptoms to Long COVID. Much of the available research shows substantial variation in the transition between a COVID to a Long COVID diagnosis. Some physicians label it as early as 2 weeks post-infection, while others wait until 8 weeks out to consider symptoms to be due to Long COVID. A lack of standard definition also contributes to Long COVID diagnoses being labeled at relatively arbitrary points in time.

Recently, the term ‘medium COVID’ has been circulating in the media. Coined by Nina Feldman, a health reporter for WHYY media in Philadelphia, it refers to the understanding that a person may not always quickly bounce back from COVID, but that experiencing relatively manageable symptoms should not necessarily fall under the umbrella of Long COVID. On an episode of NPR’s Morning Edition, Feldman noted that a gray area has emerged in Long COVID diagnosis because there has never been a true official threshold at which someone becomes a Long COVID patient. She discusses the preconceived notion that only two types of COVID-19 exist – cases that do not extend past the typical isolation period and those in which the repercussions of COVID persist for an extended period of time. Further complicating Long COVID diagnoses are the shorter isolation windows proposed by the CDC, which are intended to represent the period a person is contagious but may inadvertently give the impression that experiencing symptoms of COVID beyond 5 days is abnormal. 

In reality, some patients may just need weeks to fully recover from the symptoms of acute COVID, or to find they are finally starting to ‘feel like themselves again.’ Some of these symptoms could include difficulty breathing during exercise, fatigue, a reduced ability to socialize, or brain fog. Nevertheless, Feldman categorizes these symptoms as separate from those debilitating cases of Long COVID that can leave people “bedridden or unable to perform daily functions.” Feldman encourages patients experiencing ‘medium COVID’ to approach recovery as ‘watchful waiting,’ continuing to communicate with their primary care providers while being mindful of not rushing back into their normal routine.  

While yet to be officially defined, the use of ‘medium COVID’ brings awareness to the reality that experiencing COVID symptoms past the point of acute infection is not as binary as it has been previously perceived. 

For inquiries related to the Long COVID Initiative, please contact long_covid_initiative@brown.edu