COVID-19 Symptom: Shortness of Breath

• Shortness of breath is a common COVID symptom
• It can appear in both mild and severe COVID infections and doesn’t usually indicate more serious complications
• The duration of this symptom can be longer than other common COVID symptoms, lasting 2 to 3 months on average
• You should always call your doctor if you feel your shortness of breath symptoms worsen 

Like other respiratory diseases, COVID-19 can cause issues with breathing, such as shortness of breath. The symptom typically is not one of the first to appear, like fever or COVID cough, and it usually takes longer to resolve itself. According to The Journal of the American Medical Association, the median time for patients to develop shortness of breath is 5 days from their first symptoms. ref6 Similarly, shortness of breath also tends to be one of the lingering symptoms of the disease, taking 2 to 3 months to resolve in some patients, and up to a year in others.

While shortness of breath does not always indicate a serious case of COVID, it’s a symptom that you should monitor closely, as you should contact your doctor if your breathlessness gets worse. 

For mild cases, there are some home remedies and steps you can take to improve your breathing and experience less discomfort from your shortness of breath.

If you have COVID, you might experience shortness of breath. Feeling short of breath may vary in intensity but does not always indicate the severity of your infection. As breathlessness is a subjective symptom, it’s difficult for doctors to measure how short of breath you are. Some people may feel less short of breath than others, even though they have the same oxygen levels in their blood. 1

There are a few mechanisms that could explain why COVID-19 causes shortness of breath in some people: ref1

• Inflammation of the lung tissue debilitates the lungs’ function and causes impaired oxygen transport, which leads to low amounts of oxygen in the blood.
• Studies suggest that the coronavirus can activate a series of steps that result in the formation of blood clots, otherwise known as a coagulation cascade. This can lead to obstructions within blood vessels in some cases. If these blood clots are formed in the tiny sacs of air in the lungs (the alveoli), then this may contribute to feeling short of breath.
• The coronavirus can invade neurological structures in our body through 2 possible pathways. The first one is through the nasal epithelium, which is a specialized tissue that lines the nasal cavity that contains the olfactory receptor cells. Through these cells, the coronavirus can enter the nerve that gives us our ability to smell and can subsequently move toward the brain. The second possible pathway is through the bloodstream or lymph system via the ACE2 receptors located inside the inner lining of the airways. This way, the virus can pass on to the central nervous system through the blood-brain barrier. In the brain, the virus can disrupt the signaling pathway between the brain and the lungs, causing you to experience breathlessness.

In some cases, shortness of breath from COVID goes away on its own once the infection has cleared. However, many people have reported shortness of breath after COVID, making it the most frequent symptom of long COVID. The shortness of breath may last weeks to months, and in some rare instances persist for years, which may cause limitations in your daily activities. 1

Even though shortness of breath may happen to anyone who has been infected with the coronavirus, some studies suggest a few risk factors for a prolonged feeling of breathlessness, being: 2

• A higher amount of pre-existing medical conditions
• A higher amount of symptoms during the time of hospitalization
• Being female

There are several conditions besides COVID that can cause shortness of breath, and these are: 3 4

• Asthma
• Infections of the chest
• Obesity
• Smoking
• Panic attacks and hyperventilation
• Chronic obstructive pulmonary disease (COPD)
• Idiopathic pulmonary fibrosis, which is a condition that causes scarring of the lungs
• Heart failure
• Lung cancer
• Pulmonary embolism
• Anemia – shortness of breath can be experienced during physical activity because the blood cannot deliver the increased amount of oxygen it needs
• Chest trauma
• Foreign body inhalation, which can be more commonly seen in infants and young children

If you have health issues that cause breathing difficulties, like asthma or COPD, you can minimize your chances of contracting the virus by taking the following steps to ensure the best possible outcome: 

• Ensure that your chronic health conditions are being well-managed and that you are up to date on your medications.
• Hydrate yourself. Proper hydration maintains proper blood volume and promotes healthy mucous membranes in the respiratory system, which can help them better resist infection and tissue damage. 5
• Maintain social distancing.
• Keep yourself vaccinated and boosted.

If your shortness of breath is not caused by COVID, your healthcare provider needs to conduct further tests to determine the cause of your symptoms.

Not necessarily. Even if you experience shortness of breath as a symptom of your COVID, your chances of a full recovery are high. In some situations, shortness of breath can be a sign of more severe complications or even long-term damage: 5 6

• Pneumonia. COVID can lead to pneumonia which results in fluid building up and the lungs getting inflamed. This can cause serious breathing problems, requiring oxygen treatment or a ventilator. While most people recover from pneumonia, it can cause lasting lung damage in severe cases.
• Bronchitis. COVID-19 can cause bronchitis, an inflammation of the bronchial tubes in the lungs. This is a common complication of COVID-19 when the virus damages the respiratory tract.
• Acute Respiratory Distress Syndrome (ARDS). Severe pneumonia can cause ARDS, a serious and potentially life-threatening condition. This occurs when the lungs become inflamed and cannot provide enough oxygen to the body, leading to lung failure. People who recover from ARDS may have lasting lung scarring.
• Heart Damage. A small study found that COVID-19 patients who reported shortness of breath during physical activity 1 year after recovering from the infection may have suffered heart damage.

Find here more information about COVID-19 lung symptoms and damages.

If you are experiencing shortness of breath when you’re infected with the coronavirus, then there are a few things that you can do to relieve your symptoms: 7

• Keep your room cool by opening a window or turning the heating down. Air conditioning can aggravate a lung condition, so use it sparingly.
• Focus on breathing in slowly and gently through your nose and out through your mouth.
• Keep good posture so your lungs can fill with air when you’re breathing in. You can do so by sitting upright in a chair with your shoulders relaxed, leaning slightly forward.

You should contact your doctor immediately if your breathlessness gets worse or if: 4

• You’re coughing up blood
• You’re unable to say short sentences while resting due to your shortness of breath
• You feel confused, drowsy, or agitated
• You collapse or faint 
• You feel cold and sweaty

Shortness of breath is a possible symptom of COVID, and is the most frequent symptom of long COVID. When experiencing shortness of breath, it’s important to monitor your symptoms closely so you can contact your doctor if any changes occur.

Q: Can I get shortness of breath if I have the omicron variant of COVID? 

A: You can experience shortness of breath with any variant of COVID. 

Q: Can COVID cause shortness of breath without fever? 

A: Shortness of breath can occur with or without fever. It can be accompanied by other possible symptoms caused by the coronavirus.

Q: How long does shortness of breath last with COVID?

A: Most people who experience shortness of breath will feel better a few days or weeks after a COVID-19 infection has cleared.

Q: How long can shortness of breath linger after COVID?

A: By 12 weeks, most people recover from their shortness of breath symptoms. In rare cases, shortness of breath can persist for a year after the infection.

Q: What are some signs of COVID-19 that need immediate medical attention?

A: You should seek medical attention if you experience fainting, nausea, chest pain, notice a bluish tint to lips or nails, or have a change in mental alertness.

Q: How do you know if the lungs are infected with COVID?

A: In more severe cases, doctors can determine if there’s inflammation with a CT scan.