It's not just brain fog: Vertigo, hair loss, and lagging sex drive are also long COVID symptoms

• Health agencies around the world have acknowledged fatigue and brain fog as common symptoms of long COVID.
• But there are other symptoms, including allergies, sex drive issues, and problems peeing.
• Long COVID experts say it's evidence this is a "complex, multi-system syndrome." 

By now, you may have heard that brain fog, extreme fatigue, and heart issues can all be symptoms of long COVID.

But there are other common issues people can suffer after a coronavirus infection, including trouble ejaculating, hair loss, vertigo, urination issues, anorexia, and hot flashes.

According to a large study of nearly 500,000 UK adults published in the journal Nature Medicine on July 25, hair loss, difficulty ejaculating, and a reduced libido may all be even more common than shortness of breath or fatigue in non-hospitalized long COVID patients. 

The study lends fresh data to a trend that doctors and scientists who treat and research long COVID have known about for many months now. The coronavirus can do a myriad array of strange things to a person's body, but why and how it impacts certain individuals and not others is still poorly understood.

"My reaction to the study would be 'yeah, sounds about right,'" Amy Proal, a microbiologist at PolyBio Research Foundation, who studies chronic conditions including long COVID, told Insider.

"The chronic consequences of this virus are immense when you start to actually account for these symptoms." 

Long COVID symptoms can include reduced appetite and sexual dysfunction

Some of the most commonly reported issues in this new British study are not often mentioned in literature on long COVID from international health agencies. The chart below lists as "emerging" 15 widely reported long COVID symptoms that are not noted in official guidance or major study results released from the World Health Organization, National Institutes of Health, Centers for Disease Control and Prevention, or US Department of Health and Human Services.

But "anybody who's been following patients with long COVID knows that these are common," Dr. Alba Azola, the co-director of the Johns Hopkins Post-Acute COVID-19 Team, told Insider.

It's estimated that somewhere between 5% and 30% of COVID-19 patients may suffer some kind of long-term debilitating effect of their infection. (Part of the reason that these estimates are so broad is because there is such a wide spectrum of long COVID presentations, and people don't always agree on what counts.) Typically, in order for a person's issues to be considered a case of long COVID, their symptoms will persist for more than 12 weeks after an initial viral illness is over. 

"What this study does emphasize is the need to go beyond the most conventional symptoms that are assumed in these conditions, and actually just measure a much wider range of symptoms that may not immediately come to mind, but clearly are important," Proal said.

Issues with sexual dysfunction, reduced appetite, trouble peeing normally, and watery eyes, can all be part of  autonomic nervous system disfunction, which is common in long COVID patients. Patients may also experience "exaggerated" allergic responses, Azola said, which can lead to itchy, dry skin, or swollen eyes and lips.

Azola says even though this new study isn't surprising for her, it's still "important" for helping the general public (and policymakers) understand that such a wide array of long COVID issues is "not a made up thing," but rather indicative of a "complex multi-system syndrome." 

"It's debilitating," she said. "It's not just people having fatigue and not wanting to do things."

There is no known cure for long COVID. While there are some experimental treatments available, Azola says most of the care she does at Johns Hopkins for long COVID patients is "symptom managing."

Current COVID-19 vaccines can help reduce the odds that someone might develop a case of long COVID, but they're not perfect at preventing it altogether. The condition is remarkably similar to other persistent issues that have long been related to viral illnesses, including post lyme, chronic fatigue syndrome, and fibromyalgia.

"Viruses are really, really crafty," Proal said. "They drive a lot of symptoms and they infect a lot of cells, and they have a lot of really crazy strategies for doing that."

Akiko Iwasaki, a long COVID expert at Yale, spoke at a White House summit on next generation COVID vaccines July 26 and said, "I think it happens because the virus spreads enough throughout the body that it can establish reservoir in different tissues."