Most people who have been infected with COVID-19 fully recover, but as the World Health Organization reports, roughly 10 to 20% of them suffer from long COVID: they have new, recurring, or persisting symptoms or health issues at least four weeks after their diagnosis.

While they are not contagious, people suffering from long COVID might experience one or more symptoms such as fatigue; shortness of breath; memory and concentration problems, sometimes referred to as “brain fog”; sleep problems; muscle aches or pain; psychological symptoms, such as depression or anxiety; and changes in smell or taste. These symptoms may impact quality of life and limit the ability to complete everyday activities — making a normal working routine hugely challenging.

Looking after yourself and seeking help early on are extremely important, especially when it comes to long-term illnesses. That is why the Global Health, Safety & Well-Being team at SAP is working to make employees aware of the possible long-term effects of a COVID-19 infection and providing practical advice.

Company Medical Officer Dr. Torsten Paul shares more here about living and working with long COVID.

Q: We often hear or read about long COVID and post-COVID conditions in the media, but what do these terms mean exactly?

A: Before we go into that, I’d just like to point out that other viruses can cause long-term health issues as well, so this isn’t new.

“Post-COVID conditions” is used as an umbrella term to capture health problems that occur four or more weeks after an acute COVID-19 infection and cannot be explained by an alternative diagnosis. New, recurring, or persisting symptoms from four weeks up to 12 weeks after the initial infection are called long COVID. If you experience symptoms for more than 12 weeks and they cannot be explained by an alternative diagnosis, then we would refer to that as post-COVID syndrome.

What can I do to protect myself from post-COVID condition? Do vaccinations prevent it?

The best way to prevent post-COVID conditions is to protect yourself and others from becoming infected. Being fully vaccinated against the virus and following the measures to prevent infection help with this.

But if you do catch the virus, being fully vaccinated significantly reduces the risk of severe COVID-19 illness and the likelihood of post-COVID conditions. Although research on the prevention of post-COVID conditions is still ongoing, current findings strongly suggest that people who are vaccinated but experience a breakthrough infection are less likely to report post-COVID conditions, compared to people who are unvaccinated. Unfortunately, people who are fully vaccinated can still suffer from post-COVID-19 conditions, as our colleague Nicky’s story shows (see below).

At SAP, we are also doing our part to prevent the long-term effects of a COVID-19 infection: so far we have administered more than 30,000 vaccines to employees worldwide and continue to do so.

Does long COVID affect only people who suffered from a more severe COVID-19 illness?

The long-term health problems that can occur are mostly unrelated to the severity of the original COVID-19 illness. Sadly, this means that people who had a mild or asymptomatic infection still have a certain risk of developing long-term health issues. The good thing is that their risk is lower compared to people who had to be treated in an intensive care unit during their COVID-19 infection. Current research also suggests that women are more likely than men to develop long COVID, but we do not yet know why.

It can be difficult to distinguish many of these symptoms from symptoms that occur for other reasons.

Do physicians, hospitals, and authorities now recognize long COVID as an illness?

If a patient experiences symptoms following a SARS-CoV-2 infection, a thorough clinical evaluation is important. If the symptoms cannot be otherwise explained, physicians should always suspect a post-COVID condition. Fortunately, the general awareness of these conditions is growing, and we continue to learn more about them. Many countries now have official guidelines on diagnosing and treating post-COVID conditions.

What can employees do if they think they might be suffering from a post-COVID condition?

In most countries, the first point of contact for employees is their general practitioner or family doctor. Company physicians can also play an important role in the case of so far undiagnosed post-COVID conditions by referring patients to further external diagnosis and treatments.

What types of treatment are available?

Unfortunately, we are not yet able to treat the underlying causes of post-COVID conditions. Current treatments focus on improving symptoms and quality of life. Many official international guidelines recommend interdisciplinary, outpatient care provided by specialist physicians and in some cases by general practitioners. Because the symptoms often affect multiple organ systems, it is not unusual for treatments to involve multiple specialists in, for instance, general medicine, pulmonology, neurology, psychosomatic medicine, psychiatry, and psychotherapy, and, for children, pediatrics. Many countries have already set up post-COVID clinics or outpatient centers, some of which are located at university hospitals, to take care of patients with more severe illnesses.

How does the SAP Health team help colleagues?

We offer medical consulting and referral as part of our general occupational and preventive health services. Our services do not replace, but rather complement, the specialist diagnosis and treatments that are available outside SAP. We also have separate post-COVID consultation sessions, during which patients can discuss their symptoms with our medical experts and receive recommendations to find the right external diagnostic and treatment pathway, as well as the support available in the workplace.

For colleagues who have been ill for some time, we offer support in the return-to-work process to help ensure that their working environment meets their medical needs.

“Don’t give up!”: An SAP Colleague Reports

Nicky* is 40 and a single mother of two. She works at SAP in Germany. In mid-February 2022, her 11-year-old son caught COVID-19 at school and was briefly very sick with it. When Nicky, who was triple vaccinated, fell ill shortly afterwards, her symptoms were severe. She suffered from extreme breathlessness and chronic fatigue — and continued to test positive for four weeks.

“I could hardly move and barely think straight,” remembers Nicky. She remained on sick leave until May and then began a gradual return to work. Now, more than five months on, she is still suffering the effects of her illness. An interview with Nicky on Microsoft Teams was an experience she clearly found exhausting. She frequently had to pause and take deep breaths, and at one point needed an inhaler to ease her breathing. “I want to tell people about what I’ve been through, encourage fellow sufferers, and appeal to colleagues to show understanding for those affected.”

Nicky’s post-COVID symptoms make it hard for her to perform normal everyday tasks. “Luckily, my children help with the housework,” she says. Fatigue and concentration issues mean she is unable to drive long distances. Whereas she used to relish tackling a high ropes course with her children, she can now only watch them from the ground. “Before I got COVID-19, I played sports. Now that I can hardly move around at all, I’ve really put on weight.”

When it comes to her job, Nicky says: “I’m probably back to between 30-40% of my pre-virus productivity level.” She has returned to her part-time position and, because working from home is not an option, she makes the journey to the office. She drives there, just as she used to, but her illness presents many obstacles. “I have to go and lie down regularly, and I need a quiet place to work. I can’t walk far — to fetch a cup of coffee, for example. I also find it hard to concentrate for any length of time: I sometimes start speaking and then suddenly forget what I wanted to say. Or I’ll be reading an e-mail and my eyes will just close.”

Fortunately, Nicky’s manager and team understand and respect her situation. “There are days when I’m productive for five hours, but the next day I might be so exhausted that I can’t even make it to work,” she says. She is in contact with SAP’s company physicians, who have helped her, for example, by telling her about a post-COVID outpatient clinic near her home, and she has regular sessions with an occupational therapist.

Nicky advises others affected by and working with long COVID to be open about their illness. Her own experiences of doing so have been nothing but positive, she says. “Be open and honest with your colleagues, and don’t put yourself under pressure! Most important of all, don’t give up!”

*The employee’s name has been changed