She was a healthy teenager. 3 months after getting COVID-19, she still hasn’t recovered

JANESVILLE, Wis. — Ava Pennycook still can’t smell much. Now almost three months after testing positive for COVID-19, she’s only recently stopped struggling with shortness of breath. An All Star cheerleader who’s traveled the country for competitions, now it’s hard just to remember a choreographed routine or make it through a full practice.. 

Her friends don’t get it, she says. When people ask what’s wrong, now she just sighs–“Nevermind.” She’s tired of explaining something she doesn’t understand that well herself. 

At fifteen years old, the Janesville high schooler is one of the youngest in a group spanning tens of thousands across the globe: Covid “long haulers”. Their average age is 44, and their experience in the weeks and months after testing positive for COVID-19 is frequently marked by extreme fatigue, brain fog, and a litany of other symptoms.

“I have to reteach myself to do all the things I did before,” she said, of cheerleading. Her eyes reflect her words: “I’m just really tired.”

Ava first started feeling unwell the weekend of July 4. At first, her family thought it was infectious mononucleosis (known as mono), because she wasn’t displaying any of the symptoms most commonly associated with the coronavirus, like a fever or a dry cough. She tested negative for mono–twice–and then it got worse. She was nauseous and dizzy, and her constant fatigue confused her. She saw her pediatrician on July 23, which was when she got tested for COVID-19–and mono, a third time. Two days later, it was the COVID-19 test that came back positive.

That’s when she entered a two-week stretch of an onslaught of symptoms–shortness of breath set on, and she could barely get out of bed or take a shower on her own. Her mother detailed the symptoms: night sweats, stomach pain, loss of appetite, headaches, hot flashes, and more. When her breathing and stomach pains got particularly bad at one point, her family took her to the emergency room. Looking at selfies from that phase as she chose some pictures to share publicly, she chuckles. “I look dead,” she says. (Those pictures stayed safely on her own phone.)

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Ava Pennycook, at the NCA All Stars National Championship

Ava Pennycook, at the NCA All Stars National Championship

She tested negative on August 26–but she didn’t feel that much better. She still couldn’t smell or taste much, and the shortness of breath would continue for weeks more, only subsiding in the past couple weeks. School was about to start, and after some careful consideration, the family decided she could return to in-person schooling, with support from school staff who understood she would need extra considerations. (According to Dr. Nasia Safdar from UW Health’s infectious disease division, once “long-haulers” test negative for the virus, they typically aren’t contagious; they also often test positive for weeks at a time.)

That’s when she and her family noticed the onset of new symptoms. Ava got confused easily; an honors student for whom school came easily, now she was at times mixing up her words and struggling with work.

“I’d look at a paper and be like, ‘I don’t know what to do,'” she said. “I feel like I just get super confused all the time.”

She says it was funny at first when she would speak and mess up her words. Now, scheduled to see a neurologist soon, she’s just concerned.

“She complained a lot about feeling very tired and weak at school which seemed to make her confusion and brain fog worse,” her mother Amy noted in an email. “She’s struggling with tests and quizzes as she forgets the content they have learned…Ava is normally an excellent student, great test taker, and also is taking Honors classes.”

Brain fog is a common symptom cited in Facebook support groups for COVID-19 long haulers, where multiple groups have collected thousands of participants. For the Pennycook family, the group they joined was a source of validation in an environment where they’d long been told that the virus didn’t have much impact on children, or that you only needed to worry if you had underlying medical conditions or were elderly. Ava says it’s changed how her close friends perceive the virus; others, she says, simple don’t get it.

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Ava Pennycook says she struggles with constant fatigue, brain fog and confusion months after testing positive for COVID-19

Ava Pennycook says she struggles with constant fatigue, brain fog and confusion months after testing positive for COVID-19

“I was healthy before I got it,” she said. Counting on the upcoming competition cheerleading season, she’s already had to withdraw from one of the two teams she plays on. She’s missed the tryout for the other, and coaches are letting her wait to try out again–but the season is approaching quickly and she isn’t strong enough to do parts of the routines. She’s lucky if she can make it through half of a five-hour session. Chorography, once one of her strongest skills, is now a challenge. Missing out on competition season would be unthinkable.

She and thousands of others are struggling through a phenomenon that is still not well understood in the medical community. A July report from the Center for Disease Control and Prevention found that one in five millennial aged, healthy adults hadn’t recovered from COVID-19 weeks after testing positive. “COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions,” the study noted. According to reporting from The Atlantic, the average age for long haulers is 44, and many are women.

Dr. Safdar says it’s difficult to grasp the full picture of how many people may be experiencing drawn out symptoms, as they don’t necessarily seek out medical attention. That can risk underestimating the total, she says.

“It is very new. We’re still learning. It is important to come to grips with the scope of the problem,” Dr. Safdar said. “You can’t just assume that just because someone has mild symptoms to begin with that they will bounce back immediately.”

While the reasons why symptoms linger is largely unknown in the medical community, Dr. Anthony Fauci in sworn testimony in September named many of the symptoms Ava is experiencing as common among those with the lingering version of the virus–including fatigue, cited most frequently as one of the most persistent symptoms. Fever, shortness of breath, and brain fog were other frequent complaints. What isn’t so clear is how long it lasts; some still struggle after contracting the virus in March.

Ava hopes it’s not long enough to affect the competition season. A long row of medals hangs by her bed; her bedroom door is covered in pictures of her teams. She was young and healthy, the demographic that she was most often told was the safest.

“It can happen to anyone.”