Long Covid Treatment

Long Covid, also known as post-COVID-19 syndrome, describes symptoms that persist for weeks or months after an initial COVID-19 infection and cannot be explained by another condition.

It can affect people regardless of how mild or severe their original illness was, and symptoms may fluctuate over time.

The condition can affect multiple body systems and significantly impact daily functioning, education and the ability to work.

How common is long Covid?

Long Covid is relatively common. UK estimates suggest that around 2 million people have experienced ongoing symptoms following COVID-19 infection, although this number is gradually declining over time.

Understanding the symptoms of long Covid is the first step in planning effective assessment and treatment.

Symptoms

Symptoms can appear several weeks after the initial infection. They may come and go, and often worsen with stress, lack of sleep, or overactivity.

General and energy-related symptoms

Severe fatigue is one of the most frequently reported long Covid symptoms, affecting many people. This is not ordinary tiredness – it is often described as overwhelming, unrefreshing, and unresponsive to rest. People describe needing to nap after light activity, such as showering or reading a few pages of a book. Physical fatigue can make previously simple tasks feel overwhelming.

Closely related is post-exertional symptom exacerbation (PESE), also known as post-exertional malaise (PEM). This is an important feature where symptoms worsen hours or days after physical, cognitive, or emotional effort. The resulting exhaustion is often disproportionate to the effort involved and can last for days. Learning to pace your activities and manage your energy levels is key to reducing fatigue and avoiding symptom flare-ups.

Breathing and heart symptoms

Respiratory symptoms are common, with many people experiencing breathlessness on exertion. You might find yourself struggling to climb stairs without stopping or feeling short of breath when walking short distances.

A persistent cough can also be a feature of long Covid and may continue for weeks or months after the initial infection.

Some people experience chest pain, chest tightness or palpitations (an awareness of their heartbeat), which can be distressing and may occur even during everyday activities.

Autonomic symptoms

Long Covid can affect the autonomic nervous system, which controls many automatic body functions such as heart rate, blood pressure and digestion. This is known as autonomic dysfunction.

Some people notice a marked increase in heart rate or feel dizzy when standing up, which may be suggestive of Postural Orthostatic Tachycardia Syndrome (POTS). Others may experience problems with temperature regulation, nausea, diarrhoea, abdominal pain, or changes in bladder and bowel function.

Neurological and cognitive symptoms

Brain fog impacts many people with long Covid, manifesting as memory lapses (such as forgetting recent conversations), difficulty concentrating, and problems with word-finding. Headaches, often migraine-like, dizziness, and disturbed sleep (including difficulty sleeping, insomnia, or sleeping excessively) are also common. Loss of smell and taste can persist in some patients beyond six months after the initial infection.

Other symptoms

Other symptoms may include muscle aches, joint pain, skin rashes and new allergies. In some people, these symptoms may overlap with features of Mast Cell Activation Syndrome (MCAS).

Symptoms can vary widely, with some people experiencing a combination of physical and mental health effects that significantly impact daily life.

A thorough assessment is important to rule out other conditions and identify any complications that may require specialist input.