Long COVID living patient overview

Overview

Long COVID is the term used to describe symptoms that continue for weeks or months after having COVID-19. These symptoms can range from mild to severe and may come and go. It is also known as post-COVID-19 condition. It can affect many parts of the body, including the lungs, heart, brain, and muscles.

Yes, Long COVID is relatively common. Studies suggest that around 1 in 10 people who had COVID-19 experience ongoing symptoms for 12 weeks or more. It is a condition seen worldwide.

Long COVID can affect anyone who has had COVID-19, including children and adults. It is more common in women, people aged 35–69, those who had severe initial COVID-19 illness, and those with certain pre-existing health conditions.

Symptoms

Common symptoms

• Extreme tiredness (fatigue) that does not improve with rest
• Shortness of breath or difficulty breathing
• Brain fog (trouble thinking, concentrating, or remembering)
• Loss of or change in smell or taste
• Joint or muscle pain
• Chest pain or tightness
• Cough that does not go away
• Heart palpitations (feeling your heart beating fast or irregularly)
• Headache
• Dizziness on standing
• Sleep problems (insomnia, restless sleep)
• Anxiety or depression

Symptoms in children

• Long COVID in children is less common but can happen. Symptoms often include tiredness, trouble concentrating, headache, sleep problems, stomach pain, and feeling unusually irritable or sad.

Symptoms in older adults

• In older adults, Long COVID may cause more severe fatigue, increased frailty, worsening of existing health conditions (like heart disease or diabetes), and a higher risk of falls due to dizziness or weakness.

Causes

Main causes

• The exact cause of Long COVID is not fully understood. Possible contributors include an overactive immune response, the virus hiding in the body for a long time, inflammation in organs, or damage from the initial infection.

Risk factors

• Having a severe COVID-19 illness (especially needing hospital care)
• Being female
• Being middle-aged or older
• Having underlying health conditions (such as diabetes, high blood pressure, lung disease, or obesity)
• Not being vaccinated against COVID-19

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.
• If you have new or worsening chest pain, trouble breathing, or severe dizziness that does not go away.

Book a routine appointment if:

• If you have symptoms like tiredness, brain fog, or cough that persist for more than 4 weeks after COVID-19
• If your symptoms are affecting your daily life, work, or ability to care for yourself
• If you notice new symptoms that worry you (like unusual palpitations or pins and needles)

Diagnosis

There is no single test for Long COVID. Your doctor will ask about your symptoms, when they started, and whether you had confirmed or suspected COVID-19. They will also do a physical exam and rule out other conditions that could cause similar symptoms. This is known as a 'diagnosis of exclusion'.

Tests that may be done

• Blood tests (to check for inflammation, anaemia, and organ function)
• Chest X-ray or CT scan (if you have breathing problems)
• Electrocardiogram (ECG) to check heart health
• Exercise tests (like a 6-minute walk test) to measure endurance
• Cognitive tests if you have brain fog

What to expect at your appointment

Diagnosis may take time because symptoms vary so much. Your doctor will work with you to understand your symptoms and rule out other causes. You may be referred to a Long COVID clinic or a specialist like a respiratory doctor, cardiologist, or neurologist depending on your symptoms.

Treatment

Treatment for Long COVID focuses on managing specific symptoms and supporting your body's recovery. There is no one-size-fits-all cure, but many people get better with a combination of self-care, physical and mental rehabilitation, and medical support for any organ damage.

Self-care at home

• Rest when you are tired, but try to gradually increase activity using 'pacing' – breaking tasks into small chunks with rest in between.
• Eat a balanced diet with plenty of fruits, vegetables, and protein to support healing.
• Stay hydrated throughout the day.
• Keep a symptom diary to notice patterns and triggers.
• Practice relaxation techniques like deep breathing or meditation to help with anxiety and stress.
• Get quality sleep by setting a routine and avoiding screens before bed.

Medical treatments

Your doctor may recommend treatments tailored to your symptoms. For breathing problems, they might suggest breathing exercises or a referral to pulmonary rehabilitation. For heart-related symptoms, a cardiologist may guide you. For brain fog, cognitive rehabilitation or strategies to improve focus may help. For pain, physical therapy or supportive therapies can be useful. Always discuss any treatments with your healthcare provider before trying them.

When is surgery considered?

Surgery is not a treatment for Long COVID itself. However, if Long COVID leads to complications like blood clots or organ damage, surgery may be needed for those specific issues. This is rare and decided on a case-by-case basis.

Living with this condition

Living with Long COVID means adjusting your daily routine to match your energy levels. Some days you may feel better, other days worse – this is normal. It helps to plan rest breaks, ask for help with chores, and set realistic goals. Many people find it helpful to use a diary to track symptoms and energy levels.

Lifestyle tips

• Get outside when you can, even if just sitting for a few minutes – fresh air and sunlight can help mood and sleep.
• Stay connected with friends and family, even virtually, to avoid isolation.
• Limit alcohol and avoid smoking, as these can make symptoms worse.
• Consider joining a Long COVID support group online or in your community.

Diet and exercise

Aim for a balanced diet with enough protein, fruits, and vegetables. Avoid extreme diets. For exercise, start very gently – such as short walks or stretching – and only increase if you feel able. Listen to your body: if an activity makes you feel worse the next day, you may have overdone it. Pacing is key.

Mental health and emotional wellbeing

Long COVID can take a toll on your mental health. It is normal to feel frustrated, anxious, or low when symptoms last a long time. Talk to your doctor if you feel very sad or worried. Many people benefit from counselling or cognitive behavioural therapy (CBT). If you are having thoughts of harming yourself, call a crisis helpline immediately.

Prevention

Reducing your risk of getting COVID-19 in the first place is the best way to prevent Long COVID. This includes staying up to date with recommended vaccines, wearing masks in crowded indoor spaces, and practising good hand hygiene.

Vaccines

COVID-19 vaccines are effective at reducing the risk of severe illness and may also lower the chance of developing Long COVID. Getting vaccinated and boosted as recommended by health authorities is a good preventive step.

Screening programmes

There is no routine screening test for Long COVID. However, if you have had COVID-19 and develop new symptoms that last, it is important to see a doctor for evaluation.

Complications

If left untreated

• Prolonged fatigue and disability that makes it hard to work or do daily tasks
• Lung damage leading to persistent breathing problems
• Heart problems like myocarditis (inflammation of the heart muscle) or arrhythmias
• Blood clots (deep vein thrombosis, pulmonary embolism)
• Mental health issues like depression, anxiety, or post-traumatic stress
• Worsening of other health conditions

Long-term outlook

The outlook for Long COVID varies. Many people gradually improve over months to a year, especially with proper support and self-care. Some people have lingering symptoms for longer, but even then, many find ways to manage and adapt. Research continues, and new treatments may become available. There is hope – you are not alone, and help is available.

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