Long Covid

15th August 2023 | Dr Melanie Dani


Long Covid is defined as persistent or new symptoms, attributed to Covid-19 infection, which last for more than 12 weeks after initial infection. They are often present earlier. Such symptoms may include fatigue, post-exertional malaise, breathlessness, chest pain, inability to exercise, palpitations, brain fog and fainting. However many more symptoms have been described and it is likely that the condition encompasses a range of different problems. This is the focus of global research activity currently. It is very common indeed, and has had major implications for society as it has left hundreds of thousands of people unable to work or exercise as before. As time goes on, we understand more and more about the condition, and possible underlying causes. It is likely that there may be multiple causes, and multiple underlying conditions. It can be scary and unpredictable, and often frustrating to find yourself in the situation where you are much ‘well’, or fit, than previously. It can also be overwhelming to read about new and constantly evolving ‘cures’ which can often be disappointing, so we advise sticking to trusted sites only.

Long Covid Symptoms

A common feature in Long Covid is orthostatic intolerance, or symptoms which are worse on standing, such as breathlessness, palpitations and chest pain. We have seen a rise in cases of seemingly new diagnoses of vasovagal syncope, POTS and orthostatic hypotension associated with Long Covid. We do not yet know enough about Covid-19 to speculate on why this is, but we know that the autonomic nervous system is involved in the body’s reaction to the virus infection. We also know that post-viral phenomena such as POTS and chronic fatigue are common, and it is likely that we are seeing such high numbers due to the high number of people involved in the pandemic.

What Can I Do?

We have found that the steps we mentioned in the ‘tips and tricks’ section in the Dysautonomia section help symptoms in many cases – this is fundamental to recovery. At the moment, like other orthostatic intolerance disorders, there is no set ‘cure’ or magic bullet to cure the condition, but rather, a series of steps to gradually work on your symptoms.  It is important to pay careful attention to each step, ensuring stress reduction and gradual reintroduction of activity.  It is critically important to pace yourself, and allow yourself the time and space to get better. A useful way of thinking about this is to allocate yourself an ‘energy’ allowance for the day and plan your day accordingly, taking care not to use up all of your energy on one task and allow plenty of time for relaxation and rest. Try to space out essential tasks (such as household chores or going to the shops) throughout the week so that you do not do too much on one day. The key is to ensure you have regular gentle activity with plenty of breaks and rest, to allow your body to slowly upgrade what it can do.

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