If you display coronavirus symptoms for longer than four weeks with no other explanation, it is possible that you could have long COVID. The condition has perplexed the medical community with its heterogenous symptoms, making it difficult to treat. What are the symptoms of long COVID and what can you do to aid recovery?

Long COVID symptoms

Over the course of the coronavirus pandemic there has emerged a mysterious condition now known as long COVID that can limit health and lifespan. While the majority of people who contract coronavirus tend to recover within a few weeks, others go on to develop a wide range of health problems lasting four or more weeks after initial infection. Some symptoms are similar to those of mild coronavirus, while others are more severe. Worryingly, it is possible for anyone to contract long COVID after coronavirus infection, including those who experienced mild symptoms, those who were hospitalised with severe cases and even those who did not display any symptoms at all. Long COVID commonly involves a combination of symptoms including:

• Breathing difficulties or shortness of breath
• Tiredness and fatigue
• Cognitive difficulties (brain fog)
• Joint and muscle pains
• Increased heart rate (heart palpitations)
• Loss or change in taste or smell [1].

These heterogenous symptoms are thought to be caused by the immune system’s overreaction to coronavirus. The body protects itself from invading pathogens like the COVID causing SARS-CoV-2 virus using the innate and adaptive immune systems. While reducing viral replication, this can also cause inflammation and cytokine storms, damaging the body’s tissues. Viral infections are known to occasionally cause lasting symptoms especially when they effect the brain, for example autoimmune diseases like chronic fatigue symptoms (CFS) and myalgic encephalitis (ME) can develop following a neurological viral infection. Therefore, it is not surprising that coronavirus can cause long term pathology considering its effects on neurological pathways, causing symptoms like brain fog and change in taste or smell [2].

Preventing long COVID

The best way to prevent long COVID is to avoid contracting coronavirus in the first place. With rising cases and seemingly endless waves of infection, avoiding coronavirus completely seems increasingly impossible. The Centers for Disease Control recommends continuing protocols used throughout the pandemic; namely getting COVID-19 vaccinations and boosters. It is thought that being vaccinated reduces the risk of developing long COVID, however, speculations that long COVID symptoms can improve after vaccination have not yet been substantiated by clear empirical evidence. Other practices include wearing a mask to prevent the spread of infection, social distancing from others, regular handwashing and avoiding crowds and poorly ventilated areas [1].
The individuals most at risk of developing long COVID include older people, those with underlying health conditions and those who exhibited five or more coronavirus symptoms during initial infection. People who had to be hospitalised with severe COVID-19 may experience multiorgan effects in many if not all body systems. Hospitalisation is also more likely to cause severe weakness, exhaustion, cognitive difficulties as well as post-traumatic stress disorder (PTSD). Whether this is caused by the long-term effects of the virus, of hospitalisation, or a combination of both is uncertain and may be further complicated by spill-over effects of the pandemic like the impact of isolation on mental health, economic impacts, or lack of access to healthcare for managing other health conditions [1].
A recent study has identified a potential way to predict those more likely to develop long COVID. Using a blood test to measure immunoglobin (Ig) levels, the study found an Ig signature in those who had COVID-19 that could predict the risk of developing long COVID, in addition to patient age, history of asthma and number of symptoms experienced during primary infection [3]. Evidently, the severity and number of symptoms experienced when first infected with coronavirus influences its pathological progression and can be used to predict and support people at highest risk of long COVID.

Rest, relaxation and recovery

Considering its diverse pathology, there is currently no comprehensive treatment or cure for long COVID. However, there are several steps that can be taken to reduce its severity. Firstly, managing the physical effects of chronic disease is a good starting point. Taking care of your health is always important in preventing and managing disease. Sensible steps like eating a balanced diet, getting good quality sleep and avoiding drugs and alcohol can all help. Doing daily, low-impact exercise that gradually increases in difficulty is an effective way to rebuild your strength and fitness levels. However, it is important not to overexert yourself, as symptoms can be exacerbated by physical or mental activities, known as post-exertional malaise [1]. Taking frequent, short rests is recommended and can be less depressing than prolonged rest.

A healthy lifestyle can be supplemented by, well, supplements. Longevity supplements work differently from dietary supplements that prevent vitamin deficiencies as they effect the pathways that cause damage to the body and lead to aging. There is some research into COVID-19 and spermidine, a naturally occurring compound in the body that induces cellular renewal through autophagy. One study found that administering spermidine and other autophagy-inducing compounds maintained autophagy and reduced viral replication of SARS-CoV-2. Additionally, Humanpeople developed a supplement package containing six high strength nutraceuticals including resveratrol, N-Acetyl Cysteine (NAC) and quercetin, which support the immune system during coronavirus or long COVID.
There are also coping strategies to deal with the more qualitative experience of long-term illness, helping both your physical and mental health. Coping with a long-term illness can be challenging, however there are ways to effectively reduce stress, anxiety and uncertainty following diagnosis. Understanding what is happening to your body can be the first step in regaining autonomy over your health. Some people find becoming actively involved in the medical community can reduce feelings of hopelessness, for example reading research papers on long COVID can make people feel like something is being done. Joining support groups to understand other people’s experiences of illness can also be helpful in dealing with feelings of isolation. Enrolling in non-invasive research studies can help the empirical understanding of new and somewhat mysterious illnesses like long COVID [4].
While it is important to remain informed of developments in long COVID, becoming too preoccupied with your health can have negative effects, and there may never be definitive answers explaining long COVID. Evident throughout the pandemic, access to too much information can be overwhelming and stressful. To manage this, it can be helpful to take a break from watching, reading or listening to the news and social media. Instead, try journaling your own personal experience of long COVID. Relaxing through mediating, stretching or breathing exercises can all help, as can enjoying your favourite activities like reading a book, watching a film or relaxing in nature.
Considering the detrimental effect that isolation has had on mental health over the pandemic and that human beings are social animals, it is important to take time to nurture your social connections. Whether this be through a long COVID support group, friends and family or a trusted colleague, it is possible to feel physical relief from verbalising your feelings about your illness [4].
The pandemic has had innumerable long- and short-term effects on health and society. Long COVID negatively impacts health and wellbeing, the extent to which we are only just discovering. Looking after your physical and mental health following diagnosis can help manage a long-term condition, leading towards recovery.