Living with long COVID
Long COVID is when you’ve had a coronavirus (COVID-19) infection and you still feel unwell more than four weeks after your symptoms began. Here, I explain what we know about long COVID and what to do if it’s affecting you.
What does long COVID mean?
The term ‘long COVID’ has been used a lot on social media and in the news. There are two medical definitions.
- Ongoing symptomatic COVID-19. This is if you have symptoms of coronavirus from 4 to 12 weeks.
- Post-COVID-19 syndrome. This is when symptoms of coronavirus carry on after 12 weeks and can’t be explained by another diagnosis.
These are different from an acute COVID-19 infection, which is when you have symptoms of COVID-19 for up to four weeks.
How long does long COVID last?
For many people, the symptoms of COVID-19 go away within 12 weeks. But the recovery time is different for everyone, and anyone who has had COVID-19 can develop long COVID.
The latest COVID-19 infection survey estimates that around 2 million people in the UK have long COVID. Of these people:
- two-thirds have had long COVID symptoms for at least a year
- more than a third have had symptoms for at least two years
You may have a combination of these symptoms, varying in severity, that ease and then flare up. You may have a run of good days followed by feeling poorly again.
What are the main symptoms of long COVID?
There are many symptoms of long COVID, which can come and go or change over time. Long COVID can affect people differently, too.
Some people might have clusters of symptoms - for example, ones that mainly affect their lungs and breathing, or their nervous system. Others might have a range of symptoms that affect different parts of their body.
Some of the main symptoms that people report include:
- fatigue (extreme tiredness)
- breathlessness or shortness of breath
- muscle aches and joint pain
- brain fog (difficulty concentrating and struggling to think clearly)
- cough
- sleep problems
- feeling anxious or worried
- low mood
- headaches
- sore throat
- lost sense of taste and/or smell
- chest pain or tightness
- lung problems
- gut problems, such as diarrhoea, reduced appetite, and nausea
- palpitations (fast heartbeat)
- skin rashes
You may have a combination of these symptoms, varying in severity, that ease and then flare up. You may have some good days followed by days where you feel poorly again.
Who is most at risk of long COVID?
Long COVID can affect anyone who’s had a coronavirus infection. But it’s thought that long COVID may be more likely to affect:
- women
- people with existing health conditions, such as asthma
- people who are overweight or obese
- people who had severe COVID-19
- people who have not been vaccinated against COVID-19
Research is ongoing into risk factors for long COVID, including in children and adolescents.
What treatment is there for long COVID?
If you think you have long COVID, make an appointment with your GP. They’ll ask you about your medical history and your symptoms. They’ll also ask you how your symptoms are affecting your life.
Your GP may refer you for further tests. This is to find out if your symptoms are likely to be because of long COVID, or if it could be a different condition that’s causing them. For example, you might have a blood test, chest X-ray, or a test that assesses your ability to do certain activities.
The symptoms of long COVID are very wide-ranging. So your doctor will advise tests that are most relevant to your set of symptoms.
If your doctor is concerned about specific severe complications, they’ll refer you for relevant treatment. Otherwise, they may refer you to what’s called a multi-disciplinary service if there’s one set up in your area.
These are sometimes called post-COVID services. Here, you’ll receive advice on how to manage your symptoms and support for your recovery.
How can I help myself if I have long COVID?
Pace yourself
Many people who are living with long COVID have said it’s hard to accept that recovery may be slow and ongoing. However, they also said that realistic goals and pacing themselves helped them to progress. Try to lower your expectations of fast recovery and take it one day at a time.
Tell your loved ones
Talk to your friends and family about how you’re feeling. Let them know that you may need their support and that some days may be harder than others. You may find that telling people helps you feel better and understood.
Access practical help
Access reputable websites that offer support specifically for long COVID. We have compiled a list for you below.
- Your COVID recovery from NHS England.
This site offers lots of advice and support about recovering from COVID-19. It covers advice about how to manage ongoing effects, support for friends and family, managing daily tasks, and returning to work. - How to manage post-viral fatigue after COVID-19 from The Royal College of Occupational Therapists.
This site gives you advice about dealing with the fatigue you feel after having a virus. It sets the advice out in ‘steps’ so you can follow them according to how you’re feeling. They also have a good resource on ‘how to manage your energy levels’. - Long COVID hub from Asthma and Lung UK.
This hub of information is specifically for those who have been left with breathing difficulties from coronavirus. It offers lots of practical advice, including techniques for breath control.
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Sources Sources
- COVID-19 rapid guideline: managing the long-term effects of COVID-19. National Institute for Health and Care Excellence (NICE). nice.org.uk, last updated 11 November 2021
- Coronavirus (COVID-19) latest insights: Infections. Office for National Statistics. ons.gov.uk, published 30 March 2023
- Long COVID or post-COVID conditions. US Centers for Disease Control and Prevention. cdc.gov, updated 20 July 2023
- Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ 2021;372:n136. Doi:10.1136/bmj.n1
- Self-reported long COVID symptoms, UK: 10 July 2023. Office for National Statistics. ons.gov.uk, published 10 July 2023
- Notarte KI, de Oliveira MHS, Peligro PJ, et al. Age, Sex and Previous Comorbidities as Risk Factors Not Associated with SARS-CoV-2 Infection for Long COVID-19: A Systematic Review and Meta-Analysis. J Clin Med 2022;11:7314. DOI:10.3390/jcm11247314
- Rayner DG, Wang E, Su C. Risk factors for long COVID in children and adolescents: a systematic review and meta-analysis. World J Pediatr 2023; published online Oct 27. DOI: 10.1007/s12519-023-00765-z
- Long-term effects of coronavirus (long COVID): what are the risk factors? NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2022
- Your COVID recovery. NHS England. nhs.uk, accessed 21 December 2023
- How to manage post-viral fatigue after COVID-19. Royal College of Occupational Therapists. rcot.co.uk, accessed 21 December 2023
- How to manage your energy levels. Royal College of Occupational Therapists. rcot.co.uk, accessed 21 December 2023
- Long COVID. Asthma and Lung UK. asthmaandlung.org.uk, last reviewed 1 October 2022
- Canas LS, Molteni E, Deng J, et al. Profiling post-COVID-19 condition across different variants of SARS-CoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations. Lancet Digit Health 2023;5:e421-434. DOI:10.1016/S2589-7500(23)00056-0
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