When COVID-19 first emerged, the focus was survival. But as the acute phase of the pandemic eased, a new health concern became increasingly visible:

Many individuals continued to experience symptoms weeks or even months after recovering from the initial infection.

This condition is now widely referred to as Long COVID or Post-COVID Syndrome.

At Nellikka.life, let us explore the medical and scientific understanding of Long COVID — what it is, why it happens, and what current evidence tells us.

What Is Long COVID?

Long COVID refers to persistent or new symptoms that continue beyond 4–12 weeks after the initial COVID-19 infection, without another clear explanation.

Medical organizations such as the World Health Organization (WHO) and other global health bodies recognize it as a legitimate post-viral condition.

It can affect:

• People who had severe COVID
• Those with mild symptoms
• Even individuals who were asymptomatic

This unpredictability is what makes Long COVID medically significant.

How Common Is It?

Studies suggest that:

• Around 10–30% of people infected with COVID-19 may experience prolonged symptoms.
• The risk may be higher in:
  • Older adults
  • Women
  • People with pre-existing conditions
  • Individuals who had severe infection

However, even young and otherwise healthy individuals can develop Long COVID.

Common Symptoms of Long COVID

Long COVID is multi-systemic, meaning it can affect multiple organs.

The most frequently reported symptoms include:

Neurological

• Brain fog (poor concentration and memory)
• Headaches
• Dizziness
• Sleep disturbances
• Anxiety and depression

Respiratory

• Breathlessness
• Persistent cough
• Reduced exercise tolerance

Cardiovascular

• Palpitations
• Chest pain
• Increased heart rate (postural tachycardia)

General & Musculoskeletal

• Extreme fatigue
• Muscle and joint pain
• Weakness

Other

• Altered taste or smell
• Gastrointestinal disturbances
• Hair loss
• Menstrual irregularities

Fatigue and cognitive impairment are among the most commonly discussed complaints online and in clinics.

What Causes Long COVID?

Research is ongoing, but several mechanisms are proposed:

Persistent Immune Activation

Even after the virus clears, the immune system may remain in a heightened inflammatory state.

Chronic low-grade inflammation can affect energy levels and cognition.

Viral Residual Fragments

Some studies suggest that small viral fragments may remain in tissues, triggering prolonged immune response.

Autonomic Nervous System Dysfunction

Many Long COVID patients show signs of dysregulation in the autonomic nervous system, leading to:

• Palpitations
• Blood pressure instability
• Dizziness on standing

This overlaps with conditions like POTS (Postural Orthostatic Tachycardia Syndrome).

Microvascular Damage

COVID-19 is known to affect blood vessels. Tiny clots or endothelial dysfunction may impair oxygen delivery, contributing to fatigue and breathlessness.

Psychological and Stress Factors

Prolonged illness, isolation, and pandemic-related stress can amplify symptoms, especially anxiety and sleep disturbance.

Importantly, Long COVID is not “just psychological.” It is biologically complex, though mental health plays a role in overall recovery.

How Is Long COVID Diagnosed?

There is no single test for Long COVID.

Diagnosis is typically:

• Based on history of COVID infection
• Persistent symptoms beyond expected recovery
• Exclusion of other medical causes

Doctors may order tests such as:

• Blood tests (inflammatory markers, thyroid, vitamin levels)
• Chest imaging
• ECG or cardiac evaluation
• Lung function tests

The goal is to rule out serious complications and guide management.

Management and Treatment: What Works?

Currently, there is no single “cure.” Treatment focuses on symptom management and gradual recovery.

1. Energy Management (Pacing)

Overexertion can worsen fatigue. Patients are advised to:

• Balance activity and rest
• Avoid “push and crash” cycles
• Gradually increase physical activity

2. Pulmonary Rehabilitation

Breathing exercises and supervised rehabilitation help improve lung function and endurance.

3. Cognitive Support

For brain fog:

• Structured routines
• Sleep hygiene
• Reduced multitasking
• Brain training exercises

4. Cardiac & Autonomic Care

Hydration, salt intake (if medically advised), compression stockings, and gradual positional changes may help in selected cases.

5. Nutritional & Lifestyle Support

While supplements are not magic cures, maintaining:

• Balanced diet
• Adequate protein
• Vitamin D optimization
• Proper hydration
• Regular sunlight exposure

can support recovery.

How Long Does Recovery Take?

Recovery varies widely.

Some improve within a few months.
Others may experience symptoms for a year or more.

Encouragingly, many individuals show gradual improvement over time.

Ongoing research continues to refine treatment strategies.

When to Seek Medical Attention

Immediate evaluation is necessary if you experience:

• Severe chest pain
• Sudden breathlessness
• Fainting episodes
• Neurological deficits
• Persistent high fever

Long COVID symptoms should not be self-diagnosed without medical consultation.

The Broader Impact

Long COVID is not just an individual health issue. It affects:

• Workforce productivity
• Mental health
• Family dynamics
• Healthcare systems

Recognition and awareness are crucial for timely support and reduced stigma.

Science, Patience, and Support

Long COVID reminds us that viral infections can have lingering consequences.

While science continues to evolve, three principles are essential:

• Medical evaluation to rule out complications
• Gradual rehabilitation rather than forced recovery
• Emotional support and patience

If you or someone you know continues to experience symptoms after COVID, you are not imagining it.

The condition is real.
Research is ongoing.
Recovery is possible — though often gradual.

At Nellikka.life, we advocate informed awareness, scientific guidance, and compassionate care in navigating post-viral health challenges.