This fact sheet helps you to know when and where to get help and advice and what you can do yourself to maintain and improve your health and wellbeing on the road to recovery from Long COVID and Post-COVID Syndrome.
You may hear people referring to both ‘Long COVID’ and ‘Post-COVID Syndrome’.
Long COVID is any signs and symptoms that last more than 4 weeks after developing COVID-19. This includes symptoms of COVID-19 that take 4-12 weeks to clear, and Post-COVID Syndrome as well.
Post-COVID Syndrome is signs and symptoms that develop during or after a COVID-19 infection that continue for more than 12 weeks and are not explained by another diagnosis
Recovery from Acute COVID-19 is unpredictable and can take 2-4 weeks. Some people persist with ongoing symptomatic COVID-19 for up to 12 weeks or even longer with Post COVID symptoms after the initial illness. It is recognised by WHO as a diverse condition(1). Whether it is mild or needs hospital care, symptoms can continue, recur or fluctuate, and new ones may develop.
The definitions above are the ones used by The National Institute for Health and Care Excellence (2) and in this fact sheet.
Most people get better from Long COVID and Post-COVID Syndrome. In people with diagnosed COVID-19, 3 out of 10 people will still have at least 1 symptom at 4 weeks, falling to 1 out of 10 after 12 weeks. Whether admitted to hospital or not, some people will still have symptoms at 6 months. They can range from symptoms that are mild to those that are serious and/or disabling (NIHR report, 2021). See under ‘What can I do to help myself’ for further numbers.
Possible Long COVID Symptoms
A wide range of symptoms have been reported for Long COVID. Symptoms often present as clusters of symptoms, often overlapping, which can fluctuate, change over time and affect any system in the body. People with Long COVID may develop any number of symptoms, which range in severity and how disabling their impact. The commonest are; fatigue, loss of sense of smell (anosmia), psychological disturbances, ‘brain fog’ (cognitive impairment), breathlessness, chest tightness, cough and sleep disturbance. (3).
Fatigue (commonest symptom)
Nervous System symptoms
‘Brain fog’, loss of concentration or memory issues (‘cognitive impairment’ )
Peripheral neuropathy symptoms (pins & needles, numbness)
Delirium (in older people)
Ear, nose and throat symptoms
Loss of taste and/or smell
Anorexia and reduced appetite
Symptoms of depression
Symptoms of anxiety
What can I do to get myself better now and in the future?
From the moment you think you may have Long COVID it is important to engage, ask questions and get involved in the planning and decisions that will support your recovery.
If you have internet access, this NHS site gives useful, detailed advice on how to manage a whole range of specific symptoms including breathlessness, heart symptoms, cough, anxiety and poor concentration amongst many others.
You should also be mindful of symptoms that might suggest other conditions unrelated to COVID but which still need urgent attention. A cough lasting more than 3 weeks with a negative COVID-19 test could be lung cancer, as could unexplained breathlessness. If in any doubt, speak to a GP or ring NHS 111, NHS24 or Phone First (depending on where you are in the UK). Other symptoms include blood in your poo, urine or spit, discomfort on swallowing, bowel changes, breast changes, new moles or abnormal vaginal bleeding amongst many others.
Cancer Research has a very useful diagram of the main symptoms to watch for.
You will find it useful to monitor your goals, symptom changes (a symptom tracking app might be useful for this), your progress and your personal feelings about your recovery.
Support groups have been set up and are proving useful for people to share their experiences, find common ground and offer support. Please see the section ‘Where can I find out more?’ for further information.
You may be able to take up the opportunity for engaging locally in activities and past-times that you enjoy, or that you would like to try, through a scheme known as Social Prescribing. If this is something that might interest you, ask your GP practice for more information.
It is important that you consider self care for your general health such as healthy eating, sleeping and getting moving again, particularly if your COVID-19 has stopped you from doing things.
A very common Long COVID symptom is loss of sense of smell. There is evidence that this can be improved through ‘smell training’ by sniffing four different fragrances several times a day. A popular choice is rose, eucalyptus, lemon and clove. The 5th Sense and AbSent websites include good advice.
If your symptoms are not improving or are concerning, then you should contact your GP practice. Work with your healthcare professionals to set goals that are realistic, meaningful and at a pace that is right for you, both before and after you have had any investigations or a Post-COVID clinic appointment.
Remember you are not alone
In October 2022, the ONS report (4) suggested that an estimated 2.3 million people (3.5% of the population were experiencing self reported Long COVID, as defined by symptoms for more than 4 weeks (Long COVID). For many of these, 22%, their symptoms have persisted for over 2 years.
What can I expect to happen?
Most people will get better from Long COVID within a few weeks. If your symptoms are not severe, you may be able to manage them yourself – see the previous section.
If you have visited your GP and Long COVID is suspected, your healthcare professionals will gather further information (a medical history) from you. This will include whether you have had, or think you have had, COVID-19, your physical symptoms, how long you have had them and whether you have any other conditions such as diabetes, heart disease, lung conditions such as COPD, and mobility problems.
They will also ask you whether you are experiencing problems with your memory or thinking (some people describe this as a ‘brain fog’), how you are coping on a day to day basis and any changes to your mood and behaviour. They may check your oxygen levels during test such as getting you to sit and stand over one minute or ask you to monitor your oxygen levels at home. This is done via a small device gently clipped onto the end of a finger.
To make sure you get support from a range of health care professionals, if your symptoms are prolonged or severe, you may be referred to an NHS Post-COVID clinic or to local services for specific conditions.
Further examination and appropriate investigations will be arranged to see if your symptoms are being caused by something else and to find out how your COVID-19 infection is affecting you. These might include blood tests, appropriate exercise tolerance testing, blood pressure and heart rate monitoring, a chest X-ray if there are ongoing breathing problems, and appropriate referrals for any mental health concerns. Follow up is essential. As symptoms of Long COVID can fluctuate and new ones appear, you may feel well when you are first seen, but still need follow up.
When should I seek medical attention?
If you think you may have Long COVID
If you are worried about suspected Long COVID symptoms that last longer than 4 weeks, are worsening, are not improving or are concerning you, contact your GP practice. It will be important for them to establish whether this is a part of Long COVID, or due to an unrelated health issue which might need immediate attention.