Research Page

This page provides key findings from recent research on Long COVID, aiming to share valuable insights into this complex condition.

Disclaimer: The author of this page is not a doctor or medical professional. All information presented here is based on research and articles from the references listed below. While every effort has been made to ensure accuracy and relevance, no guarantee can be made regarding the completeness or correctness of the information. The content on this page is intended for informational purposes only and does not constitute medical advice.

Anyone seeking medical care or advice should consult a qualified healthcare provider for professional guidance. The goal is to inform and provide a resource for those interested in learning more about Long COVID. Any additional research articles or insights are always welcome for review. You can skip to the relevant research articles at the bottom of the page.

Long COVID: Understanding Your Recovery Journey

Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), refers to symptoms that last for weeks or months after recovering from the acute phase of a COVID-19 infection. The good news is that most people improve over time, and many experience significant recovery within the first year. Here’s what you need to know.

Common Symptoms of Long COVID

Long COVID can manifest with a variety of symptoms. The most common ones include:

  • Fatigue: Feeling unusually tired or drained, even after rest [12].
  • Brain Fog: Difficulty with memory, concentration, or mental clarity [14].
  • Shortness of Breath: Struggling to catch your breath during activities that wouldn’t normally cause it [11, 5].
  • Muscle and Joint Pain: Ongoing soreness in your muscles or joints [2].
  • Sleep Issues: Trouble falling or staying asleep, or waking up without feeling rested [4, 13].

When Can You Expect Improvement?

6 Months

Many people start to feel better within the first six months after their infection. Research shows that symptoms like fatigue and brain fog tend to decrease in severity during this time, particularly with supportive care like rest and pacing yourself [11, 12].

12 Months

By the 12-month mark, most patients experience major improvements or full recovery. Studies suggest that between 50% and 70% of Long COVID patients recover significantly within this period. Cognitive issues like brain fog may persist longer than other symptoms but often improve over time [4, 12].

Why Do These Milestones Matter?

Many people notice significant improvements in their Long COVID symptoms between 6 and 12 months. These milestones are important because:

  • Immune System Adjustment: After COVID-19, your immune system can remain overactive, contributing to ongoing symptoms like fatigue and inflammation. As your immune system gradually returns to a balanced state, inflammation subsides, and symptoms like fatigue, muscle pain, and breathing difficulties improve. Many people experience these changes between the 6- and 12-month mark, helping them regain energy and strength [7, 11].
  • Serotonin Levels: Some individuals with Long COVID experience reduced serotonin levels, which affect mood, memory, and cognitive function. Low serotonin is linked to symptoms like brain fog and memory issues. As your serotonin levels recover, so does your ability to concentrate and think clearly. These cognitive improvements often start to occur in the same 6- to 12-month period, contributing to overall recovery [14].

What Else is Helping the Recovery Process?

In addition to immune and serotonin adjustments, several other factors contribute to the recovery process for Long COVID patients:

  • Cellular Recovery and Mitochondrial Function: COVID-19 can impact the mitochondria, the energy-producing centers of your cells. This damage can cause lingering fatigue and exhaustion. However, over time, your cells begin to repair themselves, and mitochondrial function improves. This leads to gradual increases in energy levels and a reduction in fatigue, often noticeable as you approach 12 months or beyond [6, 4].
  • The Role of Vaccination: Vaccination not only reduces the severity of the initial infection, but it also lowers the risk of developing Long COVID by about 30%. If you’ve been vaccinated and still experience Long COVID, your symptoms are likely to be milder and your chances of recovery are higher. Vaccines also help by boosting the immune system’s response to clear lingering viral particles, which can contribute to ongoing symptoms in some individuals [12, 9].

For Those Still Suffering Beyond 12 Months

While most people experience significant recovery within the first year, we understand that some individuals still struggle with Long COVID symptoms beyond 12 months. You are not alone. Research shows that even after a year, recovery remains possible, and many people continue to improve, albeit at a slower pace [4, 7].

It’s important to remain hopeful—the vast majority of patients experience gradual improvement over time. Ongoing research is continuously shedding light on treatments and therapies, and new options are emerging that may help those with lingering symptoms. Remember to listen to your body, pace your activities, and consult healthcare professionals for the best possible care.

Even though recovery may be taking longer than expected, it is still happening for most people, and better treatments are on the horizon. Keep your focus on steady progress, however small it may seem.

A Positive Outlook

The majority of people with Long COVID experience steady improvement, especially within the first year. Studies continue to show that recovery is the norm, not the exception, and the prognosis for Long COVID is generally positive [1, 4, 11].

While recovery can feel slow, remember that you are healing. Rest, listen to your body, and stay positive. Researchers are making rapid progress in understanding Long COVID, and better treatments are on the horizon.

Note: Everyone’s journey is unique. If you’re concerned about your symptoms or need specific advice, please consult your healthcare provider for guidance.

Research Articles
… from the last 2 to 3 years

Below is a list of recent peer-reviewed research articles relating to Long COVID, which shows promising results and aids in our understanding of this disease.

If there are research articles which you have found both interesting and useful, please contact us to let us have a look, be sure to include a link.

  1. Mechanisms of Long COVID and the Path Toward Therapeutics
    Peluso, M.J., et al., (2024), Cell.
    https://doi.org/10.1016/j.cell.2024.07.054
    • Long COVID is driven by persistent viral presence, immune dysfunction, and tissue inflammation.
    • Progress in therapeutic development has been slow, with limited industry involvement.
    • There is an urgent need for experimental medicine and clinical trials to develop treatments.
  2. Antihistamines Improve Cardiovascular Manifestations and Other Symptoms of Long-COVID Attributed to Mast Cell Activation
    Salvucci, F., et al., (2023), Frontiers in Cardiovascular Medicine.
    https://doi.org/10.3389/fcvm.2023.1202696
    • Histamine blockers (fexofenadine and famotidine) improved cardiovascular symptoms and fatigue in Long COVID patients.
    • 29% of treated patients saw complete symptom resolution, compared to no improvement in controls.
    • Mast cell activation is a key mechanism behind many Long COVID symptoms.
  3. Insights into Early Recovery from Long COVID—Results from the German DigiHero Cohort
    Diexer, S., et al., (2024), Scientific Reports.
    https://doi.org/10.1038/s41598-024-59122-3
    • 60% of Long COVID patients showed significant recovery within the first 12 months.
    • Women experienced more symptoms like fatigue and brain fog compared to men.
    • The recovery trajectory varies significantly between individuals.
  4. Clinical Features, Therapeutic Outcomes, and Recovery Period of Long COVID
    Takakura, K., et al., (2022), Journal of Medical Virology.
    https://doi.org/10.1002/jmv.28316
    • Most Long COVID patients experienced symptom improvement within 6–12 months.
    • Fatigue and cognitive deficits were among the most persistent symptoms.
    • Early intervention with appropriate therapies improved recovery outcomes.
  5. Quantitative Susceptibility Mapping at 7 T in COVID-19: Brainstem Effects and Outcome Associations
    Rua, C., et al., (2024), Brain.
    https://doi.org/10.1093/brain/awae215
    • Brainstem abnormalities were identified in post-COVID patients using advanced 7-Tesla MRI.
    • These abnormalities were correlated with severe acute COVID-19 and persistent symptoms like fatigue.
    • Key affected brain regions included the medulla and midbrain.
  6. Long COVID: Mechanisms, Risk Factors, and Recovery
    Astin, R., et al., (2023), Experimental Physiology.
    https://doi.org/10.1113/EP090802
    • Mitochondrial dysfunction and autoimmunity contribute significantly to Long COVID symptoms.
    • Recovery trajectories varied, with some patients recovering between 6 and 24 months.
    • Cognitive symptoms like brain fog were particularly persistent.
  7. Improvement of Immune Dysregulation in Individuals with Long COVID at 24 Months Following SARS-CoV-2 Infection
    Phetsouphanh, C., et al., (2024), Nature Communications.
    https://doi.org/10.1038/s41467-024-47720-8
    • Immune dysregulation significantly improved by 24 months post-infection.
    • 62% of patients reported improved quality of life by the 24-month mark.
    • CRP levels and PTX3 were associated with symptom improvement.
  8. Tissue-Based T Cell Activation and Viral RNA Persist for Up to 2 Years After SARS-CoV-2 Infection
    Peluso, M.J., et al., (2024), Science Translational Medicine.
    https://doi.org/10.1126/scitranslmed.adk3295
    • Long COVID patients exhibit elevated T cell activation in tissues such as the spinal cord, gut, and lungs.
    • SARS-CoV-2 RNA persists in tissues for up to 676 days post-infection.
    • These immune responses may drive ongoing symptoms like fatigue and breathlessness.
  9. Long COVID: Major Findings, Mechanisms, and Recommendations
    Davis, H.E., et al., (2023), Nature Reviews Microbiology.
    https://doi.org/10.1038/s41579-022-00846-2
    • Long COVID affects multiple organ systems, with lingering symptoms in up to 10% of infected individuals.
    • Immune dysfunction and viral persistence are key contributors to ongoing symptoms.
    • Standardized data collection is essential for advancing treatment research.
  10. Predictors of Non-Recovery from Fatigue and Cognitive Deficits After COVID-19: A Prospective, Longitudinal, Population-Based Study
    Hartung, T.J., et al., (2024), EClinicalMedicine.
    https://doi.org/10.1016/j.eclinm.2024.102456
    • Older age, pre-existing conditions, and severe initial infection are key predictors of non-recovery.
    • Fatigue and cognitive impairment are the most commonly reported long-term symptoms.
    • Milder initial infections are associated with quicker recovery within the first year.
  11. Three-Year Outcomes of Post-Acute Sequelae of COVID-19
    Cai, M., et al., (2024), Nature Medicine.
    https://doi.org/10.1038/s41591-024-02987-8
    • Non-hospitalized individuals generally recover faster than hospitalized individuals.
    • Persistent symptoms continue in some individuals even at the three-year mark.
    • Vaccination significantly reduces the risk and severity of Long COVID symptoms.
  12. Long COVID Facts and Findings: A Large-Scale Online Survey in 74,075 Chinese Participants
    Qin, S., et al., (2024), The Lancet Regional Health – Western Pacific.
    https://doi.org/10.1016/j.lanwpc.2024.101218
    • Fatigue (30.53%), memory decline (27.93%), and decreased exercise capacity (18.29%) were the most common symptoms.
    • Vaccination reduced the risk of Long COVID symptoms by 30% to 70%.
    • Recovery trajectories varied across different demographic and geographic groups.
  13. Pathophysiology of Post-COVID Syndromes: A New Perspective
    Batiha, G.E., et al., (2022), Virology Journal.
    https://doi.org/10.1186/s12985-022-01891-2
    • Mast cell activation and immune dysregulation are major drivers of post-COVID syndrome (PCS).
    • PCS primarily affects women and is linked to neuropsychiatric and systemic inflammation.
    • Persistent inflammation can prolong PCS symptoms in some individuals.
  14. Serotonin Reduction in Post-Acute Sequelae of Viral Infection
    Wong, A.C., et al., (2023), Cell.
    https://doi.org/10.1016/j.cell.2023.09.013
    • People with Long COVID have lower serotonin levels compared to those who have fully recovered.
    • Serotonin reduction in Long COVID is driven by viral RNA-induced type I interferons, platelet dysfunction, and hypercoagulability.
    • Reduced serotonin affects vagal signaling and hippocampal function, contributing to cognitive impairments, such as brain fog.