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, 1].
  • Brain Fog: Difficulty with memory, concentration, or mental clarity, sometimes due to low serotonin levels [16, 2].
  • Shortness of Breath: Struggling to catch your breath during activities that wouldn’t normally cause it [13, 1].
  • 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 [9, 15].

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 [13, 14].

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 [9, 14].

Why Do These Milestones Matter?

  • Immune System Adjustment: After COVID-19, your immune system can remain overactive, contributing to ongoing symptoms. As your immune system gradually returns to normal, inflammation reduces, helping alleviate symptoms like fatigue and breathlessness [12, 13].
  • Serotonin Levels: Some Long COVID patients have lower serotonin levels, which affects mood and cognitive function. As serotonin levels stabilize, brain fog and memory issues often improve [16].

What Else is Helping the Recovery Process?

  • Immune Treatments for Mast Cell Activation: Some Long COVID symptoms overlap with mast cell activation syndrome (MCAS), causing fatigue, cognitive issues, and tachycardia. Antihistamines and mast cell stabilizers have shown effectiveness in alleviating these symptoms [2, 3].
  • Targeted Treatments for Reducing Inflammation: Some people with Long COVID experience ongoing inflammation in their blood vessels, which can lead to symptoms like fatigue, muscle pain, and “brain fog.” Researchers are exploring new treatments targeting this immune response, which may help reduce inflammation and relieve symptoms for patients affected by this type of immune activity [5].
  • Vaccination Benefits: Vaccination lowers the risk of developing Long COVID by approximately 30%, and vaccinated individuals often experience milder symptoms [14, 15].

Mental Health Aspects of Long COVID

Long COVID can affect mental well-being, with many individuals experiencing symptoms like anxiety, low mood, and even depression. Fatigue, physical limitations, and cognitive issues may contribute to this. Recognizing these impacts is important, and you’re encouraged to seek support if these feelings persist. Here’s how mental health plays a role:

  • Anxiety and Depression: Studies show that symptoms like fatigue, brain fog, and breathlessness can take a toll emotionally, leading to increased levels of anxiety and depression. This is common even in younger, physically fit individuals [4, 12].
  • Support and Recovery: Mental health support, such as counseling or support groups, can play an important role in managing Long COVID. If you’re feeling down or anxious, it may be helpful to talk with a healthcare provider, as many patients benefit from a holistic approach to recovery that includes mental health care.

Taking steps to care for both your body and mind can significantly aid in the recovery process, especially as you navigate the physical and emotional impacts of Long COVID. Remember, improvement is the norm, and support is available.

For Those Still Suffering Beyond 12 Months

While most people experience significant recovery within the first year, some individuals still struggle with Long COVID symptoms beyond 12 months. You are not alone. Ongoing studies show that continued improvement remains possible for these individuals, and targeted therapies such as immune treatments and antihistamines are showing promise for persistent symptoms [9, 12, 5].

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.

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 [6, 9, 13].

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

References

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. The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis

    O’Mahoney, L.L., et al., (2023), eClinicalMedicine. https://doi.org/10.1016/j.eclinm.2022.101762

    • Approximately 45% of COVID-19 survivors report at least one ongoing symptom four months post-infection.
    • Fatigue is the most frequently reported symptom among both hospitalized and non-hospitalized patients.
    • Hospitalized patients show higher rates of lung abnormalities and continued breathlessness.

  2. Immunological dysfunction and mast cell activation syndrome in long COVID

    Sumantri, S., et al., (2023), Asia Pacific Allergy. https://doi.org/10.5415/apallergy.0000000000000022

    • Long COVID is associated with significant immune system dysregulation, including T-cell depletion and elevated cytokines.
    • There is a notable overlap between Long COVID and mast cell activation syndrome (MCAS).
    • Antihistamines and mast cell stabilizers have shown promise in alleviating MCAS-like symptoms in Long COVID patients.

  3. Mast cell activation symptoms are prevalent in Long-COVID

    Weinstock, L.B., et al., (2021), International Journal of Infectious Diseases. https://doi.org/10.1016/j.ijid.2021.10.024

    • MCAS-related symptoms are common in Long COVID, including fatigue and brain fog.
    • Elevated levels of mast cell mediators, such as histamines, are observed in Long COVID patients.
    • Antihistamines have shown efficacy in symptom reduction.

  4. Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study

    Porter, C.K., et al., (2024), The Lancet Regional Health – Americas. https://doi.org/10.1016/j.lana.2024.100909

    • Even young, fit individuals report ongoing Long COVID symptoms affecting daily function.
    • Common symptoms include decreased aerobic capacity, fatigue, and mental health issues.
    • Findings highlight the need for targeted support programs for mental and physical health.

  5. Persistent complement dysregulation with signs of thromboinflammation in active Long Covid

    Cervia-Hasler, C., et al., (2024), Science. https://doi.org/10.1126/science.eadg7942

    • Persistent complement system activation contributes to inflammation and Long COVID symptoms.
    • Markers of thromboinflammation were elevated in Long COVID patients.
    • Targeting complement dysregulation may offer new treatment approaches for managing symptoms.

  6. 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.

  7. 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.

  8. 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.

  9. 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, with some cases lasting over a year.
    • Early intervention with appropriate therapies improved recovery outcomes.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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 likelihood of developing Long COVID symptoms by approximately 30%.
    • Recovery trajectories varied across different demographic and geographic groups.

  15. 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.