Long COVID: symptoms, treatment and how long it lasts

The NHS says symptoms of long COVID can be different for everyone. The most common are feeling extremely tired, shortness of breath, joint pain and aching muscles, and problems with memory and concentration (brain fog). The NHS adds that some symptoms may get better or come and go, that you can get new symptoms you have not had before, and that they may get worse if you are stressed or have been more active.

NHS inform groups the symptoms by body system, which helps show how wide the range is. It says there are many different signs and symptoms and that they may change over time.

Long COVID is the name used when symptoms of COVID-19 do not settle as expected. The NHS gives a threshold of 12 weeks. Asthma + Lung UK describes it as symptoms that last over four weeks and cannot be explained by another condition. The two descriptions fit together once you know the clinical terms, set out below.

NHS inform explains that most people's symptoms of coronavirus get better within 4 weeks, but for some, symptoms last longer or new ones develop. It adds that this is a new condition and that knowledge of it is developing all the time, so advice may change as research reports.

The NHS says there is currently no cure for long COVID and it is still being researched, but there are treatments that can help ease symptoms. You are supported by a team of different healthcare professionals who look after your physical and mental health, and they work with you to create a plan. The NHS lists the following as things the plan may include.

• Advice about how to manage tiredness (fatigue).

• Physiotherapy and exercises to help with breathing and muscle pain.

• Cognitive behavioural therapy (CBT) to help with anxiety, depression and fatigue.

• Cognitive rehabilitation, with activities to improve memory, concentration, thinking and mood.

• Help to try to improve your sense of smell.

• Help with diet and nutrition.

• Tools such as apps to track your symptoms.

• A specialist adviser who helps you access practical, emotional and social support (social prescribing).

The NHS lists things to try: work with your specialists to set goals, keep a diary to track what makes symptoms better or worse, get the details of who to contact if you are worried, talk to your GP and your employer if work is difficult, go to sleep and wake up at the same time each day, get up and move around regularly or take short walks if you can, use painkillers such as paracetamol or ibuprofen for muscle pain (asking a pharmacist what to take), and eat a balanced diet.

The NHS is clear on one point: do not start exercising again before talking to a GP or specialist, and be careful when exercising and stop if you have any symptoms. NHS inform adds that it is important to listen to your body, prioritise sleep, eat healthily and balance activity and rest, and not to compare yourself with others.

There is no single answer. The NHS says how long it takes to recover from long COVID is different for everybody. Some symptoms can improve quickly, while others last longer. Treatment can help manage symptoms, but you may have long-lasting symptoms that can affect your daily life, work and relationships for many years.

NHS inform says it cannot be said exactly how long symptoms will last, and that the reassuring evidence is that symptoms improve over time in most cases. It also says symptoms can change over time and can affect anywhere in the body, and that some people experience them for months or years. Asthma + Lung UK says some people begin to feel better within 12 weeks of getting coronavirus, but symptoms could last longer.

There is no single test for long COVID. The NHS says a GP will ask about your symptoms and how long you have had them. You may also have tests such as blood pressure and heart rate tests, blood tests and tests to measure the oxygen levels in your blood. They may suggest a symptom diary, and may refer you for other tests such as an electrocardiogram (ECG) or an X-ray. These may be done by a team of different specialists at a post-COVID syndrome service.

NHS inform says a healthcare professional may take a medical history, examine you to find out more about physical or mental health symptoms and, where needed, check that you do not have another condition causing your symptoms. You are generally able to manage most symptoms on your own, but may need help from your primary care team, which could include a GP, nurse, pharmacist, physiotherapist or occupational therapist.

Long COVID is usually managed in primary care, but some symptoms need prompt attention. NHS inform says you may be referred urgently to hospital if you have any signs that could be a life-threatening condition, and that you will be referred urgently for assessment by a mental health professional if you have a severe mental health condition or you are at risk of serious self-harm or suicide.

The NHS says to see a GP if you think you might have long COVID. NHS inform says to contact your GP practice if you are worried about your symptoms, if they are getting worse or if you are worried about how long COVID might be affecting any other health conditions you have. If you are in immediate danger, or have severe chest pain or severe breathing difficulty, call 999. For urgent advice that is not an emergency, use NHS 111.

NHS inform says its long COVID information is for people aged 18 and over, and that you should contact your GP or paediatric team directly if you are worried about possible long COVID symptoms and you are either under 18 or a parent, guardian or carer of a young person or child.

NHS England announced in June 2021 that it was setting up specialist paediatric long COVID hubs bringing together paediatricians, physiotherapists, nurses and occupational therapists to advise family doctors and see complicated cases. The announcement is from 2021, so check the current local service with a GP.

On the NHS, long COVID care usually starts with the GP practice, which can arrange tests and refer you to the right service in your local health board or integrated care board area. NHS inform says this may include occupational therapy, physiotherapy, rehabilitation services and clinical psychology and psychiatry, with other specialists such as a dietitian, an eye specialist or a speech and language therapist depending on your symptoms.

Some people also choose to see a private doctor or physiotherapist. The assessment and the types of support described on this page are broadly the same, and it helps to share any results with your GP so your records stay complete. National charities such as Long COVID SOS and Asthma + Lung UK, named by the NHS, offer information and peer support.

NHS inform says the longer-term effects will be different for everyone and that some people may need time off work. Returning to work depends on how you are feeling, the type of job and the flexibility your employer offers. It points to resources including how to talk to an employer and examples of adjustments to work duties that can help.

Support from other people can also help. The NHS says you may find it helpful to speak with others who have long COVID, at a local support group or online. NHS inform adds that social care services are available to people who need support to live independently, and that you can ask your local council for a free assessment of your care needs.