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Long COVID
Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), refers to a range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. It shares many clinical similarities with ME/CFS and dysautonomia.
Common Symptoms
Post-exertional malaise (PEM)
Severe fatigue that interferes with daily life
Brain fog and cognitive impairment
Dysautonomia/POTS symptoms (palpitations, dizziness)
Shortness of breath and chest pain
Causes & Triggers
- Viral persistence in tissues
- Immune system dysregulation and autoantibodies
- Reactivation of dormant viruses (e.g., Epstein-Barr Virus)
- Microvascular blood clotting and endothelial dysfunction
- Microbiome disruption
Diagnosis
Currently a clinical diagnosis of exclusion based on history of COVID-19 infection and persistent symptoms lasting beyond the acute phase. Specialized testing may reveal microclots, autoantibodies, or autonomic dysfunction.
Treatment Approaches
Pacing and energy management to prevent PEM
Treating underlying dysautonomia/POTS
Mast cell targeted therapies
Anticoagulant or antiplatelet therapy for microclots
Low Dose Naltrexone (LDN) for neuroinflammation
Research & Sources
Long COVID: major findings, mechanisms and recommendations
Nature Reviews MicrobiologyView Source
Characterizing long COVID in an international cohort: 7 months of symptoms and their impact
eClinicalMedicine (The Lancet)View Source