Living with long COVID: Symptoms to watch for and how to manage them

When the COVID-19 pandemic began, many people expected recovery to mean a few days of symptoms and rest, followed by a return back to normal. And for most, that was the case. But for others, their recovery has been anything but simple. Even long after the virus has cleared, they’re left with lingering health problems that affect their daily life.

The Centers for Disease Control and Prevention (CDC) estimates that nearly one in five adults who have had COVID-19 continue to experience long-term symptoms. This condition, known as long COVID, has become one of the most challenging parts of the pandemic’s aftermath.

Doctors and researchers are still piecing together exactly what long COVID is, why it happens and how best to treat it. If you or someone you love is living with persistent symptoms of long COVID, understanding what’s known so far can make the path forward a little clearer.

What is long COVID and what causes it?

Long COVID, also called “long-haul COVID”, refers to symptoms that last four weeks or longer after the initial infection.

The exact cause of long COVID isn’t fully understood. Some believe it’s related to the body’s immune system staying on high alert even after the virus is gone. Others point to the damage COVID-19 can do to organs such as the heart, lungs or brain, which may take months (or even longer) to heal. In some cases, tiny remnants of the virus may linger in the body, keeping inflammation active.

While there’s no single explanation yet, most researchers agree on one point: long COVID is real, and it can profoundly affect your health and well-being.

Why do some people get long COVID while others do not?

One of the biggest questions surrounding long COVID is why it impacts certain people but not others. Two people can contract the same strain of COVID-19 and have very different outcomes. One may bounce back quickly, while the other develops ongoing fatigue, breathing problems or other lingering symptoms that simply do not go away.

It’s believed that a combination of factors may play a role in why a select group of people develop long COVID, including the severity of the initial illness, their own underlying health issues and differences in how each person’s immune system responds. Genetics and overall health before infection may also influence recovery.

Who is at a higher risk for long COVID?

Long COVID doesn’t discriminate. It has been reported in children, young adults and older adults. It’s even been found in those who had only mild cases of COVID-19. Still, certain groups appear to face higher risk.

Older adults, especially those over 50, report long COVID at higher rates. People who were hospitalized with severe COVID-19 are also more likely to experience lingering health issues. Women seem to be slightly more affected than men, and individuals with chronic health conditions such as diabetes or heart disease may face increased challenges. The COVID-19 vaccine appears to reduce the likelihood of long COVID, but it does not eliminate the risk entirely.

What are the symptoms of long COVID?

One of the challenges of diagnosing long COVID is how differently it shows up from person to person. Some people describe just one issue, while others report several problems at once. The most common long COVID symptoms include:

• Persistent fatigue that interferes with daily activities
• Shortness of breath or difficulty breathing
• Brain fog, memory lapses or trouble concentrating
• Ongoing cough or chest discomfort
• Irregular heartbeat or heart palpitations
• Headaches or dizziness, especially when standing up
• Joint or muscle aches
• Difficulty sleeping or disrupted sleep patterns
• Loss of taste or smell that remains after the infection clears
• Mood changes, including anxiety or depression

Not everyone will experience the same set of symptoms, and they can come and go over time. Some people report that symptoms ease for weeks, only to flare up again without warning. This unpredictability can make long COVID especially difficult to manage and can take a toll on both your physical and emotional health.

Is there a difference between COVID-19 symptoms and long COVID symptoms?

While COVID-19 and long COVID share similarities, the timing, duration and nature of symptoms can be different.

During the acute phase, COVID-19 symptoms usually appear within a few days of infection and often include some of the following: fever, cough, shortness of breath, loss of taste or smell, body aches, sore throat, and digestive issues like nausea or diarrhea. Most people recover from these symptoms within two to four weeks. Long COVID symptoms, by contrast, either persist beyond four weeks or appear after the initial infection seems to have resolved.

Understanding this distinction helps you and your healthcare provider understand when ongoing care may be needed, rather than assuming recovery is complete once the initial illness passes.

How do long COVID symptoms affect your health?

Lingering symptoms of long COVID can touch nearly every part of your life. Fatigue may limit physical activity, leading to deconditioning and loss of strength. Brain fog can make concentrating on work or managing everyday household responsibilities frustrating. Sleep problems and chronic pain can increase stress, which in turn worsens your physical health.

In some cases, long COVID can worsen other medical conditions. Ongoing shortness of breath may reveal underlying lung disease, or irregular heart rhythms may point to cardiovascular complications. You might describe the feeling as though your body simply hasn’t “bounced back” the way it used to.

When to seek care for long COVID symptoms

If you’re still experiencing symptoms weeks after your initial infection, it’s a good idea to make an appointment with your primary care doctor. They can help sort out whether your symptoms are due to long COVID or another condition.

Seek emergency care right away if you develop chest pain, severe difficulty breathing, sudden confusion or fainting. These could signal serious complications that require immediate attention.

For day-to-day monitoring, this self-check guide for COVID-19 symptoms may be helpful.

How is long COVID treated?

Treating long COVID isn’t about a single pill or quick fix. Recovery is often a combination of approaches, tailored to you and your symptoms. The treatment for long COVID is personalized and ongoing. It’s not about rushing back to pre-COVID life overnight, but about taking small, steady steps toward regaining control over your health and daily routine.

For example, if you’re struggling with shortness of breath, you might start with breathing exercises and gentle activity, slowly increasing your stamina over several weeks. If brain fog is impacting your daily activities, you may benefit from cognitive exercises and structured routines to help with memory and focus.

Your physician will most likely address the most pressing symptoms first when it comes to treating long COVID symptoms, whether it’s medication for sleep disturbances, physical therapy for muscle weakness or counseling for anxiety or depression. You will work with a team of specialists who coordinate your care, helping you track progress and adjust treatment as needed.

Lifestyle adjustments can also play a key role in the treatment of long COVID. Simple changes, like pacing daily activities, prioritizing rest and gradually building physical activity, can make a noticeable difference in energy levels and overall well-being.

The role of exercise in long COVID recovery

Exercise is an especially promising area when it comes to treating long COVID. Carefully structured programs can help you rebuild stamina, improve breathing and even support cognitive function. While progress may seem slow, small, consistent improvements like walking a few extra minutes each day or completing light home workouts can make life feel more manageable again.

One study of long COVID had adults participating in an exercise program that combined home-based routines with supervised sessions, wearing devices to track their heart rate, oxygen levels, breathing and activity. The goal is to better understand how exercise affects the body over time and whether it can be used as part of a treatment plan.

While exercise is beneficial for your overall health, when it comes to long COVID, exercise isn’t a one-size-fits-all solution. You should consult with your doctor to find the best plan that works for you:

• Plans should be individualized. What works for one person may trigger setbacks for another.
• Medical supervision is essential. Long COVID can affect multiple organs, so activity should be monitored closely.
• Progress is gradual. Improvements often come in small steps, like walking a few more minutes each day or completing light home workouts, rather than sudden leaps.

Don’t get discouraged if your recovery takes time. The approach for treating long COVID offers hope for managing symptoms and reclaiming quality of life.

Moving forward with long COVID symptom treatment and care

Long COVID remains one of the most pressing health concerns to emerge from the pandemic. While there isn’t yet a cure, treatment focuses on managing symptoms, supporting recovery and helping you regain your quality of life once again.

If you’re experiencing lingering issues after COVID-19, don’t wait to get help. Talk with your healthcare provider about what you’re going through and ask about resources that can support your recovery. With ongoing research and dedicated care, more answers about long COVID, and better treatments, are ahead.

If you're experiencing symptoms of COVID-19 or think you may have long COVID, talk to your doctor or explore your virtual care options.