Long Covid

What Is Long Covid?

Long COVID means lingering symptoms after COVID-19 infection, including fatigue, POTS-like symptoms, and brain fog.

Common Signs & Symptoms

• Fatigue

• Brain fog

• Shortness of breath

• POTS overlap

• Treatment in Long Covid

Energy Management

Pacing, "Four P's" (Plan, Pace, Prioritize, Position)

Prevents post-exertional malaise; CDC & AAFP supported

Rehabilitation

Physical, occupational, respiratory, cognitive therapy

Multidisciplinary care improves outcomes

Mental Health Support

Cognitive Behavioral Therapy (CBT)

Helps manage fatigue, anxiety, depression, sleep issues

Metabolic Support

Metformin, Low-Dose Naltrexone (LDN), Dexamethasone (in select cases)

Early studies show symptom reduction

POTS Treatment

Beta-blockers, fludrocortisone, midodrine

Common in Long COVID with dysautonomia symptoms

Mast Cell Support

Antihistamines (H1 & H2), cromolyn sodium, quercetin

Symptom-targeted treatment for histamine-related issues

Nutritional Supplements

Omega‑3s, L‑arginine + Vitamin C, CoQ10, NAC, melatonin

Supports mitochondrial function, reduces inflammation

Immune Modulation

IVIg, therapeutic apheresis (experimental)

For immune dysregulation; case reports and early trials

Sleep Support

CBT-i, melatonin, sleep hygiene, trazodone

Treats insomnia and disrupted sleep

Cognitive Support

Cognitive rehab, pacing, brain training, supplements

Helps with "brain fog" and executive dysfunction

Pain Management

Neuropathic meds, low-impact exercise (yoga, tai chi), mindfulness

Adapted from fibromyalgia and ME/CFS care

Connection to Other Multisystem Disorders

Higher risk in Hypermobile Spectrum Disorder (HSD) patients.

Other Helpful Resources