Long Covid: Why Millions Are Still Struggling Years After Infection
Five years since the start of the Covid-19 pandemic, the world is still grappling with an invisible crisis: long Covid. While daily life has largely returned to normal, millions of people remain chronically ill, battling symptoms that persist months or even years after infection.
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The Scale of Long Covid
Experts estimate that between 65 million and 200 million people worldwide are still experiencing long-term effects of the virus. In the UK alone, figures from the Office of National Statistics suggest that around 3.3% of people in England and Scotland live with long Covid. Many have endured symptoms for years—31% for over three years.
A 2024 review published in The Lancet revealed that adults between 35 and 65, particularly those who are economically inactive, are among the hardest hit. The condition continues to have a significant impact on employment and daily life.
Lives Changed Forever
Stories from long Covid sufferers highlight the devastating effects.
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Cat Rowles, a former NHS nurse, became bedbound after contracting Covid in 2020. She has since battled extreme fatigue, brain fog, and an inability to return to work despite lifestyle changes and dietary interventions.
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Wendy Crawford, a finance officer, has spent thousands seeking treatment but still struggles with recurring relapses. Despite evidence that antivirals may reduce the risk of developing long Covid, she was unable to access them.
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Melanie Morby, once a half-marathon runner, now endures chronic fatigue, migraines, and breathlessness following multiple infections.
For many, long Covid has meant the loss of careers, independence, and a sense of normality.
Misdiagnosis and Medical Gaslighting
One of the greatest challenges patients face is disbelief from healthcare professionals. Many report being told their illness is “just anxiety” or “stress.” Professor Manoj Sivan of the University of Leeds emphasizes that this misdiagnosis is common, leaving patients without access to specialized clinics or treatments.
A Complex Condition with Over 200 Symptoms
Research has linked long Covid to more than 200 symptoms affecting nearly every system in the body, from the brain and heart to the digestive and reproductive systems. Common issues include:
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Severe fatigue and brain fog
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Autonomic dysfunction (abnormal heart rate, blood pressure fluctuations, dizziness)
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Persistent joint pain, migraines, and breathlessness
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Rare complications like sudden allergies, tinnitus, and blood clots
The diversity of symptoms makes the condition difficult to study, as no two patients present in exactly the same way.
Searching for Causes
Scientists believe long Covid may stem from multiple mechanisms:
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Lingering virus: Remnants of SARS-CoV-2 may persist in hidden areas of the body such as the brain or spinal cord.
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Immune dysfunction: In some, the virus sparks an autoimmune response, with the body mistakenly attacking its own tissues.
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Autoantibodies: Studies have shown higher levels of autoantibodies in long Covid patients, which may explain symptoms like chronic pain and fatigue.
Animal studies have even demonstrated that autoantibodies from long Covid patients can induce illness when transferred, strengthening the autoimmune theory.
Who Is Most at Risk?
Research suggests long Covid is more common in:
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Those infected before vaccines were available
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People with pre-existing immune-related conditions
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Middle-aged individuals working in stressful roles who returned to work without full recovery
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Individuals from lower socioeconomic backgrounds
Vaccines appear to lower the risk of developing long Covid but offer limited protection once symptoms are established.
Managing Symptoms and Future Treatments
Currently, treatment is focused on symptom management rather than a cure. Strategies include:
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Pacing and energy management to reduce relapses from fatigue
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Antihistamines for those experiencing allergy-like flare-ups
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Medications and lifestyle changes to manage autonomic dysfunction, including increased fluid and salt intake
Promising research is underway. Experimental treatments include therapies targeting mitochondrial damage, amino acid cocktails, and immunotherapies designed to switch off harmful autoantibodies. While some patients respond to supplements like CoQ10, L-arginine, and vitamin C, results remain inconsistent.
Experts agree that a universal cure is unlikely. Instead, progress depends on identifying patient subgroups and tailoring treatments to their unique biological profiles.