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Long COVID (post-viral syndrome)

Syndroma post-COVID-19 · Dlouhý covid (postvirový syndrom)

What it is

Symptoms lasting months after infection — probably several different diseases sharing a name.

Symptoms & signs

  • Fatigue and post-exertional crash
  • brain fog
  • breathlessness
  • palpitations on standing
  • loss of smell
  • sleep disruption

🚩 Get help if…

  • call 112 / 911 now Chest pain or breathlessness at rest
  • call 112 / 911 now Sudden leg swelling or pain with breathlessness
  • see a doctor soon Fainting or a racing heart on standing
  • see a doctor soon New confusion, weakness or thoughts of suicide

Where it strikes

Medical treatment

  • Symptom-specific management
  • treat POTS and mast cell activation
  • pulmonary and cognitive rehabilitation
  • pacing rather than graded exercise

Natural & lifestyle

  • Energy pacing
  • salt and fluids for orthostatic symptoms
  • breathing retraining
  • smell training
  • graded return to work

Emerging & experimental

  • Extended nirmatrelvir-ritonavir — no benefit in trials so far not confirmed in trials
  • BC007 — no benefit in its phase 2 trial not confirmed in trials
  • immunoadsorption
  • microclot-targeted therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Hyperbaric oxygen — a small Israeli trial improved cognition and energy early / small studies
  • Low-dose naltrexone — small studies early / small studies
  • Nattokinase and serrapeptase for 'microclots' — popular; untested, bleeding risk with blood thinners anecdotal / traditional
  • Nicotine patches — case reports only anecdotal / traditional

ICD codes