Long Covid symptoms and their course can be very varied and differ from person to person. In a study with over 3000 participants, far more than 50 possible symptoms were reported. Although there are symptoms that occur very frequently, there are very different variants of how post-covid or long Covid can manifest themselves.

This article explains some Long Covid symptoms.

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Fatigue

Fatigue occurs as a syndrome in various chronic diseases. For example in cases of multiple sclerosis, cancer or rheumatism. It is estimated that there are more than 100 million people worldwide who could be affected by fatigue.

Fatigue is physical or cognitive exhaustion that exceeds normal levels and is out of proportion to previous activity. This means that simple activities, such as going shopping, showering, etc. lead to severe physical exhaustion, meaning that those affected have to rest for hours or even days.
Fatigue attacks can occur even after the slightest exertion. This is called “Crash” or Post Exertional Malaise (PEM). A so-called crash or PEM is a temporary stress reaction that occurs approximately 24-72 hours after the triggering event. A crash can lead to a worsening of general symptoms, in particular to this enormous exhaustion. The exhaustion can be physical (e.g. weakness and tiredness), but also cognitively (e.g. attention and concentration disorders). Patients often have to spend hours or up to days lying in bed or on the couch with plenty of rest until the symptoms improve.

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soreness

There are various types of pain that can occur during Long Covid. Up to 44% of Long Covid patients report headaches (migraine or tension headache), and up to 19% report body aches. Nerve pain is also reported. Nerve pain is pain or discomfort of the nerves that is commonly felt in feet and legs or hands and arms. This pain can have various causes and should be discussed with the treating physician in order to provide appropriate treatment.

So that this pain does not become chronic, i.e. that you have to live with this pain permanently, you should react as soon as possible. In addition, pain can increase other side effects, such as fatigue, which is why you should pay particular attention to this.

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If you suffer from pain, discuss it with your doctor to ensure the best possible pain management. In order for the doctor to be able to assess your pain in the best possible way, it is important that the pain is described very precisely.

Document your pain and try to answer the following questions:

• Where exactly do you feel the pain?
• (Since) when do you feel the pain? Does it occur regularly at certain times of the day?
• Can you provoke pain through certain actions?
• What does the pain feel like? Stinging? Dumb? Burning?
• Do you feel any other discomfort, such as a tingling sensation?

In addition to medication, other measures also help with pain. For example, there are physiotherapy and physiotherapy approaches that can help with pain. Patients report, for example, that regular stretching and progressive muscle relaxation could provide relief. Mindfulness exercises, relaxation or meditation can also support pain management.

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skin changes

With around 25% of those affected, comparatively few patients are affected by skin changes. Reported skin changes include hair loss, reddening, hives, blisters, and dry skin. Bluish swelling over the base joints of toes and fingers has also been reported.

Most of these skin changes heal spontaneously or even without specific treatment within weeks. However, if there is very intense itching, treatment can be based on symptoms, for example with antihistamines, cooling, or cortisone ointment. However, the exact procedure should definitely be discussed with your doctor. If the symptoms do not heal spontaneously or worsen, you should visit an appropriate specialist clinic or specialist doctor after consultation with the general practitioner.

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olfactory disorders

Olfactory disorders are among the most common symptoms of Long Covid. At 80-95%, the majority of those affected report extensive improvement or regression of olfactory disorders within two months. Around 5-20% report permanent restrictions so far, but at the time of writing this article, there is no historical data on the further development of olfactory disorders.

Basically, a distinction is made between “reduced” olfactory capacity and a “significant loss” or even a “complete loss” of olfactory capacity. A sudden loss of olfactory ability is often very specific to Covid-19 and can be an indication of an infection if there are no other symptoms. It is currently recommended to see an ear, nose and throat (ENT) specialist only if the symptoms persist even 12 weeks after the illness.

To help regenerate the sense of smell, regular olfactory training can be carried out in your own home. This attempts to irritate the olfactory mucosa by traditionally smelling 20-30 seconds of scents such as lemon, rose, eucalyptus and clove in the morning and evening. This may improve olfactory ability over the coming weeks and months.

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Persistent cough

Many Long Covid patients are also affected by persistent coughing. Coughing is a common side effect, especially in the first 6-12 weeks after the illness. If the symptoms persist for a longer period of time, further clarification should be made with the treatment provider.

Respiratory or physical therapy may be helpful to alleviate symptoms and improve breathing. Other treatment is based on the guidelines for “cough” and should be discussed with your doctor.

You can also find further information in our article on respiratory problems.

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sleep

Sleep problems are a common problem with post/long COVID. This can have long-term consequences and, for example, lead to a disturbed sleep/wake rhythm. If you also suffer from sleep problems, a good sleep routine can help prevent them. For example, try to stick to fixed bedtimes or establish daily bedtime rituals to prepare yourself for bed (such as drinking a cup of tea). If possible, these should also be observed on weekends. The bedroom should be darkened and quiet. If that's not possible, you can create optimal conditions for yourself with earplugs or sleeping goggles.

In addition, try to prepare yourself for sleep as follows:

• Four hours before sleep
  Avoid stimulating, caffeinated substances such as coffee, black and green tea, cola or mate
• Two hours before sleep
  Avoid alcohol as it affects sleep quality as deep sleep phases are reduced.
• 30 minutes before sleep
  Avoid screens, including TVs, laptops, tablets, and cell phones. The blue light prevents the body from releasing the sleep hormone melantonin. Some devices now have a night mode, which reduces the blue list. So if you can't do without screens, reducing blue light is a compromise.

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Psychological symptoms

Stress, symptoms of depression, anxiety disorders, or post-traumatic stress disorder are among the psychological symptoms that can occur with Long Covid. These are serious medical conditions that should be discussed with your doctor.

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synopsis

There are several symptoms that can occur with Long Covid. In order to be able to deal with your illness better, it can be helpful to know it. There is still a lot of uncertainty about exactly how the disease develops, which is why “only” symptomatic treatment is provided here. This means trying to alleviate the existing symptoms without being able to combat the underlying cause. In addition, many symptoms that you might be worried about go away on their own after a while.

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