Long COVID: what it is and how to cope

How long does it take for long COVID to go away?

Long COVID - also called post-COVID syndrome - refers to ongoing or new symptoms that appear after recovering from the primary phase of a COVID-19 infection.

Deborah Grayson, Pharmacist and Nutritional Therapist, Practice With Confidence, Greater Manchester, UK says these symptoms can last weeks, months, or even longer, and they vary widely in severity and type.

She explains that long COVID can affect you even if your initial infection caused only mild symptoms - or none at all. There are also certain factors that may increase your chance of developing it.

What are the symptoms of long COVID?

According to Grayson, long COVID is diagnosed by ruling out other possible causes of the symptoms.

She says: "Diagnostic tests and evaluations may vary depending on the symptoms."

What is the cure for long COVID?

There is no specific cure for long COVID. Current treatment for this condition typically includes a combination of lifestyle adjustments, supportive therapies and, in some cases, medical care.

Grayson says there are a number of medicines used to treat long COVID symptoms including antihistamines and antidepressants.

What to do for long COVID symptoms?

Long COVID triggers a heightened state of alert in your immune system. This leads to inflammation and immune dysfunction - often referred to as the 'cell danger response'. Usually, this response is designed to protect your body's cells from harm. However, in the case of long COVID, the response remains active even after the infection has cleared.

"Patients with long COVID have issues with the mitochondria," says Grayson. "These are essentially the battery of every cell in the body and are affected by the heightened cell danger response. This means that your body can't make enough energy to function properly. It's a key cause of many long COVID symptoms, where cells cannot function as they should."

Regular exercise

It can take months - or even years - for your symptoms to resolve depending on your circumstances. However, Grayson says engaging in activities that support your nervous system and help lower stress levels can reduce your body's immune response.

She advises you to slowly increase your physical activity levels without making your tiredness worse. It's important to rest and pace yourself during these activities to help you recover. This also applies to more simple, everyday tasks.

Mindfulness techniques

Practising mindfulness techniques can also help regulate your nervous system response.

A healthy diet

By following a balanced, nutritious diet that supports healthy blood sugar levels, you can strengthen your immune system and help your body recover from long COVID.

According to Grayson, some supplements may also alleviate symptoms relating to long COVID - especially tiredness.

"Avoiding sugar and ultra-processed foods in favour of a whole food approach can also help," she adds. "As can reducing your alcohol intake."

What is a low histamine diet?

Although research is still ongoing, people with long COVID may find their symptoms are eased by incorporating a low histamine diet. Histamine is a chemical produced and stored in your immune cells (mast cells). It plays a vital role in supporting the body's immune response.

"Many symptoms of long COVID are linked to issues with histamine levels - particularly histamine intolerance and mast cell activation," says Grayson. "In these cases, people might find their symptoms improve if they follow a low histamine diet."

Grayson warns that long-term use of a low-histamine diet may lead to nutrient deficiencies and is generally unsustainable in the long term. She recommends following it for an initial 28-day period under the guidance of a healthcare professional.

Grayson adds: "To a lesser extent you can also include brewer's yeast, fish - especially tinned - tomato products, chicken, yoghurt, aubergine, dried fruits, mustard, and coffee."

Foods that trigger histamine release in other foods:

• Citrus foods.

• Chocolate.

• Nuts.

• Papaya.

• Pineapple.

• Beans and pulses.

• Tomatoes.

• Wheatgerm.

• Additives.

• Egg - especially raw.

• Strawberries.

• Fish and shellfish.

• Alcohol.

• Milk.

Diamine Oxidase (DAO) is an enzyme that helps break down histamine.

Grayson says that DAO can be found in certain food sources. These too could be included in a low-histamine diet plan.

Long COVID can have lasting effects that may significantly impact your health over time.

"It may cause long-term impacts on the organs of your body, including respiratory diseases, and damage to the heart and kidneys," says Grayson. "It could also impact your thyroid and reproductive hormone function."

Adopting healthier lifestyle choices - such as those mentioned above - can improve your overall wellbeing and help manage some of the symptoms associated with long COVID.