Most people who get COVID-19 recover within a few weeks. But for some, symptoms don’t go away — or come back unexpectedly, weeks or even months later. This lingering condition is known as Long-Haul COVID, or more formally, Post-Acute Sequelae of SARS-CoV-2 Infection (PASC).

As someone who has walked this difficult road personally, I know how frustrating and confusing it can be. You might feel like you're getting better, only to find yourself struggling again with fatigue, brain fog, or strange new symptoms. You may feel dismissed by doctors or misunderstood by loved ones. But let me assure you — you are not imagining it, and you are not alone.

In this post, we’ll explore what Long-Haul COVID really is, why it happens, how it affects millions of people across the world, and what steps you can take to move toward healing.

What Is Long-Haul COVID?

Long-Haul COVID refers to a set of ongoing or returning symptoms that persist for weeks, months, or even years after the initial COVID-19 infection has cleared. These symptoms can impact nearly every system in the body — from the nervous and cardiovascular systems to the lungs, gut, and even skin.

The CDC defines Long COVID as a condition where symptoms last four weeks or longer after infection and cannot be explained by another diagnosis (Centers for Disease Control and Prevention [CDC], 2022). This umbrella term covers a wide range of physical, cognitive, and emotional issues.

Researchers and doctors use several names for the condition:

• Long COVID

• Chronic COVID Syndrome

• Post-COVID Condition

• PASC — Post-Acute Sequelae of SARS-CoV-2 Infection

The unifying theme across all these labels is the experience of not returning to full health after COVID-19 — sometimes long after the virus has left the body.

Common Symptoms of Long-Haul COVID

What makes Long COVID especially challenging is the diversity of symptoms. It doesn’t look the same for everyone, and it doesn’t follow a predictable pattern. Many people describe it as a “rollercoaster” of good days and setbacks.

Some of the most frequently reported symptoms include:

• Fatigue — not just tiredness, but energy-draining exhaustion that doesn’t improve with rest

• Brain fog — difficulties with memory, focus, word retrieval, or processing information

• Shortness of breath — even at rest or with minimal exertion

• Chest pain or tightness — sometimes mistaken for heart issues

• Palpitations — irregular or fast heartbeat, especially when standing

• Muscle and joint pain — often shifting or inconsistent in severity

• Sleep disturbances — trouble falling asleep, staying asleep, or unrefreshing sleep

• Digestive issues — nausea, bloating, diarrhea, or appetite changes

• Headaches and dizziness — including lightheadedness or feeling faint

• Persistent cough or sore throat

• Changes in smell or taste — including complete loss or distortion (called parosmia)

• Mood symptoms — anxiety, depression, irritability, or feeling disconnected from others

• Tingling or numbness — sometimes described as “pins and needles” in the hands and feet

• Menstrual irregularities — in women, cycles may change or worsen

It’s not uncommon for new symptoms to appear weeks after the initial infection. For example, someone might feel almost fully recovered, only to develop intense fatigue and joint pain a month later.

A 2022 study published in Nature Medicine found that more than 200 distinct symptoms have been associated with Long COVID, across 10 organ systems (Davis et al., 2021).

How Common Is Long-Haul COVID?

Long-Haul COVID is far from rare. In fact, it may be one of the most widespread chronic health issues of our time.

• Studies estimate that 10% to 30% of COVID-19 survivors will experience long-term symptoms (Groff et al., 2021).

• That means tens of millions globally, and millions in the U.S. alone, are dealing with lasting effects.

• A 2023 report from the Brookings Institution estimated that at least 16 million working-age Americans are living with Long COVID — with about 4 million unable to work due to disability (Bach, 2023).

It’s also important to note:

• Long COVID affects people of all ages — including young adults, teenagers, and even children.

• It can occur after mild or asymptomatic cases, not just severe illness.

• Some people develop symptoms after a reinfection, even if they were fine the first time.

What Causes Long-Haul COVID?

Scientists don’t yet have a single answer to explain Long COVID, but several leading theories have emerged. It’s likely a combination of factors — not one single cause — that triggers symptoms in different people.

1. Lingering Viral Reservoirs

Research has found that fragments of SARS-CoV-2 — the virus that causes COVID-19 — can persist in tissues long after the infection ends. One autopsy study detected viral RNA in multiple organs, including the brain and gut, up to 230 days after infection (Chertow et al., 2021). These residual viral bits may continue to provoke immune responses.

2. Immune System Overactivation

In some people, the immune system may remain in a state of chronic inflammation, even after the virus is cleared. This can damage healthy tissues and trigger autoimmune-like symptoms. Blood markers in Long COVID patients often show elevated cytokines — chemical messengers linked to inflammation (Phetsouphanh et al., 2022).

3. Autonomic Nervous System Disruption (Dysautonomia)

Many Long COVID patients experience issues with the autonomic nervous system, which controls things like heart rate, blood pressure, and digestion. This dysfunction can lead to conditions like POTS (Postural Orthostatic Tachycardia Syndrome), which causes rapid heartbeat and dizziness when standing (Blitshteyn & Whitelaw, 2021).

4. Microclots and Circulatory Issues

Studies have found evidence of tiny blood clots — called microclots — in the plasma of Long COVID patients. These clots may restrict oxygen and nutrients to tissues, contributing to fatigue, brain fog, and muscle pain (Pretorius et al., 2022).

5. Gut Microbiome Imbalance

COVID-19 can disrupt the gut microbiome — the collection of trillions of bacteria living in the digestive tract. Research shows that patients with Long COVID often have low levels of beneficial bacteria and increased gut permeability, which may worsen inflammation and contribute to fatigue and neurological symptoms (Zuo et al., 2020).

Who Is at Risk?

While anyone can develop Long COVID, some factors appear to increase the risk:

• Older age — especially those over 50

• Female sex — women report Long COVID symptoms at nearly twice the rate of men

• Pre-existing conditions — such as diabetes, asthma, autoimmune disorders, or obesity

• Unvaccinated individuals — vaccination lowers the risk of developing Long COVID (Al-Aly et al., 2022)

• Reinfection — those who’ve had COVID more than once may be at higher risk

• High viral load — people with more virus in their system may be more vulnerable to persistent symptoms

Still, many healthy, active individuals with no prior health issues have developed Long-Haul symptoms — including athletes, health professionals, and young adults.

Living with Long COVID: A Personal Note

Before COVID, I was active. I walked daily, traveled with my grandchildren, and volunteered with a Christian youth choir. Then came the virus — and everything changed.

I spent weeks in the hospital. Months in rehab. I went from walking independently to needing help with basic tasks. The worst part wasn’t just the physical struggle — it was not knowing what was happening to me, or when (or if) I’d recover.

There were days I felt hopeless. But I also experienced moments of deep grace — in the hands of caregivers, in the prayers of family, and in the quiet whisper of God’s presence through it all.

I’m still recovering. But I now feel called to share what I’ve learned — not just the science, but the faith, grit, and community it takes to heal.

What Can You Do If You Have Long-Haul COVID?

If you or a loved one is dealing with Long COVID, know that there are steps you can take to improve quality of life, even while medical answers continue to develop.

📝 Track Your Symptoms

Keep a journal or app-based log of your daily symptoms, triggers, and energy levels. This can help your doctor identify patterns and tailor treatment.

🧑‍⚕️ Find a Knowledgeable Provider

Seek a physician familiar with Long COVID or post-viral illness. Some hospitals now offer Long COVID specialty clinics.

🧠 Practice Pacing and Energy Conservation

One of the most important strategies is pacing — the art of balancing activity with rest to avoid crashes. The “spoon theory” is a helpful model for conserving energy throughout the day.

🧬 Support Your Gut Health

A disrupted gut microbiome may be contributing to inflammation. Consider adding prebiotics, fermented foods, or probiotics (under medical guidance). A gut-focused anti-inflammatory diet may help reduce symptoms.

🧘‍♀️ Address Mental Health and Isolation

Long COVID can be emotionally draining. Reach out to support groups, mental health professionals, or spiritual communities. You're not meant to walk this road alone.

💉 Stay Up to Date on Vaccinations

While vaccines don’t eliminate Long COVID risk entirely, studies suggest they lower the likelihood of developing it after infection or reinfection.

🙏 Stay Hopeful

Healing is often nonlinear — two steps forward, one step back. But many people do improve with time, rest, and proper care.

Final Thoughts

Long-Haul COVID is a life-changing condition, but it’s not the end of your story. Whether you’re newly diagnosed or have been struggling for months, know that there is hope, research, and support available.

This site was born out of my own journey — from ICU bed to walking again, from fear to purpose. I’ll continue to share tools, science, faith, and encouragement for anyone navigating Long COVID or chronic illness.

You are not forgotten. You are not broken. You are still here — and that means your story is still unfolding.

References

• Al-Aly, Z., Bowe, B., & Xie, Y. (2022). Long COVID after breakthrough SARS-CoV-2 infection. Nature Medicine, 28(7), 1461–1467. https://doi.org/10.1038/s41591-022-01840-0

• Bach, D. (2023). Long COVID is Keeping Millions of Americans Out of Work. Brookings Institution. https://www.brookings.edu/articles/long-covid-is-keeping-millions-of-americans-out-of-work/

• Blitshteyn, S., & Whitelaw, S. (2021). Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection. Immunologic Research, 69(2), 205–211. https://doi.org/10.1007/s12026-021-09185-5

• Centers for Disease Control and Prevention. (2022). Long COVID or Post-COVID Conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html

• Chertow, D., Stein, S., Ramelli, S., et al. (2021). SARS-CoV-2 infection and persistence throughout the human body and brain. Nature, 612(7941), 758–763. https://doi.org/10.1038/s41586-022-05542-y

• Davis, H. E., Assaf, G. S., McCorkell, L., et al. (2021). Characterizing Long COVID in an International Cohort. Nature Medicine, 27, 601–609. https://doi.org/10.1038/s41591-021-01292-y

• Groff, D., Sun, A., Ssentongo, A. E., et al. (2021). Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection. JAMA Network Open, 4(10), e2128568. https://doi.org/10.1001/jamanetworkopen.2021.28568

• Pretorius, E., Vlok, M., Venter, C., et al. (2022). Persistent clotting protein pathology in Long COVID is accompanied by increased levels of antiplasmin. Cardiovascular Diabetology, 20, 172. https://doi.org/10.1186/s12933-021-01359-7

• Phetsouphanh, C., Darley, D. R., Wilson, D. B., et al. (2022). Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nature Immunology, 23(2), 210–216. https://doi.org/10.1038/s41590-021-01113-x

• Zuo, T., Wu, X., Wen, W., et al. (2020). Alterations in Gut Microbiota of Patients With COVID-19. Gastroenterology, 159(3), 944–955.e8. https://doi.org/10.1053/j.gastro.2020.05.048