The majority of people infected with the coronavirus that causes COVID-19 recover within a few weeks. However, one study of 1.9 million people with COVID-19 found 23.2 percent had at least one COVID-19 symptom 30 days after their initial diagnosis. Among those who had been hospitalized for their initial COVID-19 infection, half still had at least one symptom after 30 days.

Most health organizations currently define “long COVID-19” as having symptoms of COVID-19 that last longer than three months and are not caused by another diagnosis. Long COVID-19 can affect many organ systems and cause a wide array of symptoms, which poses challenges for treatment.

Currently, researchers do not understand exactly why some people develop long COVID-19, and there are no established treatments that will work for everyone. Studies are beginning to identify promising treatments that may help improve symptoms and quality of life.

Learn more about how long COVID-19 is diagnosed.

The Best Measure Is Prevention

People who have been fully vaccinated against COVID-19 can develop breakthrough infections and then develop long COVID-19. However, the rates of long COVID-19 in vaccinated people are substantially lower than the rates in unvaccinated people. Vaccination, wearing well-fitting masks, and social distancing remain the best methods for preventing both acute COVID-19 and long COVID-19.

Integrative Medicine

Since long COVID-19 can affect the body in so many ways, a combination of approaches may be the best way to treat this disease. Integrative treatment may include medication, lifestyle changes, and alternative therapies.

One 2021 study describes individuals with long COVID-19 who were treated with many different approaches. One individual who had asthma before developing COVID-19 was still experiencing breathing trouble and migraines nine months after their COVID-19 diagnosis. They were prescribed meditation for five minutes a day, escitalopram for anxiety, a new regimen of migraine medication, and walking for 30 minutes daily.

Another individual in the study had symptoms of poor sleep, weight loss, joint pain, and brain fog seven months after being diagnosed with COVID-19. They were prescribed a continuous positive airway pressure (CPAP) machine for sleep apnea, meloxicam and turmeric for joint pain, a 30-minute daily walk, and a meal plan for weight gain.

Both individuals experienced improvement in several symptoms. These cases present evidence that a multipronged approach to treating long COVID0-19 symptoms can be beneficial.

Occupational Therapy

A July 2021 report in the American Journal of Occupational Therapy examined the effects of occupational therapy for people with long COVID-19. According to the study, a thorough assessment by an occupational therapist can help people with long COVID-19 develop a modified physical fitness routine to gradually increase their exercise tolerance. Gentle exercises, such as yoga or tai chi, can improve sleep and combat symptoms of depression. Occupational therapists can help people regain the skill sets they need to return to work and other activities they enjoy.

Short-Term Corticosteroid Treatment

In one small study, nine people experiencing persistent symptoms after a COVID-19 infection were treated with corticosteroids for four days. Everyone in the study treated with corticosteroids experienced improvement in symptoms, and some even had a complete recovery.

The study found that long COVID-19 had caused immune system changes in the study participants, and these were partially corrected by steroid treatment. Moreover, the corticosteroid-induced improvements lasted for at least four months after treatment. While results from this study are promising, its small size means further investigation is necessary.

Stellate Ganglion Block

Symptoms associated with problems in the autonomic nervous system — including fatigue, brain fog, and loss of taste or smell — have been reported in people with long COVID-19. Stellate ganglion blocks are injections of anesthetic into the neck that decrease nerve signaling and can improve blood flow to the brain.

One study describes two cases of people with long COVID-19 who were treated with stellate ganglion blocks. The first person described experiencing extreme fatigue, brain fog, inability to concentrate, racing heart, issues with sleeping, loss of appetite, and loss of smell and taste eight months after being diagnosed with COVID-19. A stellate ganglion block was implemented on the right side and two days later on the left side. The individual experienced improvement in all symptoms, which lasted through a 60-day follow-up.

The second person described long COVID-19 symptoms which had lingered for seven months, including cognitive dysfunction, stuttering speech, fatigue, weakness on the right side of the body, inflammation in the brain, altered taste, and body pain. The individual was treated with a right-sided followed by a left-sided stellate ganglion block. The individual described improvement within minutes of treatment, and the improvement was stable through the study’s 60-day follow-up.

These cases support the idea that stellate ganglion block may improve neurological symptoms of long COVID-19.

Targeting Self-Reactive Antibodies

Some studies have observed autoimmune mechanisms of long COVID-19. Autoantibodies are immune proteins that attack the body instead of invading viruses or bacteria, and these can be triggered during a coronavirus infection.

In one study of 31 people with long COVID-19, autoantibodies targeting types of receptors called G-protein coupled receptors (GPCRs) were detected in their blood serum. Similar autoantibody levels have been observed in people with other neurological and cardiovascular health conditions.

One case study described a person who experienced two COVID-19 infections, followed by long COVID-19 with fatigue, altered taste, brain fog, inability to concentrate, loss of balance, and increased blood pressure. The individual had preexisting autoantibodies against a GPCR, associated with glaucoma, but additional autoantibodies were detected after COVID-19 infection.

The individual was treated with an experimental drug called BC 007, which targets and disables autoantibodies against GPCRs. After treatment, the individual experienced decreasing levels of autoantibodies through a four-week observation period. They also had improvement in fatigue, cognitive symptoms, and sense of taste.

While more research is needed, these studies suggest that treatments targeting autoantibodies against GPCRs may improve symptoms of long COVID-19.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) involves placing an individual in a chamber with 100 percent oxygen that is pressurized to improve oxygen saturation in the body. HBOT has been successfully used to treat chronic fatigue syndrome, and fatigue is one of the most common symptoms of long COVID-19.

A small study evaluated 10 people with fatigue and cognitive issues due to long COVID-19 who were treated with 10 HBOT sessions over 12 days. All individuals in the study experienced some improvement in fatigue and cognition after HBOT. This study suggests that HBOT is a potential treatment for some symptoms of long COVID-19.

Microcurrent Stimulation Therapy

The most common and often the most debilitating symptoms of long COVID-19 are fatigue and cognitive impairment. Additionally, eye symptoms have been reported by some people with long COVID-19.

These symptoms may be related to coronavirus-induced impairments in blood vessel health. Vascular abnormalities impair oxygen and glucose flow to the brain, impacting nerve cell function.

Microcurrent stimulation therapy uses small electrical currents applied to parts of the body, most commonly to relieve pain. Microcurrent stimulation is known to improve blood flow, which may improve some long COVID-19 symptoms.

A case study investigated two people experiencing long COVID-19 with extreme fatigue, muscle weakness, inhibited cognition, and impaired vision. Each had several sessions of microcurrent stimulation therapy conducted over 13 days. The individuals experienced improvements in vision, cognition, and fatigue within three to four days.

This study supports the idea that improving blood flow with microcurrent stimulation therapy may help to treat long COVID-19, although more research is needed.

Cognitive Behavioral Therapy

In addition to extreme fatigue, people with long COVID-19 can experience many mental health symptoms, including anxiety and depression. Cognitive behavioral therapy has been successfully used to help people with fatigue from chronic health conditions. Researchers are currently recruiting for a trial of cognitive behavioral therapy to test its effects on fatigue in people with long COVID-19.

Although cognitive behavioral therapy does not treat the underlying disease mechanisms of long COVID-19, it may help people with long COVID-19 to better manage their mental health and their symptoms.

Outlook for the Future

Overall, there are many experimental therapies that show promise for treating and managing long COVID-19. The U.S. National Institutes of Health has launched new initiatives to fund long COVID-19 research. As researchers learn more about how long COVID-19 works in the body, new treatments and therapies will emerge.

Find Your Team

On myCOVIDteam, the social support network for those recovering from the effects of COVID-19, you can connect with others. Members come together to ask questions, give advice, and share their stories with others who understand.

Are you living with long COVID-19? What therapies have helped you manage your symptoms? Share your insights in the comments below, or start a conversation by posting on myCOVIDteam.