Long Covid in Adults
Long Covid Symptoms
Here we focus on the experiences of people who still had symptoms many months after they first had Covid.
This page covers:
- The range and pattern of symptoms that people with Long Covid have experienced
- Experiences of fatigue
- Experiences of brain fog
- The psychological effect of ongoing symptoms
The range and pattern of symptoms that people with Long Covid have experienced
Most of the people we interviewed had had some symptoms when they first got Covid. In the first few days of being unwell, these ranged from mild to severe. Grayson described how his symptoms “all kind of swirled around like they were playing some game of tag” for the first 12 weeks. They would sometimes come “all at once” and sometimes one at a time. Sometimes a particular symptom would disappear for a week or so and then come back. Jamie had felt really unwell when he first got Covid. A couple of days after his breathlessness started, he had to go to bed with “the worst flu ever... like a cross between flu and sunstroke”. He said his whole body felt “horrendous”. When he thought he was getting better, he took his child to the park but when he got back, he was so unwell that he felt “horrible”. Annabelle felt “very unwell” initially and had to take four weeks off work “which is quite significant for me”. She had to take more time off a few months later because she “couldn’t get out of bed in the mornings”.
Jennifer had thought that she was getting better, but when she tried to get back to running, she realised she was still very unwell. Tom thought he was fully better, apart from a “bit of a cough” and occasional tightness in his chest, but several months later he developed a deep-seated weariness that destroyed his ability to concentrate. Richard also got worse, after thinking he was starting to get better.
Jennifer thought she had recovered from Covid. When she tried to get back to her training for a half marathon, she felt “awful”. Her heart rate and blood pressure were high.
Jennifer thought she had recovered from Covid. When she tried to get back to her training for a half marathon, she felt “awful”. Her heart rate and blood pressure were high.
I got better, I felt like I was over it. I had a couple of weeks I felt I’m getting back to normal. And because my focus before it had been on the half marathon training, and at that time we thought it’s just a virus, you’re over it, and things were locked down, but they were talking about it all being open by the summer. So, my half marathon was September, so I thought I’ll get back to training, I’ve lost, you know, almost two months. So, I went on a little run round my block basically [laughs] and, that was quite tiring. It was, it was barely a run as far as I was concerned. So, I left it another week and thought right, I’ll just see how I feel. Went on another run and that one was terrible, and my heart rate was over two hundred and I thought I was going to pass out and, I was just like oh this isn’t right. So, I was in bed the next day, I had like a definite relapse, felt awful. And then on the Monday I, that was the weekend, and on the Monday, I felt well enough to take my dog on a little walk, but when I was out, I felt dreadful and I felt really odd, just can’t even describe it, just dizzy and odd. So, I went home, and I said to my husband, “I don’t feel right, I feel this, I feel my heart was going and I just felt really strange.” So, he has a blood pressure monitor, so he took my blood pressure and it was high, my heart rate was high, so we phoned the doctor and she went through a few things with me about, it’s not a heart attack basically, but this isn’t right so, you know, rest up.”
Five months after he thought he had fully recovered from Covid, Tom was suddenly hit by crippling fatigue and brain fog.
Five months after he thought he had fully recovered from Covid, Tom was suddenly hit by crippling fatigue and brain fog.
By the time I got to the middle of April, then, I considered myself to have fully recovered, and the definition of full recovery then was, I had a bit of a cough left, which I've never had before, and an occasional tightness of chest, but that was it. April, May, June, July, August, all passed, there was no issues, you know, the cough started to, you know, was going away, there was still just a tiny remnant of it. But then I got to the, September, and from nowhere, I was hit with this absolutely crippling fatigue. The term brain fog, I think it’s a kind of fabulous couple of words that can describe a whole kind of plethora of conditions. But, you know, it absolutely fits for, for what I suffered from, or am suffering from. I tried struggling through it, failed miserably, you know, I've never taken time off work before, but I ended up being signed off for five weeks.
People with Long Covid described a lot of different symptoms. They included:
- Extreme tiredness and fatigue
- 'Brain fog’, difficulty concentrating and memory loss
- Difficulty breathing and breathlessness
- Persistent coughing
- Weaker voice and losing voice
- A high heartrate or other heart (cardiac) symptoms
- Dizziness
- Problems controlling body temperature
- Loss of taste and smell
- Problems with vision
- Insomnia and disrupted sleep
- Headaches
- Aching joints and muscles, and body pains
- Gastrointestinal symptoms (e.g. diarrhoea)
- Numbness and/or pins and needles.
People found it hard to make sense of their Long Covid symptoms, particularly in the early part of the pandemic when Long Covid wasn’t properly understood. Their symptoms had a huge impact on their day-to-day life. Many people we spoke to had had a large number of symptoms. Claire said: “I mean I had tons of symptoms; I think at some point I listed them and there were about forty-odd.” Maria counted forty-five symptoms that she had experienced, and Sarah said that the number of her symptoms had reduced to around eight or nine “that have lingered ever since” her initial infection. Ben had a lot of different symptoms, including joint pains, chest pain, groin pain, shortness of breath, headaches and disturbances to his vision, dizziness, problems with his skin, scalp and hair, pins and needles, and brain fog.
Mary was able to act as translator for her mother. Mary said Esther had been bedbound for some time. Before she had Covid, her mother Esther was active and independent.
Mary was able to act as translator for her mother. Mary said Esther had been bedbound for some time. Before she had Covid, her mother Esther was active and independent.
She did have severe, severe body pain – complete body pain. And her eyes were watering constantly.
And she was sneezing at all times. Her head was in constant pain. And she was not able to eat anything at all. And it was only liquid diet, there was no taste and, no taste sense, no smell, no smell, no taste. And she didn’t want to eat anything. It was only liquid diet.
And, watery. And it has to be on not even in large quantities; even if little she takes, she was throwing that up. And she was in shivering, severe cold. And, it didn’t, recover very quickly.
She went through all this, and she was struggling to stand. She was, stumbling as well. So, as a result it was over a period of time, even she was not able to have a shower. She went in to have a shower – again that’s December – she had a severe fall in the tub and then she couldn’t get up from the thing. She was screaming from inside and the door was locked. I had to get someone to open and then carry her out and to get…give her the first aid.
And she had all her ribs broken. She was in that severe pain that she couldn’t even stand still. If she stands, she would fall.
And her breathing was affected as a result. It did take a lot of time for…because I was giving her the complete… bathing, her care and everything – whatever needed, right from scratch for her. It wasn’t easy for me as well going through it.
And, I had to get people involved. I had to employ some people to come and do that support and help us, because I was affected, and to support my mum.
People who had experienced a wide range of symptoms could feel like their bodies were out of control. Some symptoms were there all the time. Others came and went, often without any apparent reason (See ‘Thoughts about recovery and the future’ for more about changes to symptoms and improvements over time).
Adele had a very wide range of symptoms. Her symptoms came in waves over more than a year and affected every part of her system. As a doctor she struggled to make sense of it all, especially some of the stranger symptoms.
Adele had a very wide range of symptoms. Her symptoms came in waves over more than a year and affected every part of her system. As a doctor she struggled to make sense of it all, especially some of the stranger symptoms.
So, I guess I was expecting, a bit like when you have the flu, to wake up one day and for things just to be better, but that never really came. I would describe it as waves of feeling unwell, and those waves would actually start numerous times a day, when I was in the very acute. I would have moments where I'd think that it’s passing, I must be getting better, now, that was the, that was the bad bit. Actually, it all just recurred over a period of weeks. I don’t know if that was my fever spiking, or the virus replicating, and increasing in my system, I really don’t know. But that was a persistent feature, and really difficult, because every time I got worse, it made me feel a little bit let down.
That second acute phase, where I was a bit doolally, in honesty, that kind of petered out, into a more subtle phase, which lasted, gosh, probably about a year, a year or more, so until now, in varying degrees of intensity. So, I have had what they’re calling Long Covid, I’ve had ongoing symptoms, some have been cognitive, so even now, I'm struggling to do the job that I was doing before I got Covid. When I was in the thick of it, maybe eight months ago, I was struggling to do things like read anything, watch TV, follow recipes, you know, I just, I couldn’t really do anything, I couldn’t work out how to put stuff in the washing machine, or hang out clothes on the clothesline, I couldn’t organise the process in my head. Things definitely have got better, in terms of the cognitive, in that way.
I also joined a, a group for doctors with Long Covid, which was super helpful for me, actually, because there was so much information. It was just so good to speak to other people who were going through the same thing. Because a lot of the symptoms that I had in that third phase, protracted Long Covid, were bizarre, and difficult for other people to believe, I think. And they affected just about every system going. So, headaches – if I start from the top and work my way down – headaches and migraines, I had ongoing visual disturbance, in terms of the scintillations, the flashing lights, for quite some time. A change in ability to focus my eyes, as well. postural headaches, so headaches when I would stand up. A lot of postural symptoms, so heartbeat absolutely racing, there were times just standing up. I remember feeling so unwell when I stood up to just go for a shower, so that’s moving from one room to another, really, my pulse went up to a hundred and forty something. And it felt as if, there were extra heartbeats as well, so ectopic heartbeats, and a definite feeling of the heartbeat in my chest. I would also feel dizzy, at the same time. And I came to understand through this group that I'd joined, that these symptoms fit with a condition I had never heard of before, called PoTS, postural orthostatic tachycardia syndrome
So, essentially, it’s the autonomic system that has gone a bit haywire, and is causing symptoms, like the tachycardia, like blood pressure dropping, people call it brain fog, the brain not being able to work properly, particularly when you're upright. All of these things could be accounted for by this, so it was really good to discover that, because then I could look at what the treatments for that might be. So that did represent a bit of a turning point.
And I think, you can probably get a sense that a lot of this illness, because it’s all been new, a lot of it has just been me trying to work out what on earth is going on. And as a doctor, that has been really, really difficult. I can’t imagine what it would be like as a lay person. The neuro stuff, I thought had gotten better, so you know, the phantom smells, the tinnitus, I'd had some strange nerve pain, like a poker in my ear, really bizarre, but it was very, very painful. Strange kind of scalp sensations, as well, but all, all such vague and strange things, I didn’t even mention them to my GP, because I thought she might think I was completely mad [laughs]. So, I'd thought all of that stuff was behind me, and then at, probably, month ten, I developed peripheral neuropathy. So, I started getting ice-cold, and burning hot pains in my lower leg, and my feet, which was really uncomfortable. I also got it in my right hand, and my fingers, with some pins and needles, as well. And in addition to that, the initial leg pain, and restless legs at night, that came back at month ten, as well. So, I'm not entirely sure why it did.
Grayson had difficulty breathing, muscle soreness and pain, acute dizzy spells, ringing in the ears, headaches and brain fog. His breathing problems developed into asthma and his dizziness could be frightening.
Grayson had difficulty breathing, muscle soreness and pain, acute dizzy spells, ringing in the ears, headaches and brain fog. His breathing problems developed into asthma and his dizziness could be frightening.
There was probably then about nine weeks after that of slightly different post-Covid symptoms. So, I’m…I’m just looking at some notes I made at the time of those. So, I continued to have quite acute shortness of breath, difficulty breathing, had to try and keep upright all the time, it was difficult to breathe when lying down, still had a cough though not as bad as during Covid. I acquired dizzy spells this was something completely new. I should have mentioned on my original Covid symptoms that the first place I felt the infection was in my hip where I’d had a hip replacement three months before I caught Covid. And you could definitely feel it in the muscles around the knee joint. In this post-Covid era, the sort of weeks three to nine, I suffered incredible soreness and tenderness of the muscles in both of my hips, particularly the one most recently operated on, but I’d had the other one replaced about eighteen months before. Sorry, about a year before. So, I had a year-old major surgery wound and a three-month-old major surgery wound and around both of those, incredible soreness and tenderness of the muscle sheath. The doctor told me that that’s what he felt it was.
I can only describe it as feeling like a combination of cramp and how you feel after you wake up the next day after you’ve run a marathon. All of the muscles were incredibly sore around that joint and that kind of soreness and fatigue in my hips spread out from my hips. I also had it in my back. But that was probably one of the most acute post-Covid symptoms. I also had quite acute dizzy spells and tinnitus which I had during Covid as well, but it continued quite acutely into that sort of weeks three to twelve period. And also a slight feeling of like having a bad hangover. If you know what I mean by that? It was almost like having a hangover every day, feeling kind of fuzzy, not, you know, brain fog people call it. And all of that lasted until April sometime, in fairly consistent form. It did evolve over time, so these acute dizzy spells which really did quite worry me came for about three weeks and then they went, and they seemed to be associated with the tinnitus in my ears and some of the headaches. I used to, I don’t anymore, suffer from migraines and it was a bit like a post-migraine fog, very similar feeling, which is also a bit like a hangover [laughs].
So just, you know, really feeling not yourself, I was quite, I developed a lack of confidence, a slight wobbliness on my feet, partly I think because Covid interrupted my rehab from my hip replacement and I still haven’t really recovered my confidence of balance and moving around and some of those things. So, it kind of slowed everything down. And then, from April onwards, I have kept what now appears to be, and the doctors are in the middle of kind of diagnosing this, it’s morphed into a late onset asthma. I’ve never suffered from asthma, but I currently have a set of symptoms that look very like late onset asthma. Not acute wheeziness but shortness of breath and difficulty getting lungful’s of air, particularly when I’m sitting in certain positions, or lying in certain positions. Not brought on by exercise or anything like that particularly. So, that’s accompanied by an asthma type cough, not a Covid type cough but, if you know what I mean? If you go like that, it makes you cough, and I can feel like a physical pain in my back and my lungs. And so, I’m still having a few more tests but the doctors think that it has now turned up as late onset asthma. And in terms of the doctors’ care, what I’m experiencing is what I’m sure other people are experiencing is they don’t know. They’re speculating. So, you know, I’m receiving some long Covid treatments, but I’m certainly not in the, like, most acutely affected group, there are people, you know, far worse affected than me but yeah, it seems to be the final manifestation of the lung problems that I had during Covid.
In that sort of middle period, was there anything that you noticed that seemed to particularly trigger flare-ups in symptoms? Was there any pattern to it or was it, from your perspective, quite random?
Yeah, in terms of the dizziness, there did seem to be something to do with my head being at an angle to the left so I was speculating it was in the inner ear. So either an infection or swelling or something in the inner ear, and it would be triggered by sudden movement like that, suddenly you get a dizzy spell. There was a really frightening phase in the middle where it would just come as I was, I could be walking along and suddenly absolutely everything would be kind of, you know, all over the place. Way back in the past I’ve experienced a little bit of Meniere’s disease, I mean you lift your head off the pillow and the whole world swims round. But I’ve never had feeling dizzy when I was upright, so there was a little bit of what felt a bit like Meniere’s when you’re kind of just resting and you move your head suddenly and it triggers something. But this was …but this was, you know, I would be walking in a straight line and literally I had to stop and everything’s moving and if I could get to a chair I’d sit down, but sometimes if I was out walking in the park, I would just have to sit on the ground. And it would go crazy for thirty seconds to a minute and then go. That was frightening because you never knew, you know, it never happened to me when I was driving but I was obviously really worried it might happen when I was driving, or when I was, you know, going up and down stairs or you know, somewhere where I’d be particularly vulnerable. That kind of suddenly stopped about week twelve and didn’t come back.
Iain described the way he experienced his symptoms over six/seven-day cycles. He said, “I just go through that cycle continually”.
Iain described the way he experienced his symptoms over six/seven-day cycles. He said, “I just go through that cycle continually”.
So, it’s quite a…it’s pretty severe. And if you imagine now, you know, it’ll be two years next year that I’ve been suffering. So, I’ve had diarrhoea for two years. So that in itself is madness. You know, I’ve… and it… you know, it’s not… the trouble is it’s not like diarrhoea. You know, you…people have a…you know, a certain, kind of…what they think a feeling like that is. You know, so you get a, sort of, dicky tummy, you get, sort of, butterflies in your tummy and then you need to…it’s not…it just comes. Just literally just comes.
And so that’s really been my worst symptom, so what happens with me is I get, like, a six-day cycle sort of, seven day, six/seven-day cycle. So, I start off you know, and you have these symptoms all the time. It’s just that… these are, like, the more predominant ones on the daily basis. So basically, get bone ache, I get muscle fatigue, I get, brain fog. Then I get, sort of, mental, kind of, fatigue, you know, general fatigue and then I have, like, a mini episode of Covid. And then it starts again. And I just go through that cycle continually.
And depending on what I'm doing, you know, the brain fog could come and go, you know, …to the extent, you know, I’ve had the occupational therapist down, you know, my wife has to take responsibility for me taking my heart medication. You know, I can remember to take it, but I might…but I might not, you know, or I might forget or…you know, whatever. So, that’s quite a big…quite a big thing for me.
So, in that cycle, I’ve yet to receive any actual treatment for it. I’ve had lots of investigations into what it’s not, you know, if you…if you're…just look at the…you know, the diarrhoea. So, I’ve had everything up to a colonoscopy to find out what it’s not. And they can't find out what it is. You know, so it’s just what it’s not. And that’s the same with everything.
It was not unusual for the people we spoke to have experienced dizziness. This could feel like a severe spinning feeling, or nausea or seasickness. Some people’s dizziness came on rapidly and was unpredictable. Some people became dizzy after making sudden movements or when they were very tired or after standing for long periods of time. Like Grayson, Jamie had found his dizziness frightening at times.
Jamie describes his unpredictable dizzy spells as his “scariest” symptom. They affected his confidence in doing things.
Jamie describes his unpredictable dizzy spells as his “scariest” symptom. They affected his confidence in doing things.
You mentioned before your dizziness, Jamie is that…?
Yeah, that’s been kind of scariest symptoms for me, to be honest. It’s not like vertigo where the room’s spinning, it started off when I went back to work a few weeks later. I kind of just got this, it’s like you’re going to pass out that’s how it started, and it was like a, kind of like a pressure around my neck, I thought it was to do with blood pressure, or something. And it just generally, it kind of gradually got better but it’s like your brain and your eyes aren’t working in unison, that’s the only way I can describe it. It’s not like vertigo where the room’s spinning, it’s just like, if you turn your head too quick, it’s like your brain and your eyes aren’t quite working together properly.
And has that affected what you’re able to do on a daily basis?
It just makes me really anxious. I mean, yeah, on a daily basis, it kind of, it just makes you lose your confidence in doing things. Because you do get dizzy. I mean, I can still drive, I don’t really get it when I'm driving, it’s more when I'm moving around. It’s like, it’s just a really horrible, your eyes and your brain aren’t working together properly, it kind of feels like. I mean, I’ve had a CT scan of my brain, and that came back normal. I did an ultrasound on my heart and that came back normal, as well. So, I mean, nobody really has the answers to tell me what it is.
Anthony described the dizziness he felt when tired. He felt less confident about what activities he could do and it meant he tended to “err on the side of caution.”
Anthony described the dizziness he felt when tired. He felt less confident about what activities he could do and it meant he tended to “err on the side of caution.”
And do you think you have learned then quite subtle cues from your body? Like, what would you say are the very earliest signs that you’ve now learned, right, this is a sign I'm getting tired?
A sort of, lack of concentration sets in… sometimes dizziness. You know, my…you…you…I feel dizzy and I just, need to sit down or stand still or rest against the wall or something like that.…, it’s usually… it’s a combination of, sort of, both mental and physical cues that can tell you. But really you know, when you’ve got to that stage you’ve gone too far. You have to stop before you get there [laugh].
And that’s…that I still find very hard to do.
Yeah. It’s almost like you get no warning until it’s the actual tiredness, then it’s very hard to know when before that sets in, so…
Yeah. And if I can just follow up on that, this is …I mean, this has implications for the rest of your health of course because it means that you can't get out and do the normal amount of exercise that you would do., this doesn’t necessarily mean running ten miles but, you know, even just cleaning the house or hoovering or, you know, doing the washing or the washing up or the pottering around in a garden.
You know, all of those things. And particularly…I mean, particularly things like doing things in the house where you’re, kind of, moving around all the time. You generally move quite quickly, and you bend over and your turn around and you do this…those sudd…well not even sudden movements but the kind of things that you norm… just take for granted turning round, bending over, doing that quite quickly, all of a sudden you just have to catch yourself before you fall over.
And I was going to ask, do you think there’s any level of anxiety? Do you feel, kind of, anxious about things?
Well, that…
…in terms of balance and…?
…that then…yeah, that then starts to build in because, you know, you have incidents when, you think, I can't do this, I mustn’t do this because I'm feeling dizzy or tired or I’ve got headaches. Then the next time you think, well…mm, should I do this, or shouldn’t I do it?
So, this, kind of, anxiety then does, kind of, build in. So, and it becomes difficult to know when you should or shouldn’t do things sometimes. And you…because you’ve been told to and because experience tells you, you err on the side of caution. And I don’t know…yeah, that’s just what happens. So, you, sort of, develop, kind of, this anxiety…kind of, almost does build up over, kind of, weeks and months I would say. Yeah.
It was also common for people to talk about headaches they had experienced. Frances described “blinding [and] splitting headaches” which prevented her from doing anything. Laurie and Anthony spoke about extremely painful and debilitating headaches.
Laurie said her headaches felt like someone “bashing nails into my head” and “like lightning strikes in my head.” It felt to her like she had “the worst teenage hangover ever.”
Laurie said her headaches felt like someone “bashing nails into my head” and “like lightning strikes in my head.” It felt to her like she had “the worst teenage hangover ever.”
And the pains in my head, I would have I would get neuralgia, and I called them the neuralgia gnomes, because it was like having gnomes bashing in my head. The things that that got me through actually were the metaphors that I was coming up with to discuss things with other, you know with people on social media. Obviously, I wasn’t getting any other kind of contact but other sufferers and other people, so the neuralgia gnomes were, you know, almost the humorous way to discuss what was going on in my head, like somebody literally bashing nails into my head it was so painful and it could happen up to three times a minute it was just, you know just like lightning strikes in my head. Another one that stuck was the gaslighting jerk virus a Twitter conversation very early on with some of the some of the earlier doctors that have become friends.
[name] who actually spent quite a lot of time, you know, she’s done, did media things because she [audio cuts], open about what’s been going on with her. And she was just like ‘oh this virus is an idiot’ and I just said, “Oh it’s such a jerk, it’s such a jerk it’s gaslighting jerk virus because every time you think you’re getting better, you get worse again.”
It feels like I’m being gaslit by this, it’s like the worst ex-boyfriend ever [laughs]. And the idea that the like, it just felt like I had a constant hangover, and I had this conversation with [name] on Twitter, just like it’s just like, it’s like I’m 13 years old and I’ve raided my parents’ liquor cabinet and I’ve drunk all the Kahlua and Malibu and I just feel sick and my head hurts and I’m so dehydrated and it’s just this, just like the worst teenage hangover ever.
Anthony described different types of headaches. Along with flashing light headaches, he experienced very severe headaches that come on suddenly and “stop you in your tracks”.
Anthony described different types of headaches. Along with flashing light headaches, he experienced very severe headaches that come on suddenly and “stop you in your tracks”.
But there were also other headaches associated with this, which, sort of, became more apparent over time…over time. And these have changed. And these have been in some ways much more unpleasant than the flashing light headaches. They have been really severe headaches where, it stops you in your tracks, you…you just have to, sort of, sit down or lie down and shut your eyes and, you know, take yourself off to a dark room a dark, quiet room. The problem with those sometimes is that they’ve been worse when I’ve been lying down. So, you…you feel dreadful, you don’t want to do anything, you want to curl up and just rest. But they get worse when you lie down, so you have to prop yourself up.
That’s not as relaxing as it could be. The…these became particularly bad, earlier this year, 2021.
But again, these periods of, you know, quite intense headaches come and go and sometimes they come on really very suddenly. It’s not just as if it’s a gradual build up. You know, within, thirty seconds, I…you know, I’ve suddenly found myself with very severe and very localised headaches, very localised headache. And they’re just odd. They can be very localised. They can move around. They can extend from, you know, one side of your head to the other. And again, at times they…they’ve become worse when you’re lying down.
Yeah. That sounds horrible.
It’s pretty ghastly, yeah [laugh].
Adele, Ellen, Shakila, Ben and Raj now had problems with their body temperature. Ben said “I don’t have a comfortable temperature. I’m cold trying to get warm, and then I am so hot that I need to do something about it. It’s never that middle ground”. Adele described a “spine-chilling type of feeling” which was “like cold water being poured down your back”. She said it was completely overwhelming, “really, really disturbing” and “probably one of the most bizarre symptoms” that she had “this awful feeling of my blood running cold all the time”.
Several people experienced a high heart rate (tachycardia), even when they were resting, and other cardiac symptoms, such as chest pain or high blood pressure. Laurie said she would be sitting down knitting and notice on her Garmin watch that her heart was beating as fast as if she was working out at the gym. Ellen had a number of heart and chest symptoms – “the chest pain was both sides and there was also chest tightness where you just felt you were just getting squeezed. It was more than pain; it was just you were struggling for breath. [I also had] heart palpitations or times where my heart was like looking at a cartoon where your heart was bouncing and coming out [of your chest] and it was horrible.” Ellen, Adele, Ben and others had all sought medical help for these symptoms. Adele had chest pain when she first became unwell. This flared up again nine months later when she started trying to do some exercise. She had intense chest pain and “classic” angina symptoms – “it was brought on by exercise, it was relieved by rest, it would sometimes radiate down my left arm.” Ben experienced a racing heart and other heart symptoms.
Ben had a higher heart rate than before. He felt like his heart was “working hard”. He went to A and E when he got chest pain “out of the blue”.
Ben had a higher heart rate than before. He felt like his heart was “working hard”. He went to A and E when he got chest pain “out of the blue”.
So, the next one is a fairly obvious one, it’s tachycardia, my heart rate is higher than it usually is, and even at rest, it’s now a good bit more than kind of where I was before. And particularly post-exercise and, and using exercise in the lightest of sense there, post walking round a single floor flat, it can be raised considerably. This can tie into interactions with medical staff, or kind of the medical side of it, at both points I ended up in A and E because of it, and my heart rate was kind of one sixty, one seventy, just resting and I think it combines a few different things. It’s a level of anxiety looking at your heart rate, your heart rate then goes up because you’ve looked at your heart rate, you’re in a hospital so you get white coat syndrome and it then goes up a bit, but this was on both occasions it was really quite a high increase compared to my resting heartrate. So that’s generally gone down. I would attribute that to, to what I’ve been doing with [named organisation], particularly. I can go into that detail of kind of what those are but certainly it was the initial impact, it’s now kind of stopped a little bit, but still even walking I would say stairs or any incline, you get quite a feeling that your heart is working hard.
The next one, and this again I’m sorry to bring it in later when it relates to something earlier, I was getting very prickly pain, a very sharp prickly pain. I can really only kind of link it to, if you imagine kind of the pain of sticking your finger in a bramble but almost like a circular version of that and it would move kind of across my ribs, under my arms on both sides, towards my back and at various times that came on, that was what triggered me to go to A and E. And a considerable chest pain out of the blue.
So you were worried that the kind of vice-like pain might be like angina or that kind of thing?
Correct, yes. Just something, something other than just what it was, and certainly on the first visit, I got told kind of, okay, there’s nothing much we can do, we think it’s chronic fatigue syndrome, just rest, but if you get any heart or chest pain, reattend for that, just given that it could be something else. And that has, and again I’ll link onto the medicine side of what helped resolve that, but it was a very uncomfortable pain which again in the anxiety side of it, is it something else than what it looks like? Especially the fact that the second time it presented, it was very linked to kind of heart and felt kind of middle of chest, starting kind of in the back, moving under arms and then moving to the chest so that as quite, quite concerning.
Just as you’re talking about that pain moving around, is that like over seconds or over minutes or over hours?
Yeah, so this was kind of a rapid onset and then it was probably ten or fifteen minutes that it was sore for, got to A and E and it was still quite painful, so by the time I got seen that was kind of half an hour of, of kind of prickly chest pain. And then we looked at the heart rate, that was elevated, it was just attributed to, to that, but my GP actually thinks that that’s linked more to the costochondritis. And that’s linked into how we’ve treated that, and I think that’s actually been fairly accurately treated. I’m quite glad to get that one off.
Both Lynne and Emily experienced a worsening of their asthma symptoms after having Covid.
Although Lynne’s asthma had been well controlled before, after she got Covid she needed to use her inhaler up to 40 times a day. Eventually she was able to speak to her asthma nurse who straightaway realized that she needed to see her GP.
Although Lynne’s asthma had been well controlled before, after she got Covid she needed to use her inhaler up to 40 times a day. Eventually she was able to speak to her asthma nurse who straightaway realized that she needed to see her GP.
So, unfortunately, after a few weeks, it hadn’t gone away, and I was getting gradually worse, rather than better, and so at that point, obviously nobody knew about these long-lasting effects. I wasn’t able to speak to my GP because it was a case of, well it’s Covid related, phone NHS twenty-four. So, I was speaking to a variety of different doctors, and just saying, you know, it’s not going away, so, their advice was, you have to keep staying at home. So, it went on, I think it was about seven or eight weeks, we all had to stay isolated at home, because I still had symptoms.
And my breathing during that time was getting worse, and worse, and worse. To the point where, one of the doctors advised me, just keep taking your blue inhaler, as much as you need it. So, I was taking it about forty times a day at one point, and I was saying, you know, that this was really unusual for me, I don’t think that’s very good for me [laughs]. But that, that was really the only answer. Apart from an occasional, then, I was getting, just steroids, and antibiotics thrown at me as a, a safety net of, well if it’s something else, then it would catch that, so it was just, keeping taking your anti…keep taking your inhalers, take this antibiotic, take steroids, and there’s nothing else we can do for you, we don’t know what’s going on. And eventually, one of the doctors that I spoke to said, you're not the only one, other people are having this as well.
So, it was sort of reassuring, but at the same time, it was that worry of, well what’s going to happen, then, because it’s not going away. So what help, what’s the next step. And there wasn’t really a next step. So, I was just getting gradually worse. At the same time, the kids were trying to be home-schooled, my husband is working full time from home, and I was also still trying to work,
But so, it was just a case of, get to the summer holidays, but by this point, I couldn’t walk the length of the garden with the kids, I couldn’t play with them. I struggled even to get from my living room into my kitchen, struggled to get upstairs. Obviously, washed and dressed, and things like that, I couldn’t, I just couldn’t get a breath, couldn’t breathe, I was exhausted. So, it was tough, it was really difficult, at that time, eventually, it went on, this went on for months, and eventually, I think it was my mother-in-law who very helpfully said, can you speak to your asthma nurse, rather than trying to get your GP, who, quite rightly, the receptionist just kept saying, no it’s Covid related, you can’t speak to them.
But I felt like I needed to speak to someone who had a little bit of understanding of my medical history, and that this wasn’t normal. So, thankfully, I spoke to my asthma nurse at the GP clinic, and she was just fabulous, and straightaway said, no, this is not right. And straightaway gave me an appointment with the GP, to change my medication, which was helpful.
So different inhalers, and then started taking Montelukast which helped a bit. But yeah, I was still pretty much unable to do anything, really. I couldn’t go out for walks, couldn’t really play with the kids, I struggled even just to put them to bed, or bath them, or anything like that. So, it was a complete change, because usually I'm fit, healthy, very active.
It was a big change, so, yeah, so that went on for a long time. And then obviously, when it came, the end of the summer holidays, I just couldn’t go back to work, so I had to have that conversation with my boss of, I can’t physically do it. As soon as the schools were going back in, and not home schooling – home schooling, I could manage. Although it was very difficult, having my own children at home as well, I could manage, because I wasn’t standing, it wasn’t talking. Because I find it difficult to talk for long periods of time, it was a bit easier, but as soon as the kids were coming in, I had to say, I can’t do this.
So, I then ended up off work for over a year just because, physically, I wouldn’t be able to physically manage to do it.
Ongoing changes to smell and taste was also something that several people told us about. For some, like Hazeem, Fiona A, Annabelle, Susan, Emily and Zoya, their smell and/or taste had never quite returned to normal. Ricky was getting “distorted” smells and tastes that would come and go – “such a weird taste and smell [and] a real strong taste at the back of your throat”.
For a time, Megan was getting “just this awful horrendous smell” before feeling like she was then able to smell less in general. Emily was also getting a “horrible smell [like] eggs are cooking” and her taste had changed - “I still can’t eat peppers, they taste disgusting [and] red wine is disgusting”. Robert’s only Long Covid symptom was his loss of taste and smell. This still really affected his day-to-day life more than a year after he first became ill. At first, he lost these senses completely. He began to get some faint smells and some “replacement” or “blocking” tastes and smells which were “weird” and unpleasant.
Robert describes trying to make sense of very faint or strange and unpleasant tastes and smells that have begun to come back. Whisky, white bread and hand sanitiser smell the same to him now. He doesn’t feel “quite in tune with everything”.
Robert describes trying to make sense of very faint or strange and unpleasant tastes and smells that have begun to come back. Whisky, white bread and hand sanitiser smell the same to him now. He doesn’t feel “quite in tune with everything”.
Now I get a lot of different kinds of, I get replacement smells now as opposed to a lack of smell. So, you know, onions and garlic are a, a good one. I think that’s been identified by a few people now. They are, they come out as, like, a weird blocking smell. It’s the only way I can describe it is, kind of like, stale old dusty potpourri with a hint of rotten mouse. Which, I know it sounds weird, but have you ever had a rodent or anything like that go in a house or something. There’s a, there’s a sweetness, the smell of it, and that, that’s in there as well and it’s very strange indeed. And that comes through, and I haven't identified everything yet but with the onions and garlic removed, it’s made a big difference because you can, there are other bits you can taste and it’s very, very, very sharp and clear [audio breaks up], you don’t get [audio breaks up] or anything like that at all. It’s very, [audio breaks up], if you know what I mean. With the other flavours, the other blocking smells and then you tend not to taste the smell, taste, sorry, taste anything apart from, like, the onion and garlic. Weird, sort of, edge, sort of, smell. If that makes sense? [Laugh].
So, when you say a blocking taste or smell, does that mean you can experience those but it’s drowning out everything else?
Yes, it’s like the same smell, from the onions and garlic and then I get off swede at the minute as well. But it’s the same smell or the same, sort of, taste. It’s always the same sort of flavour that comes through which isn't anything to do with what you’re eating. It’s not an attractive, it’s not a pleasant taste or smell. I'm talking more about taste at the minute. But it not any, you don’t get any pleasure from it. It’s kind of, meh, it’s slightly unpleasant at best basically. And that’s about it. So yeah, it is kind of, strange.
When, you remove some of those, bits, I do get very faint bits of flavour coming through. I mean, you get salt and sweet, vinegar, vinegar is a good one. Like a packet of, salt and vinegar [audio breaks up] enjoy now, but it’s because I get the sharpness of the salt the vinegar. But I don’t get the real depth of the flavour. I don’t taste the potato in the crisp and things like that. But it’s almost recognisable but it’s not quite there.
So, yeah, it’s a weird one. With the, with the smell as well, smell’s a funny one because there’s the blocking taste thing backs up in, with the smell as well. So, if I smell onions and garlic, it tastes exactly the same as I smell. But then lots of other smells, it’s like, put a glass of whisky in front of me, a bottle of hand sanitiser and a loaf of white bread, they all smell exactly the same. It’s like the ethanol in the hand [sanitiser bottle]. And in the, in the whisky I can smell, but none of the other flavours. And then weirdly, I presume it’s the additives in the bread. In like a cheap white loaf, say. Because you open that up and it smells like a, like a solvent almost. Or like ethanol almost. But I guess that’s already there. But the bread smells add to it or mask it. So, when you actually smell it normally you, you don't get just that. But it, it’s weird how some have just completely gone and then you, you do get, sort of, strong whiffs of other things. Hand, like, hand sanitiser’s a weird one. I can smell it from miles off when someone puts it on, just the, the alcohol. And I used to have a lot of, solvent-y, sort of, petrol-y type of flavour, smells. They were the first ones to come in after I lost my sense of smell and taste completely.
It sounds as if it’s very tiring because it sounds like you’ve been trying to analyse every food stuff?
You’re trying to find it everywhere because you know it’s there, if you know what I mean, you know. You know when you smell a pack of smoked bacon that it’s, it’s in there and then sometimes you can, you get a little waft of it. But then you can smell it again and you don’t. And that’s weird because it’s like, is that a memory or is that actually bacon that’s making me smell like that because why can't I smell it again then. And it was never a strong smell. It’s always very, very faint. But it’s, yeah, it is. And it, kind of, even in day-to-day life because you’re walking around and you’ve lost, you know, a whole sense, or two, you know, depending on how you look at it [laugh]. But, like, so your, kind of, your environment doesn’t necessarily back up, you know, you’re used to walking down the street and you’ll get smell, smells and bits and bobs, be them nice or not, as you’re walking around. You’ll see things and then you’ll get a smell of a car or something and it’ll back it up, and things like that. You don’t, there’s a hint of numbness about it almost, like, within, when you’re walking around because you’re not, it’s a bit like having your earphones on walking down the road, you’re not quite in tune with everything like you were before. Which is quite unpleasant.
Robert’s loss of taste and smell has taken away his enjoyment of making and eating food. It has been very difficult for him because he is a chef. His Long Covid symptoms have taken away a lot of the pleasure of cooking for other people, at home and at work. Diane’s sense of taste had come back a little bit and she tried to stay optimistic about it returning fully. Hazeem felt like he was missing aspects of his life because of his reduced sense of smell.
Diane described herself as “a big foodie” and said she would love to get her sense of taste back.
Diane described herself as “a big foodie” and said she would love to get her sense of taste back.
So, I met up with a friend recently and he’s advanced nurse practitioner specialising in ENT, Ear, Nose & Throat.
So, he’s dealing with a lot of similar Covid patients and what he, he suggested was promoting was to do regular taste testing and taste and smelling exercises on myself, so I do try and, you know, smell things like vegemite and things like strong smelling things. And occasionally, you know, I did get the [inaudible] it all and you always have to check if there’s onion something or if they’re, you know, if there’s mustard or, you know, I was at a restaurant with some friends in England recently like over in February and there was wasabi, cabbage on part of the entrees and I was just eating it and not really being affected and they were all saying how strong it was. You know, my daughter made a really strong chilli at the weekend and, you know, I couldn’t really, I knew it was a bit hot but I couldn’t really get the taste, I still enjoy the food and I think it’s about textures and the family seem to say that what I’m cooking is really tasty but I think that’s helped by the fact that I am an okay cook, but I have to ask them for reassurance, is it okay because I can’t really taste if it’s bad anyway, so that’s interesting. I’d love to get my taste back because I am such a big foodie.
So, I’m really annoyed about that, and other people can get quite depressed by the fact that they can’t taste, I didn’t think I’d, I’d get depressed because I think I still enjoy eating it’s more about looking than tasting and getting the occasional taste and textures but, you know, I would like to get that back. And at least it hasn’t, it is coming back a little bit which is better than zero, so I’m always taking the positives from that and I’m hoping it will just keep improving but I’ve been told that if it doesn’t come back in a year it won’t, so I don’t know.
I remain optimistic.
Experiences of fatigue
A common symptom that people talked about was debilitating fatigue. People described feeling completely exhausted after trying to do simple everyday tasks, such as walking a short distance or shopping. This could have a life-changing effect. It affected people’s ability to work or look after their family or do other things that were important to them. (See Managing Long Covid day to day and Work and Long Covid). Many people said they found it hard to describe the fatigue they experienced. Esther used several different words to convey just how tired she felt. She told us that before she had Covid her life was “was very active” and she was “able to do a lot of things a lot better, and my thinking was completely different from what it is now at the moment”. Now she felt “Very fatigued, very tired, lazy, and exhausted”. Milembe said, “[the fatigue], you can’t explain it”. Irene said, “the tiredness was just horrific, absolutely horrific… I just can’t describe it, [it was] devastating.” Zoya described it as “extreme energy loss”. Sam said: “I can’t ever describe a fatigue like it. I can only describe it as like being plugged into a socket [and] someone had pulled the power out. Like all of my energy was just gone, like I couldn't eat. I could barely talk.” Frances and Emily described the fatigue and lethargy they felt as “overwhelming” and Ellen said, “I’ve never felt anything like it”.
For some of the people we spoke to, their fatigue could cause an overpowering need to sleep. But some people reported poor quality sleep or feeling unrested even after sleeping for much longer than usual.
Maria said sleep didn’t fix her fatigue. Sometimes she would wake up feeling worse and it would take her a couple of hours to be able to “move slowly about the house.”
Maria said sleep didn’t fix her fatigue. Sometimes she would wake up feeling worse and it would take her a couple of hours to be able to “move slowly about the house.”
Incredibly fatigued yes, and it’s like nothing I’ve ever experienced before. It wasn’t necessarily that sleep would fix it at all in fact sometimes I woke up feeling worse than when I went to sleep, it was like every day it would take me two or three hours to warm up and then I wouldn’t say I felt okay but I’d be able to move slowly about the house but and then yeah I’d go back to bed and the whole cycle of waking and feeling horrendously hungover almost, would start again.
I’ve never really been a napper during the day, I’m not a big fan of napping in the day because I, I, type of ways of feeling terribly disorientated and yeah I’d try not to, once I was up I tried to stay up. So yeah so it more a case of having a long morning sleeping and then getting up early afternoon rather than getting up and then going back to bed again but yeah no the sleep just didn’t touch the fatigue at all and if anything it made me feel worse when waking up.
Annabelle described feeling like she had to crawl out of bed in the morning and like she could go to bed at 8pm. This level of fatigue had been a consistent symptom for her.
Annabelle described feeling like she had to crawl out of bed in the morning and like she could go to bed at 8pm. This level of fatigue had been a consistent symptom for her.
Yeah, just for me it’s the tiredness that is…is chronic fatigued feeling that if I could stay in bed ’til twelve o’clock every day, I would.
How would you describe that sense of tiredness? What’s it like?
For me, I think [sighs] I think if I didn’t have children and I didn’t have the financial overheads, I wonder whether or not I would be getting out of bed until later on in the day. And I think because there just isn’t an option, it is…I will crawl out of bed and get out of bed to make sure I am up with my youngest.
And with work as well because if I don’t work then we don’t have a home and I really love my home and I don’t want to go down that route [laughs]. And I just wonder, am I…is it because I don’t have the choice or is it actually because I am able to physically get up and go on and I just really need to motivate myself to do that? I was weighing it up, thinking God if I had, I don’t know, another condition [sighs] or that was causing this, or could it get so bad that I couldn’t physically get up then, I wonder? But no, I do feel like I am improved in the day though.
Yeah, in the day. I do feel like sort of early afternoon, I just could go to bed every day at sort of eight o’clock, happily. In fact, I do, pretty much every day about eight, nine o’clock [laughs].
But the earlier the better.
So, you feel that initial fatigue very early on, some improvement in the middle of the day and then needing to go to bed earlier than usual?
Yeah, definitely earlier. And definitely, I think, in terms of life pattern I’d have gone to bed reasonably early – being realistic, I…my child wakes up at half five every day – so we go to bed early anyway. But we would go to bed and, you know, talk or…or watch something or read something or, you know, just be awake maybe for an hour or so. But, yeah, now it is we go to bed, we go to sleep because I’m so tired. And I don’t sleep well as well, I am up and down.
And that kind of tiredness and fatigue, has that been something that has been pretty consistent since you initially had Covid? Or does it come and go in waves? Is it sometimes better, sometimes worse?
No, it’s been consistent. I would say that’s been a consistent thing that I’ve had.
Some people said their fatigue came in cycles, so they could manage to function reasonably well for short periods before their fatigue kicked-in, forcing them to sleep or rest. Some people described how ‘post-exercise malaise’, a complete exhaustion after they had done too much, could last for several days. Paul said the “post exertional malaise [is] the only reliable thing about [Long Covid] really.” Susan said, “the post exertional malaise has been what’s sort of stopped my living, as it were.”
Adele described how her fatigue completely changed her life.
Adele described how her fatigue completely changed her life.
And how does that compare with life living with Long Covid, or Long Covid ongoing symptoms?
So, all of that, pretty much, went in the bin my hobbies, my interest, I couldn’t, I just felt so unwell [laugh]. I certainly wasn’t able to do things like look after pot plants, and do gardening, so a lot of the plants died, or got given away, the garden grew wild for a year. Reading, I couldn’t do, I couldn’t concentrate, TV programmes, I would sit in front of, but it’s not being taken in. And it just felt like there was no joy to life. So, I could understand why people perhaps thought there was a stronger element of depression, because your interests, and your pleasure just go, when you're sick and not feeling well. Social interactions obviously became difficult because of lockdown, but also, they were just so mentally draining. There was a while, a period of a few weeks, I think, when I really struggled to have any conversation, it was difficult to follow the conversation, very difficult to take it in and digest it, and then formulate a response. And I had fairly marked word identification as well.
So, speaking to me was, a little bit challenging, because I just couldn’t compute what people were saying, and the time, so the long delays before I would reply, and often, I just got the wrong end of the stick. And the socialising kind of went out the window, and work, of course, I couldn’t work. I tried to work through the first week, and then, I think I was pushing myself to do it, but words were jumping about on the screen. I was working from home, but I just couldn’t focus on anything, concentrate, and then the visual, the flashing lights, the scintillation started. And I just, I stopped, around about a week in when I got really unwell. So, not working was difficult because you miss the social contact, you miss, having a role, you miss having a purpose.
Tom’s symptoms had been “life-changing”. Physical or mental exercise triggered his fatigue. It affected his memory and his ability to concentrate.
Tom’s symptoms had been “life-changing”. Physical or mental exercise triggered his fatigue. It affected his memory and his ability to concentrate.
So, for me, it’s been really quite life-changing. And in terms of the, the symptoms, so what does it feel like? So, I’ll wake up in the morning, half past seven, eight o’clock, and I’ll almost always feel fine. Then, if I do anything that involves mental exercise, or physical exercise, and actually, mental exercise tends to trigger it more quickly, then tiredness will kick in. And in a normal working day, because my work, my job does involve a lot of mental exercise. I’ll get to about noon, and I'll start to struggle, I’ll start to struggle quite badly. and if I can continue past that point of struggling and keep going, I’ll get worse. Which then has a knock-on impact, not only for the rest of that day, but for subsequent days. And, when I feel tired, it’s weariness, it is fatigue, it’s not just I'm, I'm feeling a little bit sleepy just now. But what’s much worse is the way it just completely destroys my ability to concentrate.
Experiences of brain fog
Many people described how their deep-seated fatigue affected their ability to think clearly, to take things in and to ‘process’ or remember things like names, words and recent conversations. This was described as ‘brain fog’, having a ‘foggy brain’, or feeling like their brain was ‘shutting down’. Laurie said having brain fog was “the worst thing” for her and it was “really, really distressing”. Brain fog had a noticeable impact on daily life because it made everyday things, like making simple decisions, much more difficult than they had been in the past. Frances was “unable to make a decision about anything [and] it was just really debilitating”. Even being asked if she would like a cup of tea felt like “a really big question” to her. Anthony said that brain fog made social interactions “very tiring” and that even a telephone conversation “scrambles my brain”.
Ben describes what having ‘brain fog’ is like for him.
Ben describes what having ‘brain fog’ is like for him.
The fatigue is very, very linked to what is known as brain fog. I often end up calling it brain frog, because it’s brain fog.
As soon as it is more than one thing I’m doing, all the plates just drop. It’s not like I can spin two plates. So, if I’m in a coffee shop and somebody asks me something and then somebody behind says to the person, oh, no, get me a latte or get me a cappuccino, I can literally go, like, why am, why am I with you again, what am I here for? So, it’s that kind of, it’s the, the brain, linking to that brain fog, can be really, really impact on my. Often I’m not somebody that usually has to think about what they were going to say. I am finding myself have to really plan, and this comes back to your point about planning. I have to plan the conversation out to think, okay, what, what are the options they’re going to ask me? Do I have, maybe they’re written down so I know what the question’s going to be, and it’s that kind of, if somebody says to me, okay, I’m ordering a coffee, can I have a latte, please? Or what syrup do you want? That would throw me entirely, and it’s, that’s not, that’s not me at all. So, I’m, yeah, that’s still there, kind of everything, physically and mentally, is a little bit harder than it needs to be.
And that’s, yeah, that’s something that I think, I feel like I’ve improved over the last month considerably with probably two things that I’ve been doing which we can go into. But certainly when I’m, if I have a relapse or if it’s just come on in those early stages, that was, that was the biggest thing because it has such a psychological impact on you as well in terms of its, I think that to make it really simple, it makes you feel stupid, it makes you feel almost kind of ga-ga, like you’ve gone mad, that you can’t just ask for something, like the, the brain fog and the brain frog thing is a really good example. Like the words that, I know fog is very different from a frog but my, my brain doesn’t know. I think that’s one of the [inaudible] into the brain fog and the [inaudible] it’s kind of an autopilot failure, that’s the easiest way that I can, I can explain it. I can go into the kitchen knowing I’m going to do something and reach into the cabinet to grab the item that I need, and like it happened the other day, I loaded the dishwasher, was ready to put the dishwasher on, and the dishwasher tab that you put in the dishwasher and my [inaudible]. I opened the fridge, to look in the fridge for the, the dishwasher tablets. I know they live in the cabinet because I put them in the cabinet but no, I was in the fridge looking for it, and that’s, that’s happened a few times with kind of you’re doing something by autopilot, and it just goes wrong [laughs].
There was a time when my partner found a bowl that had meant to go in the dishwasher had been put in the fridge. It’s that level of kind of you know you wouldn’t do it if you were thinking about it, but you don’t have that ability to stop yourself from doing it because you’re not thinking about doing it So that’s, that’s where it’s really kind of impacting on kind of memory, is the other side of it, that I can be told something in one room and then I literally go into the other room, and I’m like what was the answer to that, or I would say the opposite.
Razia said her brain fog meant “the most obvious thing just leaves the brain.” She wouldn’t allow her children to be in the kitchen with her when she was cooking because she was so anxious that they might get hurt.
Razia said her brain fog meant “the most obvious thing just leaves the brain.” She wouldn’t allow her children to be in the kitchen with her when she was cooking because she was so anxious that they might get hurt.
And but I get major brain fog. I’m just going to bring my wrist in and quickly show you. I don’t know how clearly you can see that.
Yeah, yeah. I can see it.
Now anyone in their right mind would know that if you’ve put the kettle on, it’s going to get hot. Now but when I say brain fog, I don’t just mean that you can’t remember phone numbers, or you can’t remember whether you’ve done something, or you can’t remember why you came into the room. I get I get that anyway from having kids and, you know, like baby brain as I call it, but it would be those moments still, it’s getting less and less, thank God touch wood, but there’s moments still where the most obvious thing just leaves the brain.
And I remember when we had to take my daughter, my second, my middle baby, you know, [...], so we had an appointment last week in [city]. So, we decided to go there overnight so it was just easier, kids not fussing, what have you, easier if we’re already there and up and get a taxi to the hospital. So, we’re in the hotel, I put the kettle on, so I know it’s on, I put the kettle on and then I thought, okay, I’ll just put the tea bags in the cups, and it had just started the whistling stage, the kettle, and my brain didn’t function like nothing alerted me in my head and I literally, casually, just put my arm over the kettle.
And as soon as I, just to grab something from behind it, and as soon as I did it just squirted the hottest, boiling steam out and I spent all night with two buckets of ice on my wrist after I had had a long day with the children and my husband like, bless him, he could barely keep his eyes open but every, you know, twenty minutes or so he’d be like, “Okay?” I was like, “It’s all right. Go back to sleep. I’m fine.” No, I’m not fine, you know, but that’s just the most, the latest.
Over the last six months there’s been random moments where again, I’m cooking, I’m doing something and I, I’ll just be cooking and obviously when you’re cooking there’s hot things around you but my brain, the health and safety side of my brain, wouldn’t function. So, I burn myself, like I drop things, I hurt myself.
I’d forget how to do the basic things and so, when people talk about brain fog and then I tell, you know, it it’s like when you’re pregnant, when you’ve had a baby or when you’re a parent you might get it anyway, you’re, you know, even if you work long hours, you might be used to forgetting things. It’s not just why you’ve walked into a room or forgetting where you’ve put the keys.
It’s actually it’s actually bigger than that because, when you’ve got three, because it scared me. I said to my husband, I’ve got three little ones at home and, you know, he’s going to work probably thinking, “Are they safe with her today? Is she going to be all right?” [laughs]. Yeah, no, he’s right to but then the anxiety starts kicking in because I think, before I do anything stupid get the kids out the kitchen and I literally, got to a point where I was like, I’m not having the kids in the kitchen.
Even when I’m not cooking, even when no oven is on, no nothing is on, nothing is boiling, my anxiety would kick in. I get so anxious, I’d be like, no. And I’d look around thinking, literally, like cooker’s off, hob’s off, oven’s off, kettle’s off, everything is off. Right. And then I’m like, what else could they hurt themselves, what have I not done? I then start looking for things I might have got wrong because it was happening that often.
So, it was a bit of, it was a longer break this time, but it happened, and my husband says to me, “And you did not think that steam was going to come out.” And I was like, “It just didn’t even occur to me.” I was just casually grabbing something whereas, normally, you would not, I would not to do that, you know.
Fiona B described difficulties she’d had with getting words in the right order. She also felt her short-term memory was worse and hoped these problems were temporary.
Fiona B described difficulties she’d had with getting words in the right order. She also felt her short-term memory was worse and hoped these problems were temporary.
Yeah, and when you said at the end of January you fell off a cliff, can you describe what that was like for you?
Cognitively, that…I’d really deteriorated. I couldn’t get words and I’d been with family at Christmas, so it was before the vaccine, and I wasn’t getting the words right, and words were back to front, like park car instead of car park, short term memory atrocious.
We all have that time, don’t we, at times, where we go into the fridge, and we don’t know why we’re there. But this was going into a room, going into a cupboard, going into this, and just thinking, well, what am I doing here?
And then the other things, and that’s when family started getting a bit frustrated at Christmas time, was that I’d be constantly being told, well, I told you that five minutes ago, and it wasn’t…it wasn’t there. I’d get sent to the shop for three items, and I’d remember one. And I think, good God, but it seemed to get so much worse.
I think the cognitive symptoms have been the ones that have worried…you know, as people have got over the most intense tiredness, you know, the most intense fatigue, I think the cognitive symptoms are the ones that a lot of people have found really quite distressing.
It’s the short-term memory, it’s horrible.
You do…you don’t remember things. I’ve got to write things down, and even when I write things down, I don’t always look at the piece of paper [laughs], but the short-term memory now is still there, and, you know, going into supermarkets, you’ll just go in with…it’s like going in the fridge moment that we all have. It’s like I’ve come in here, what am I here for? It’s like I’ve aged, you know, I feel as though I’ve aged about fifteen years in about five months.
And I hope, I so hope it just goes back to normal [laughs]. But I’m smiling here, but I…underneath, you know, I kind of worry that some permanent damage there that I’m not…or it’s going to progress, you know, dementia wise or something, I mean…but you don’t want to think about that too much, but it’s there, you’re thinking about it.
The psychological effect of ongoing symptoms
Not surprisingly, the people we spoke to also talked about the psychological impact of being so unwell for so long. Most had been healthy and leading very active lives before they developed Long Covid. They described how some of their physical symptoms made them worried, anxious or frightened (see more on the emotional impact of managing Long Covid symptoms). Annabelle had experienced hair loss since having Covid. She said the psychological impact of that had been “a huge thing for me” – “I’ve always had thick long hair. My hair is now non-existent [and it] really bothers me”. Some people had noticed that their physical symptoms could get worse when they were feeling anxious and vice versa. Shaista said, “when I’m feeling stressed the coughing immediately kicks in [and] shortness of breath kicks in.”
Sam’s symptoms got worse when he felt stressed. He thought that his physical symptoms made him feel anxious and when he felt anxious about something his physical symptoms could get worse – “it seems like either of them set each other off.”
Sam’s symptoms got worse when he felt stressed. He thought that his physical symptoms made him feel anxious and when he felt anxious about something his physical symptoms could get worse – “it seems like either of them set each other off.”
I think I’ve had my best run of a few days since I’ve been in the sunshine on holiday. I had quite a few days in a row where I’ve just started to feel much brighter in my head, my head felt more switched on and I could feel it in my brain. I felt like I could think better and more clearly.
I mean, I’ve had a couple of, I’ve had a couple of smaller like I felt suddenly just gone and I felt incredibly wiped in bed, and extremely tired…. The Wednesday before I was actually watching a film that had, I’d generally been trying to watch the happy stuff and even if didn't follow it all, where I get tired, the process of information would wear my out.
Simple stuff like that that is quite happy and cheerful and that’s it. But I watched a film that, a gangster film that quite horrific torture scenes in it and watching that, weirdly, it set a bit of my symptoms again. I was really struggling to, the chest tightness of the breathing and I felt dizzy and I wanted to lie down and so, I think, you’ll probably know more about this than me—quite a common theory with this whole is it your…. It actually attacked the whole Long Covid thing, your vagus nerve is just completely out of kilter which connects your mind to your body. When I, you know, having sort of read up, you know, lots of those kind of theories from what look like well trusted sources.
Yeah, it does make sense now that if you’re watching something that’s starting to like make feel a bit uncomfortable and a bit, you know, it’s trigging, you know, it’s sending those kind of messages of blood to your body that’s starting to cause those problems. And even on Monday by my two housemates had just gone, an extremely early pregnancy, the baby has now been an extremely early birth.
So, the baby is now born and healthy. When that was all kicking off on Monday, it was, you know, it was extremely stressful for them as it would be and even kind of being close to that made me feel on the morning that I found out about that, I was just all over the shop. And so, yeah, like even external events that cause any sort of anxiety or stress in my mind can then trigger my body and then it, and then it can be vice versa and sometimes when I, if I’m walking somewhere and again, I always try to take it really slow and really easy. But there are some days when I’m trying to do that and I just feel, you know, if I can feel it start to, I suddenly start to get more exhausted.
And then I think, ‘Oh God, I need to lie down.’ And at that point, I kind of, it almost starts to set off some of the breathing and then that then makes me mentally a bit stressed. It’s so hard to know sometimes where the boundary is between mental anxiety and stress and then the physical stress. It seems like either of them set each other off. So, it’s honestly the most weird, weird, bizarre illness I’ve ever had. Well, I’ve never really had a proper illness like Covid. It’s such a bizarre beast.
Feeling constantly unwell and not being able to get back to their ‘normal’ life made some people feel depressed from time to time.
Sophie found her breathlessness “psychologically demanding”. She felt like she couldn’t breathe, “hour after hour every day for weeks”.
Sophie found her breathlessness “psychologically demanding”. She felt like she couldn’t breathe, “hour after hour every day for weeks”.
And I then started to get really short of breath, it was just really noticeable, and in the kind of early evenings where I felt like I couldn’t breathe. Like my lungs weren’t inflating properly kind of thing in and out, it was like really shallow breathing, and, I just tried to, ignore that, go for walks and stuff, just probably, you know, it was just tiredness that was bringing it on. It started to get more intense, stronger and then it started to peak earlier, so it was then like earlier in the evening. This went on for a week and it was happening earlier and earlier, when it was then starting in the afternoon, and then, it was like just felt really, really hard to breathe, so I phoned up the doctor, and then she just did a telephone appointment call with me. And she said to me that she thought it sounded very like Covid, and it would just be that the, basically because I said to her, during that time I did actually get a PCR test, which turned out to be negative. And she said that would probably mean, she said it could be that I’ve maybe had Covid, but this is now the aftermath of it. And it’s, affecting the receptors, kind of like how asthma would manifest.
So, she said that would be something that sounded like long Covid at this stage because I was still testing negative, and she suggested it could be long Covid, but they can’t obviously confirm that one hundred per cent, because I’ve not had a positive test for Covid. But she said it did sound very much like it, and she said that it would probably just take time to go away itself, and I was to try and do breathing exercises, I tried that, but it just had no impact on it whatsoever, and she said it would take time, she said that there was no time frame for that, because it’s different for everybody.
I don’t think they understood how bad it felt. I think they just thought, oh, it’s a wee bit shortness of breath, here’s some breathing exercises, and it’ll go away. But it was like, well, for me it was just like I couldn’t breathe, and to have that, like hour after hour every day for weeks is psychologically demanding, because you have to focus your mind out of that dreadful feeling.
Being constantly unwell made Jamie feel depressed, unlike his usual upbeat ‘bubbly’ self. His symptoms caused anxiety. He was frustrated when people suggested the anxiety caused his symptoms.
Being constantly unwell made Jamie feel depressed, unlike his usual upbeat ‘bubbly’ self. His symptoms caused anxiety. He was frustrated when people suggested the anxiety caused his symptoms.
Do you think that makes it more difficult, that you appear to be relatively normal to people, or some of the people that know you better, would they sort of be able to detect real differences?
I think people notice a difference in my attitude, a lot. I was usually a really upbeat kind of, bubbly, kind of up for a laugh guy, and I mean, I'm getting better now, [Interviewer's name] I feel. But the last year, 2020, I mean, I was just, I felt depressed. I was just constantly feeling not well.
And like, like people, the GPs, a lot of them were really great, and I think as they got drip-fed information about long Covid, they started to think, well these people are actually not well. I think a lot of them thought, I got told a lot of the time I was suffering from anxiety. Which I do think, I agree, I do have, I have got anxiety. But it’s the symptoms that are causing the anxiety, whereas they seem to think the anxiety is causing the symptoms, which is really frustrating.
And when you say people, is that the health care professionals you’ve been in touch with, or is that…?
Yeah, some of the GPs seem to think it’s all down to anxiety. And I’ll be honest [Interviewer's name], I think anxiety does play a part. But a hundred per cent, it’s the symptoms that cause the anxiety, which, maybe first, but it’s definitely not anxiety that’s causing the symptoms.
Adele recognises “there’s a psychological element to everything” As a doctor, she thought her anxiety could be linked to ’adrenal overload’. She felt ‘on edge’ as if she was ‘full of adrenaline’.
Adele recognises “there’s a psychological element to everything” As a doctor, she thought her anxiety could be linked to ’adrenal overload’. She felt ‘on edge’ as if she was ‘full of adrenaline’.
One thing that I haven’t spoken about is, I suppose the psychological effects of Covid. So, I do so with a little bit of trepidation, because one of the things that has been really difficult, about this illness, is that a lot of people have wanted to pigeon-hole it as psychological, long Covid in particular. And when you're experiencing symptoms, when you’ve got palpable tachycardia, you know, when you have raised inflammatory markers, when you have palpably sore joints, it’s really difficult to think that people might think that there’s more of a psychological element to it.
I do understand there’s a psychological element to everything [laughs]. What I would say is, because the autonomic system is affected, for months and months, I felt like I was anxious, I felt like I was on edge, I felt like I was full of adrenaline, and I didn’t understand it at all.
I now know that can be secondary to PoTS, and that can be secondary to the dysautonomic symptoms. which gives me a bit more understanding, because logically, I wasn’t, I was trying to think, why am I feeling anxious about things, but I couldn’t give a good answer to that. I didn’t really understand why I would feel anxious, really, particularly when things were getting better. It was only when I read more about, PoTS, and the dysautonomic side of things that, it made more sense. It’s just adrenal, overload, really.
For people who had pre-existing health problems before getting Covid, it wasn’t always easy to tell if their symptoms were due to Long Covid or the conditions they had previously been diagnosed with.
Sofia had a pre-existing autoimmune condition but felt her health had got worse since Covid. She had mentioned this to the doctors managing her condition.
Sofia had a pre-existing autoimmune condition but felt her health had got worse since Covid. She had mentioned this to the doctors managing her condition.
Yeah, I think I’m a bit more, I’m a bit more tired. Sometimes I have a bit of a cough that sort of comes and goes. I’m breathless a bit more. I was breathless before but I was a bit anaemic as well. But yeah you can tell when I walk a bit. And I’ve got one of them oximeters now that I put it on my finger and I check my oxygen levels at home, and before it never used to go down as much as it does now.
So, what I do then is, when I do feel like that, I just rest. Like half an hour, and then I just carry on, but I don’t exert myself anymore so, yeah. But I do feel the difference; I can see it. I do feel I’ve gone a bit more, worse in terms of that, yeah. But they said it can last up to six months or even longer, so you’ve just got to deal with it really.
So, you were saying that you felt better after a couple of weeks, but you said that still something’s not right, you’re still continuing…
Breathless and tired, yeah.
When did you sort of start to notice, I’m not back to myself here, something’s different?
I’d say about a month later. But then when I spoke to the doctors about that at the hospital, I had an appointment about my condition anyway, I mentioned it to them and they just said that, it can take a while for you to get back. It can even last up to six months. And I’ve had family and friends they’ve said the same thing. So, it hasn’t really been six months yet. I can still feel like if I go to the kitchen, I have to sit down again; I get really breathless. So, that’s when I know that it’s not…I’m not the way I used to be.
Because of all the breathlessness. So, I think they do want to do another scan on me as well at the hospital and just to see in my lungs if it’s affecting me more long term or if there’s any issue there.
Others had noticed that having Covid had made existing health issues flare up. Adele said her eczema and psoriasis had got worse. She thought her joint pain had got worse too. This made her wonder whether there was an “auto-immune” component underlying her symptoms.
Jennifer had shingles a few months after getting Covid. Her sinus problems flare up when she is having a ‘bad patch’ with the Long Covid symptoms.
Jennifer had shingles a few months after getting Covid. Her sinus problems flare up when she is having a ‘bad patch’ with the Long Covid symptoms.
I don’t have too many different symptoms now. I just seem to have the fatigue and the brain fog, and the heart rate thing. And so, there’s things associated with that, like I said, the dizziness; but they all kind of come together. But certainly, in the early days of both Covid and long Covid it was like that, it was like you don’t know what’s coming next, are these random symptoms. And certainly, from reading people’s stories in the Facebook groups some people have a lot more ongoing different symptoms and they’ll say, “I’m, I’m losing my hair all of a sudden.” Or they get, rashes and things. And it’ll just come and go and there’s no real, but it’s just your whole system is just so affected.
I did get shingles last August, and I’ve had shingles, I’ve had chicken pox before, and I got shingles in the August. And that was, again that’s really common that things that are sort of, like shingles lies dormant in your system, so anything you’ve kind of carried on from previous experience will flare up [laughs]. So, if someone’s prone to something it will come back after Covid; it just seems to be it, it ignites all these things again. So, people who’ve had skin issues or something that will come back.
But yeah, a lot of people have lost their hair. I haven’t luckily, or eyelashes and things. So, it just, it just affects every system, so anything can happen really because you don’t know what that will bring if it affects a particular system. So, stomach issues, I have reflux that I didn’t have before; I still have that at night. and other people have, like, gut issues, that come and go as well. And people seem to be more likely to have allergies, or if you’ve been slightly allergic, you’ll be more allergic, and things like that. So, histamine issue like seems to be a big deal as well. So, they’ve been more affected by hay fever than they were. I am prone to sinus problems, and I get that, that comes back. If I’m having a bad patch that will flare up. So, it’s just like whatever your little weakness is or has been it, it comes back because of this, your body’s reaction to this virus.
In other sections people talk about how their exhaustion, brain fog and other symptoms affected their lives (see Managing Long Covid day to day and Work and Long Covid). They also talk about trying to find help, information and support. Sometimes this was through health care professionals, like their GP. Sometimes it was through other sources of help and support. Online peer support had been particularly important for many people, especially early in the pandemic. The experiences that people described when they talked about their symptoms could be all the more difficult for people because Long Covid is still such a new and poorly understood condition. It will take some time before health care professionals are sure about what is the best way to treat various types of symptoms.
Another section of this site covers how a wide range of people experienced becoming unwell with Covid and then recovered within the first few weeks after contracting Covid-19.
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