Still Living with Long COVID: What It Is, How It Feels, and What You Can Do
- Mark Esterle, MD
- Sep 12, 2025
- 4 min read
By Dr. Mark Esterle, Pulmonary and Critical Care Medicine
Louisville Pulmonary Care, PLLC
It is Summer, and I am seeing several patients in the office for persisting cough and shortness of breath, and many of these people have a common theme of presuming these persisting symptoms to be " worsened allergies". As it turns out, many of these patients are in fact dealing with the COVID virus again this Summer. Most people don't want to hear that, and are just tired of COVID entirely, so they aren't testing anymore, blaming all cough and upper respiratory symptoms on their allergies. Luckily, most people have pretty mild symptoms and really just need symptomatic care and time. However, it has reintroduced discussions of ongoing symptoms that are consistent with long haul COVID. For many people, COVID-19 fades after a few rough weeks. But for others, the story doesn’t end there. If you're still feeling off long after testing negative—tired, foggy, short of breath—you’re not imagining it. You're not alone. You could be one of the millions living with Long COVID. I am still seeing patients in my office that are complaining of persisting symptoms related to their most recent, and for some, not so recent COVID-19 infection. Let’s walk through what we know about this condition, how it shows up, and what you can do to start feeling better.
What Is Long COVID?
Also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC), Long COVID refers to persistent symptoms that last beyond the initial infection—weeks, months, or even longer.
According to the World Health Organization, it’s considered Long COVID if:
Symptoms appear or continue 3 months after COVID-19 infection
They last at least 2 months
There’s no other explanation
What Are the Common Symptoms?
Long COVID can affect nearly every part of the body. Common symptoms include:
Fatigue – extreme tiredness that doesn’t improve with rest
Brain fog – trouble focusing, remembering things, or finding words
Shortness of breath, even during mild activity
Chest pain or heart palpitations
Joint and muscle pain, weakness
Digestive issues – nausea, reflux, diarrhea
Neurological symptoms – headaches, dizziness, tingling, trouble sleeping
Mood changes – anxiety, depression, PTSD
Loss of smell or taste, ringing in the ears, menstrual changes
Symptoms often wax and wane, with good days and setbacks.
When Should You Talk to a Doctor?
Please seek medical attention if:
Your symptoms persist longer than 4 weeks
They’re disrupting your daily life
You develop serious symptoms like chest pain or confusion
Your symptoms suddenly worsen
New symptoms develop after you’ve started to recover
How Is Long COVID Diagnosed?
There’s no single test. Diagnosis is based on:
Your medical history
A thorough physical exam
Lab tests (inflammation markers, vitamin levels, thyroid function)
Possibly specialized tests (lung function, heart imaging, cognitive assessments)
The goal is to rule out other conditions and confirm Long COVID.
Who’s at Risk?
Anyone can develop Long COVID, but risk is higher in people who:
Are female
Are between 30–50 years old
Have conditions like asthma, diabetes, or autoimmune disease
Experience anxiety or depression
Were unvaccinated during infection
Had more symptoms during the acute infection
Why Do Some People Get Long COVID and Others Don’t?
We don’t have all the answers yet. Current theories include:
Lingering virus particles causing chronic inflammation
Autoimmune responses triggered by the virus
Microclots or vascular damage
Reactivation of dormant viruses (like Epstein-Barr)
Genetic factors and individual immune responses
Is Long COVID “Just Stress”?
No. Long COVID is a real medical condition backed by research:
It shows up in lab work, scans, and objective findings
It affects people worldwide, across demographics
It has distinct patterns unlike typical psychological conditions
That said, mental health matters, too. Anxiety, stress, and depression can intensify physical symptoms and make recovery harder—which is why a whole-person approach is so important.
Can Long COVID Be Prevented?
These steps may reduce your risk:
Stay up to date on COVID-19 vaccinations
Rest and recover fully during acute infection
Consider early antiviral treatment if you're high-risk
Practice prevention – good ventilation, masks in crowded places, etc.
Why Is It Still Happening?
Long COVID continues to affect people due to:
Ongoing infections and new variants
Multiple infections in the same individual
Underdiagnosis and lack of awareness
Some symptoms appearing months later
How Long Does Long COVID Last?
It’s different for everyone:
Many feel better within 3–6 months
Others experience symptoms for a year or longer
Recovery often happens in ups and downs
Healing takes time—and support.
Treatment and Management
There’s no cure yet, but we can help manage symptoms and support recovery:
Symptom-specific treatments:
Pain medications, GI treatments, sleep support
Rehabilitation:
Physical therapy for fatigue or weakness
Cognitive rehab for brain fog
Breathing therapy
Pacing and lifestyle changes:
Learning how to conserve energy
Avoiding overexertion to prevent crashes
Multidisciplinary care:
Specialists including pulmonologists, cardiologists, and neurologists
Long COVID clinics offering coordinated care
Final Thoughts from Dr. Esterle
If you’re struggling with symptoms weeks or months after COVID, don’t ignore them. You’re not alone. And you’re not imagining it.
At Louisville Pulmonary Care, PLLC, we understand how frustrating and isolating Long COVID can feel. We’re here to listen, evaluate, and help guide you on the path to recovery.
Recovery may be slow, but many people do improve—especially with support, care, and persistence. If you or a loved one is having persisting symptoms, feel free to reach out. We are here to help.
Dr. Mark Esterle Pulmonary & Critical Care Medicine
Louisville Pulmonary Care, PLLC
📍 4003 Kresge Way, Suite 312, Louisville, KY 40207
📞 (502) 899-7377
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