Long COVID 2025: Symptoms, diagnosis, post-COVID treatments and the latest long COVID research
What is long COVID? What are the signs of long COVID? Does getting COVID multiple times increase long COVID risk? What long COVID treatments are available?
Akiko Iwasaki, PhD, Sterling Professor of Immunobiology at Yale University, discusses new long COVID research, emerging treatments for long haul COVID, and the latest from the Yale Long COVID clinic. American Medical Association CXO Todd Unger hosts.
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AMA Update April 7, 2025
00:00 Post COVID syndrome: How to tell if you have long COVID?
01:10 Root causes of long term COVID: What is long COVID and why is it so complex? (Epstein-Barr virus)
01:48 Common symptoms of long covid
02:33 How many different causes of long COVID are there?
03:38 Post COVID-19 condition
04:07 Long COVID-19 symptoms: Why is diagnosing long COVID so difficult?
04:21 Internal tremors: Weird long COVID symptoms (internal vibration, POTS, Postural Orthostatic Tachycardia Syndrome)
05:13 Long COVID diagnosis and treatment
05:47 Can vaccines help prevent long COVID?
06:05 If I have long COVID should I get the vaccine?
06:49 How to prevent long COVID: Are there any preventive measures for long COVID?
07:08 Are there any effective treatments for long COVID?
07:50 What kind of drugs are being tested for long COVID? (drugs for long COVID, valacyclovir)
09:15 Therapeutic trials long COVID: What needs to change in long COVID clinical trials?
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50 Comments
Is thermodysregulation a possible symptom?
Thank you.
Thank you for your research! My 23 year old son has been suffering for 4 years. 😢
Prevention, adequate treatment, or resolution of internal tremor (vibrations), would be greatly appreciated. Thank you for this report. I had wondered about testosterone, and believe other hormones likely impact sufferers managing overlapping conditions, such as peri-menopause, menopause, empty sella (mainly afecting women), and connective tissue disorders. Keep up the work and educating primary care physicians to look for and order testing as necessary. ty
I had Covid in September 2023. Barely was sick but lost hearing in my left ear and then had a raging case of sebhorreic dermatitis that took months to heal. Am now suffering with digestive issues… the Covid wasn’t the worst part of having it. It’s the after effects that have devastated me.
Such important information! Thank you so much!
One of my favorite musicians, the semi-famous stringed-instrument wizard David Lindley passed in 2023 from kidney failure and pneumonia brought on by long Covid. Most of you have probably heard his lap steel slide guitar on Jackson Browne songs such as Running On Empty and That Girl Could Sing, but he also toured and recorded with Linda Ronstadt, Warren Zevon and many many others. Guitar, violin, mandolin, banjo, the Oud, Greek Bouzouki, Turkish Saz…..he could play anything with strings, and after his mutant reggae-rock jam-band ElRayo-X broke up, he traveled the world to play and record with indigenous musicians in Norway , Madagascar, Japan and elsewhere. He was still playing solo live shows in his 70's until Covid disabled him. A mudical giant, taken too soon. There are lots of great Lindley and ElRayo-X concert videos on YouTube….he was unique, one of a kind.
AMA, you have unique position to help us. I live in Kansas. I have been seeking treatment since November. I have an appointment with someone with no Long COVID expertise on November 19, one year after seeking treatment, just in hope of getting into the system.
Cleveland Clinic has its renowned telehealth Long COVID RECOVER program. I contacted thrm in early February for an appointment. After numerous phone calls, insurance cleared them to call me 5 weeks later to set an appointment. They said the first appointment must be in person. Forget about paying hundreds for a flight and hotel: I am bedbound and could not see how I could make my way through an airport, rental car, hotel check-in, etc..
My condition has deteriorated over the last 8 months. Although I do not know how, I need to move to another state to find regular care. I have a farm, which is not easy to move.
Why must bureaucracy make telehealth for bedridden people impossible. Policy must change. Help?
Thank you for continuing to investigate therapies for long COVID and keeping us informed, from someone who has finally accepted (given up?) being greatly limited after contracting COVID in March 2020. It’s still frustrating and maddening if I think about it.
Is uncontrolled shaking of hands or muscle twitching associated? I suddenly experienced these from mid January through late March, after three days of removing snow in mid-January.
No Truer words spoken! People who have had Covid or repeated Covid infections do not want to hear they have Long Covid. They Do! So many Drs. are not educated and scratch their heads. It is so gobsmacking that 5 years and most Drs show the same ignorance.
Haha this is being recommended to me woooohoooooo
Thank you so much for keeping this issue at the forefront – especially in the face of attempts to erase it.
Really good video, I really, really, really appreciate it! 🙂
I've had ME/CFS for 18 years after EBV. PEM and fatigue are my worst symptoms. I feel really bad for the long covid folks. At least long covid is being recognized as real and not dismissed as psychosomatic.
I have been considering the possibility that I have Long COVID. I'm hesitant to self-diagnose, but hearing Dr. Iwasaki describe reactivation of Epstein-Barr stopped me in my tracks. I was diagnosed with mononucleosis last year as an adult approaching 40yrs old. I was hospitalized for a week and ended up with splenic infarct. My doctor and I couldn't figure out how it all happened, but now I am wondering if it was COVID related. I'd so love to participate in clinical research. Though I suppose what I'd love more than that is to understand whether my consistent brain fog, fatigue, post-exertional malaise, and continuing slightly heightened ANA markers are Long COVID or just an unrelated set of symptoms.
I have long covid and now pots and if they can’t manage my symptoms I’ll be diagnosed with ME/CFS in July. So many medications thrown at me and they’re not helping. Still bed bound. I recommend anyone get the visible arm band to get a POTS diagnosis it was the only way I got it.
Don't stop! Thank you!
I. m sorry you subjec matter
Thank you!
5 years w LC for me. Thank you for all of your efforts on our behalf❤
😂
Some physicians may not be able to diagnose their own long covid as well….I wonder if that is true and how it may affect their view of this issue. Doctors and nurses had such high exposure rates. I wish there were data in this as well. HCW deserve help as well
Thank you Dr. Iwasaki. I’m a healthcare worker. I’m neurodivergent and my son and I have long covid. My son is autistic and the first infection he got led him to be hospitalized. This was so scary for him. Listening to you helps me not fall into depression. If at the very least there was more awareness about it to buy us some time while all of you work tirelessly to figure things out. I’m trying not to get sick both my son and I wear 3M aura N95 everywhere we go and it’s a s disheartening to be put at risk by healthcare professionals who think I’m exaggerating. It’s even more disheartening that even after knowing that my son has been hospitalized for Covid that they would at least be cautious around us. Long covid destroys lives. This isn’t living. I don’t want this to get worse for my son. I don’t want it to get worse for me. I’m a single parent and I’m scared. So scared. I think a third time would be it for me and I don’t know how I will
Make it. If we can get more awareness. Basic information for the general public and for clinicians so it’s not stigmatized. My biggest heartbreak has come from being dismissed by doctors. Patients have to carry the burden of being sick, being dismissed by doctors, and being disbelieved by everyone. It is very lonely very depressing. I refuse to be depressed but it’s pretty damn close. Had it not been for all you at the forefront working diligently I wouldn’t make it. Thank you thank you thank you
Thank you Dr. Iwasaki. I’m a healthcare worker. I’m neurodivergent and my son and I have long covid. My son is autistic and the first infection he got led him to be hospitalized. This was so scary for him. Listening to you helps me not fall into depression. If at the very least there was more awareness about it to buy us some time while all of you work tirelessly to figure things out. I’m trying not to get sick both my son and I wear 3M aura N95 everywhere we go and it’s a s disheartening to be put at risk by healthcare professionals who think I’m exaggerating. It’s even more disheartening that even after knowing that my son has been hospitalized for Covid that they would at least be cautious around us. Long covid destroys lives. This isn’t living. I don’t want this to get worse for my son. I don’t want it to get worse for me. I’m a single parent and I’m scared. So scared. I think a third time would be it for me and I don’t know how I will
Make it. If we can get more awareness. Basic information for the general public and for clinicians so it’s not stigmatized. My biggest heartbreak has come from being dismissed by doctors. Patients have to carry the burden of being sick, being dismissed by doctors, and being disbelieved by everyone. It is very lonely very depressing. I refuse to be depressed but it’s pretty damn close. Had it not been for all you at the forefront working diligently I wouldn’t make it. Thank you thank you thank you .
Very good and comprehensive information. But what I lack, and not only in this video but from the health society in general, is the other treatments besides prescription drugs, that help so many of us with long covid. Pharmaceutical is important, I use them myself such as antihistamine, but there are other treatments that are helpful as well, such as vagus nerve stimulation, pacing, doing the right amount of physical exercise with the help of a properly trained physiotherapist, and some vitamins and minerals that have shown to be helpful, and more.
I was surprised about the question “does getting vaccinated reduce the chance of getting long Covid”
Getting vaccinated greatly reduces your chances of getting Covid in the first place, and if you do get Covid, it greatly reduces the severity of it. How in the hell could getting vaccinated NOT lessen your chances of getting long Covid? It doesn’t take a genius to figure out that if you lessen your odds of getting Covid, less chance you will get LONG COVID!
Stay up on your vaccinations! Billions have been vaccinated. How many have had a bad result?
Is your work on this research include both vaccinated and unvaccinated? If yes, how do you know what caused the symptoms.
She lays in bed and expects more energy⚡️👹bigger stronger faster 💀
Thank you so very much 💕💕💕
I had COVID in December 2020. I was in the ICU for 9 days, but thankfully I only required supplemental oxygen. Since then I have had numerous health issues, but the most troubling is what I call, "the wall of tired". It can hit at any time during the day. When it occurs, my O2 levels will go into the 80's and I have to rest. I went from working a full-time job to working part-time from home.
Affirming that long covid IS A THING means so much to me. All my HMO doctors I have seen; my GP, Cardiologist, Memory, Psychiatrist, all appear to not accept there is such a thing as long covid.
But I have struggled with multiple infections and brain troubles since back to back covid infections July 2024.
I was fully vaccinated and boosted before I was covid infected, but I was totally down with it for 2 whole months.
Now all that is being ignored, and I'm going through a series of different mind drug treatments that are so far making me worse.
It's kind of reassuring I'm not just randomly having these problems, but very likely long covid.
Thank you for this acknowledgement of long covid.
**I was one of the unfortunate people when given paxlovid, I was hit a second time with covid immediately after last paxlovid dose. Also having serious asthma, I do believe my vaccine and boosters did keep me off a ventilator.
There are many of us who have what we call long covid long before covid. Other retroviruses can do the same thing combined with autoimmune issues, genetics, metals, vaccines, chemicals, how all that combines in any given person.
Cronic fatigue and COLD FEET!
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Dr. Iwasaki initially included those of us with "long vaccine" in these studies, which was greatly appreciated, however, this part of the study seems to have gone silent. I would hope someone is investigating why some people have rare and permanent side-effects to the vaccine so we can prevent them in the future. Because I had permanent damage to my auditory system from the two initial Moderna shots, I am not boosted – therefore my life continues to have limitations I would prefer not to have.
Dr's here in Georgia think there is no such thing
My grandson has had it for a year and a half. He got covid after a bout of strep throat. He had to retake a bunch of his junior yr of college classes. Hopefully more research will be done that will be helpful. Thanks for keeping it in the news.
These happens with all illnesses Just suck it up
HOW DOES ONE GET LONG COVID HELP WITHOUT INSURANCE?
Let go from contract job. In process of job search. Stress of all of this has made long covid symptoms significantly worse. Any assistance u can provide is greatly appreciated.
i may have had MECFS more mild pre 2020 in hindsight, but after two covid infections i am mostly confined to my dark room and bed, and its been this way for especially the past three years after my second infection. it is like living under house arrest with even less freedom. because it impacts everything. your ability to think, process, move, socialize. This has robbed my lfe from me. the grief is immense and unyielding. I still mask on the rare chance i can go outside. it blows me away how unwilling so many are to understanding how important preventing this disease is. I get sad seeing all the kids go to school, everyone going to concerts, medical workers treating us like we are crazy, while a mass disabling event continues to tear through our populations and claim lives. Diseases and conditions like this cause terrible quality of life, brain damage and high risks for suicide as well. I just cant understand it. the mass ignorance. i cant. ive managed to convince some people but others have accused me of doing a psyop.
Thank you to Dr. Iwasaki for all her hard work on this and her continuing efforts. If anyone can find answers to this intractable disease, she can. Hang in there. Thanks much for the update.
Thank you for staying with this!
I feel that I had sinus damage from COVID. I had sinus surgery 3 years later.
When you say reactivation of latent herpes viruses, does that mean people with covid or long covid can I have a shingles outbreak?
no help at all
I hadn’t realised internal tremors were so common with it! My doctors were all so surprised. In case it’s helpful, for me a daily magnesium supplement has helped those immensely for me.
I have EDS. I don't know where one symptom ends and another begins…. I absolutely get internal tremor though.
Thank you for this very informative video. I’ve had COVID twice, January 2023 and January 2022. I’ve developed heart problems and suffer from fatigue that seems to come and go. It’s very frustrating
Thank you. I just had it again. I swelled up and ended up with a pneumonia like situation I never had before with previous infections. Please keep up the good work.
Inflammation all over different systems