Long COVID and post-COVID condition

Long COVID refers to health problems that persist, recur or develop beyond the acute illness phase of four weeks after a SARS-CoV-2 infection. The term post-COVID condition is used when symptoms continue or develop after twelve weeks and cannot be adequately explained by another condition. Symptoms can vary widely. Commonly reported problems include marked fatigue, difficulties with attention and memory, breathing difficulties, and muscle or joint pain. Not everyone affected has all of these symptoms. No single laboratory value, BIA measurement or strength test can reliably confirm or rule out long COVID.

How you respond to exertion is particularly important for treatment. Some people experience worsening symptoms after even a small amount of physical or mental effort. This deterioration can be delayed and last for an extended period. It is known as post-exertional malaise, or PEM. Please tell us whether activities such as shopping, a conversation or a brief period of movement cause a marked setback on the same or following day. If you experience this response, general instructions to try harder or increase activity regularly are not recommended. The first step is to recognise overexertion and adapt activities and rest periods to the energy available. This approach is also called pacing. If you do not experience this worsening after exertion and there are no other medical reasons against it, individually adapted movement may be helpful. Whether it is suitable for you, and in what form, is assessed together with your treating doctors. A rigid exercise prescription is not appropriate.

We record how your symptoms have developed over time and discuss how much they affect everyday life, work and movement. Existing test results and your medicine list help us take account of questions that have already been answered. The physical examination is adapted to your symptoms and current capacity. For muscle and joint symptoms, a targeted orthopaedic examination may be helpful. Further functional or muscle tests are considered only if they answer a specific question and are manageable for you. They are not a requirement for your symptoms to be taken seriously. Exertion tests are not performed simply to demonstrate limitations. We discuss the findings, possible measures to relieve individual symptoms and any need for further assessment. The consultation does not include a complete assessment of all organ systems and does not replace specialist ME/CFS care. Significant breathlessness, heart symptoms, circulatory problems or neurological symptoms in particular may require investigations in other specialties. Please coordinate the next steps with us and your GP.

Treatment is guided by your symptoms and the findings identified. Goals may include recognising treatable coexisting conditions, relieving pain, avoiding overexertion and managing everyday life better. Whether a measure is useful must be assessed individually for your situation. There is currently no treatment that reliably cures long COVID in everyone affected. We therefore promise neither a cure nor a fixed recovery time. IHHT is not automatically part of long COVID treatment. Having a device available or early research findings is not enough to promise you a proven benefit for long COVID or PEM.

When making an enquiry, please refer to “Long/Post COVID”. Use “Appointments & enquiries” or contact us by phone. Our team will clarify whether the clinic fits your needs and which appointment is possible. If a long journey or sitting in the waiting area is difficult for you, please mention this when you enquire. Existing medical letters, previous test results, a medicine list and brief notes on the course of your symptoms are helpful. You do not need to arrange additional investigations at your own expense beforehand. When arranging the appointment, you will be told whether further documents or a referral are needed. Our initial consultation is available to patients with German statutory health insurance (GKV), private health insurance (PKV) and those paying for themselves. We assess your symptoms and work with you to make sense of them. If this leads to recommendations for subsequent treatments, their likely costs will be discussed with you. If you are paying for the agreed service yourself, you will receive cost information for its planned scope in advance. Additional investigations or treatments will be discussed with you separately. For patients with German statutory health insurance, we provide self-funded services only after a written agreement. We cannot promise reimbursement by private health insurers or German civil-service healthcare allowance schemes (Beihilfe).

For acute severe breathlessness, new severe chest pain, unconsciousness or sudden paralysis, please call 112. Do not wait for a routine consultation in these situations.