Long COVID
Mild → somewhat betterIll 4 years before improving or writingNeeds ongoing treatment
Long COVID with brain fog and tachycardia, somewhat better after reducing medications
- Condition
- Long COVID
- At worst
- Mild (working or studying, with limits)
- Ill before improving or writing
- 4 years
- Last post
- Oct 2024
In their words
- Condition: Long COVID
subsequently developed long COVID, which I've spent the better part of almost two years getting treated (SoB on exertion, tachycardia and palpitations, anxiety, brain fog)
In context ↗ - At worst: Mild
If I exert myself like I did recently on two different stress tests (one treadmill, one nuclear—both related to PACS symptoms), my HR will get up to 165+ within seven to eight minutes.
In context ↗ - Now: Somewhat better
my set of complaints—brain fog and tachycardia—did not and have not resolved in the four years I struggled with long COVID
In context ↗ - Began after: COVID
first had a positive PCR test in June 2020 and subsequently developed long COVID
In context ↗ - Says they never had: Loss of smell or taste
I never lost my sense of taste nor smell
Read from 46 of their posts and comments; links to the 33 this page draws on
Summary
A 37-year-old man developed long COVID after a June 2020 infection, with tachycardia, palpitations, cognitive impairment, fatigue and breathlessness. Donepezil improved his brain fog within days, and beta-blockers managed his heart rate, but brain fog and tachycardia remained unresolved after four years. A short prednisone course made him feel normal temporarily; he felt better after reducing several medications.
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What they tried
What they credit
Also tried
Vortioxetine (Trintellix)· HelpedMetoprolol· HelpedPropranolol· HelpedModafinil / armodafinil· Helped · wore offSolriamfetol (Sunosi)· HelpedMethylphenidate ER· HelpedLemborexant (Dayvigo)· HelpedGuanfacine ER· HelpedNAC· HelpedLevocetirizine· HelpedPrednisone· Helped · wore offBipap / PAP therapy· HelpedSertraline (Zoloft)· No changeBupropion· No changeLevomilnacipran (Fetzima)· No changeTrazodone· No changePaxlovid· No changeFexofenadine· No changeFamotidine· No changeAcyclovir· No changeLow-dose naltrexone· No changeCelecoxib· No changeCOVID vaccination· No changeVitamin D· WorseAmlodipine· Not saidMelatonin· Not saidHydroxyzine· Not saidCromolyn sodium· Not saidKetotifen· Not saidQuercetin· Not saidTriple anticoagulant therapy· Not saidFluticasone inhalation spray· Not saidAlbuterol· Not saidSecukinumab (Cosentyx)· Not saidAnastrozole· Not saidTestosterone· Not saidAllergy immunotherapy (allergy shots)· Not saidEmpagliflozin· Not said
Their words about each treatment
- Donepezil · Helped a lot
it has worked wonders for me. I practically feel like my old self regarding brain fog and short-term memory function
In context ↗ - Sertraline (Zoloft) · No change
Tried and failed sertraline, bupropion, levomilnacipran, and trazodone.
In context ↗ - Vortioxetine (Trintellix) · Helped
Vortioxetine (Trintellix) has made a substance difference in my mental health.
In context ↗ - Metoprolol · Helped
although metoprolol lowered my heart rate, nebivolol feels better in general
In context ↗ - Propranolol · Helped
While the medication lowered my heart rate, it didn't really help with my anxiety.
In context ↗ - Nebivolol · Helped a lot
I currently take nebivolol 5 mg daily and it works wonders.
In context ↗ - Amlodipine · Not said
I also discontinued taking amlodipine 5 mg daily during my five-day course of Paxlovid
In context ↗ - Paxlovid · No change
No significant difference in how I felt/feel since taking fifteen days of Paxlovid.
In context ↗ - Modafinil / armodafinil · Helped
over the summer, I noticed the stimulants weren't having the same effect—I’d still feel sleepy even after taking them in the morning
In context ↗ - Solriamfetol (Sunosi) · Helped
I felt clear headed and motivated without the tunnel vision-like focus that modafinil (and especially armodafinil) tends to cause
In context ↗ - Methylphenidate ER · Helped
Taken together I feel alert and can concentrate better than taking either alone or not at all.
In context ↗ - Lemborexant (Dayvigo) · Helped
Lemborexant (Dayvigo) works really well for me.
In context ↗ - Melatonin · Not said
Add a small (< 5 mg) dose of melatonin to get a solid eight hours of rest.
In context ↗ - Guanfacine ER · Helped
Coupled with guanfacine, my brain fog feels less intense.
In context ↗ - Hydroxyzine · Not said
I also discontinued taking ... hydroxyzine ... and am feeling okay compared to when I started taking them
In context ↗ - Fexofenadine · No change
I tried fexofenadine early in my LC treatment at 180 mg daily ... neither seemed to offer much help
In context ↗ - Famotidine · No change
have long taken famotidine 40 mg daily to treat acid reflux and neither seemed to offer much help
In context ↗ - Levocetirizine · Helped
I notice second-gen antihisamines like fexofenadine and levocetirizine seem to slightly improve my broken circadian rhythm.
In context ↗ - Cromolyn sodium · Not said
I also take cromolyn sodium, levocetirizine, and famotidine (among many others) daily to treat elevated histamine.
In context ↗ - Ketotifen · Not said
Also taking cromolyn sodium, ketotifin, and quercetin.
In context ↗ - Acyclovir · No change
EBV DNA is undetectable now. I can't say I feel any meaningful improvement in symptoms, though.
In context ↗ - Low-dose naltrexone · No change
I took 4.5 mg daily for a couple of months without any meaningful improvement in my brain fog nor tachycardia.
In context ↗ - Tirzepatide (Mounjaro) · Helped
Tirzepatide (Mounjarno/Zepound) helped me lose over 60 pounds and I felt great on it.
In context ↗ - Triple anticoagulant therapy · Not said
After discontinuing my triple anticoagulant therapy (apixaban, pentoxifylline, and aspirin), I noticed, curiously, that the stimulants' effects returned.
In context ↗ - Celecoxib · No change
I have acyclovir, celecoxib, and took Paxlovid as part of the Yale study and can't report any significant improvement in brain fog nor tachycardia.
In context ↗ - Prednisone · Helped
I felt damn good: no chest pain, no back pain, clear headed, and my sinusitis symptoms abated.
In context ↗ - Vitamin D · Worse
Soon after discontinuing the supplement I noticed my palpitations improved.
In context ↗ - Fluticasone inhalation spray · Not said
I also discontinued taking fluticasone inhalation spray, Albuterol
In context ↗ - Bipap / PAP therapy · Helped
I can definitely attribute an improvement in my overall sleep to using my bipap every night.
In context ↗ - Secukinumab (Cosentyx) · Not said
I take secukinumab (Cosentyx) 300 mg once per month to treat ankylosing spondylitis with no discernable adverse effects.
In context ↗ - Anastrozole · Not said
I treat my low T with anastrazole 1 mg weekly.
In context ↗ - Testosterone · Not said
it's possible the fatigue is improving due to that and not the Paxlovid
In context ↗ - COVID vaccination · No change
I didn't feel any meaningful improvement after getting each shot. Similarly, I didn't get worse nor have any lingering symptoms after each shot.
In context ↗ - Allergy immunotherapy (allergy shots) · Not said
especially now that I get weekly allergy shots
In context ↗ - Empagliflozin · Not said
(managed with either a GLP-1 agonist or empagliflozin)
In context ↗
Approaches: GLP-1 drugs · Beta-blockers · Other drugs and medicines
Their path
They say too little about how ill they were at each step to draw it on the severity scale, so the steps are listed as they describe them. Dates are when they posted.
| When | What happened | Where they were | After |
|---|---|---|---|
| June 2020 | COVID-19 infection followed by long COVIDfirst had a positive PCR test in June 2020 and subsequently developed long COVIDIn context ↗ | Not stated | |
| January 2022 | Donepezil improved brain fog and word recallMy word recall is basically back to normal.In context ↗ | Not stated | |
| December 2022 | Short prednisone course for sinusitis made him feel normalI felt like a normal person.In context ↗ | Near normal | Corticosteroid pulses |
| February 2023 | Chest discomfort and palpitations improved after stopping high-dose vitamin DSoon after discontinuing the supplement I noticed my palpitations improved.In context ↗ | Not stated | Vitamin D and sun exposure |
| July 2024 | Still had brain fog and tachycardia; felt better after reducing medicationsbrain fog and tachycardia—did not and have not resolvedIn context ↗ | Not stated |
Adverse events
- Paxlovid / nirmatrelvir“two or three side effects of the medication: weird taste in my mouth, diarrhea, and a chronic cough” In context ↗ Side effects
- Propranolol (Inderal)“I discontinued propranolol due to gaining weight” In context ↗ Side effects
- Vitamin D and sun exposure“Excessive vitamin D could explain why I developed kidney stones.” In context ↗ Liver or kidney problems
- Tirzepatide (Mounjaro, Zepbound)“the Mounjaro causing withdrawal side effects since it's been ten days since my last dose” In context ↗ Withdrawal problems
- Famotidine (Pepcid)“I discontinued famotidine along with apixaban, pentoxifylline, and aspirin and noticed an improvement in my affect.” In context ↗ Mood or psychiatric effects
- Paxlovid / nirmatrelvir“I also had the metallic taste, but it wasn't as pronounced during the study as it was the first time I took Paxlovid in 2022” In context ↗ Side effects
Symptoms mentioned
Anxiety & low moodBrain fogBreathlessnessGut problemsHeart symptoms & palpitationsMast cell (MCAS) & allergiesPain & fibromyalgiaSleep problems
Their words about their symptoms
- Brain fog
brain fog, cognitive impairment, and slow word recall
In context ↗ - Heart symptoms & palpitations
Tachycardia, palpitations, cognitive impairment, and fatigue.
In context ↗ - Breathlessness
Initially there was shortness of breath on exertion, but that resolved on its own.
In context ↗ - Anxiety & low mood
anxiety, brain fog
In context ↗ - Mast cell (MCAS) & allergies
My histamine titer is literally off the chart
In context ↗ - Sleep problems
preexisting delayed sleep phase disorder
In context ↗ - Pain & fibromyalgia
lower back pain
In context ↗ - Gut problems
Mild heartburn is tolerable.
In context ↗
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