UPDATED July 2024
If you get Covid, your might be tempted to just let things resolve on their own. But any Covid infection can result in post-viral symptoms that can last for weeks, months or longer.
You may be able to avoid the worst lingering symptoms if you act swiftly to reduce the duration and severity of illness.
According to Dr. Akiko Iwasaki, Yale immunologist: "the quicker one can eliminate the virus, the less likelihood of developing persistent virus or autoimmunity, which may drive long Covid."
If you're confirmed Covid positive
This advice is based-on what I've learned through reading science journals. Click on a link to read the source.
Don't just "ride it out." Contact your health provider and ask for treatment, even if it needs to be done remotely. If your provider tells you to "wait and see," tell them you want to be proactive to reduce illness severity and duration and avoid long term problems.
Find treatment
In the U.S., you can use the HHS Covid-19 Treatments website to find medication.
You may be able to go to a "Test-to-treat Center" for PCR testing. If you test positive, treatment (such as Paxlovid) can be offered on-the-spot.
Paxlovid: your best option
Ask about Paxlovid, a Covid antiviral which can reduce the severity and duration of Covid infection. This treatment must be taken within 5 days of a positive PCR test. Availability may vary depending on your area, but in many regions, doses are going unused. Note: it's very important that you check drug interactions.How to take Paxlovid
- Talk to your primary care physician.
- Go to a Test-to-Treat Center.
- Try online urgent care, such as Plushcare or eMed.
Talk to your doctor about off-label prescription medication
Get the probiotic "L. Rhamnosus"
Studies have shown that Covid can significantly reduce the presence of this "friendly" bacterial strain in your gut.
A course of the probiotic Lactobacillus Rhamnosus has been shown to reduce symptoms. This probiotic is widely available with a well-established safety profile. Ideally you'll want to start taking it as soon as you can after infection, but in theory you can start any time to help rebuild healthy flora in your gut.
Though there are many kinds of probiotics on the market, this particular strain is the one with strongest evidence. Read carefully to make sure that Lactobacillus Rhamnosus (or L. Rhamnosus) specifically is listed in the ingredients. (Any brand name should work, but look for "Rhamnosus" because there are many other strains in the Lactobacillus family.)
Take the probiotic for 6 weeks, but not longer. You can take the probiotic concurrently with Paxlovid.
You can find L. Rhamnosus commonly at online stores, including here and here.
Get a positive PCR test
I strongly recommend getting a PCR test (not just a home rapid test) to document your positive case of Covid. Having this may become essential for you to get important things later: getting insurance to pay for future treatments, getting disability benefits, and even getting the right treatment and care from medical specialists going forward. (I encountered these obstacles myself.)
If you've had a Covid exposure but you're not sure if you're positive, the best time to get a PCR test is on days 2, 3 and 4 after Covid exposure.
For the first few weeks after infection
Take recovery seriously. Get plenty of rest. A scientific survey says that among common attributes of people with severe post-Covid symptoms include "inadequate rest in the first two weeks of the illness."
Check-out this article: Why you should rest -- a lot -- if you have Covid.
Seriously, DON'T overdo it
Avoid cardio and take a break from the gym for awhile. Listen to your body. Simple stretching and gentle walks daily are beneficial, when you feel ready for them.
If you think you're having post Covid symptoms, you may even need to take it easy for several months. Pushing through fatigue and exercising too much and too early can make Long Covid much worse. “The consensus is now that long Covid requires a much more slow, steady increase in all aspects of activity led by the patient. Returning too quickly precipitates relapses.”
In the coming weeks if you find yourself saying "I can probably just muscle through this," stop. Don't push. Don't power through it. Just do some simple stretches and get some physical movement each day.
Avoid further exposure to Covid
You might think it's futile to avoid Covid, but it's important to reduce exposure as much as possible. The more exposure you have, the more likely the virus may gain a foothold in your body. And the more times you get Covid, the more likely you'll experience long term symptoms.
For the next few months:
Even if your initial infection is mild, keep an eye on unexplained symptoms. It's not uncommon for Long Covid symptoms to appear weeks or even months after infection.
Keep on top of symptoms, even if they seem small. Write them down or track them with your smartphone. Ask your health provider to take your symptoms seriously and be proactive. Don't panic. Get appointments with specialists as needed.Keep an eye out for signs of deep vein thrombosis (DVT). If you notice swelling in one leg, notify a healthcare provider immediately. Possible other clues include pain, cramping, soreness, redness or feeling of warmth in one leg. If pulmonary embolism or blood clot develops in a blood vessel it can travel to a lung artery where it suddenly blocks blood flow. (If you catch it in time, you can get treatment for thrombosis before it becomes potentially dangerous.)
After Covid infection, some people may be more susceptible to fungal overgrowth -- such as candida. Watch for symptoms (general symptoms such as nail fungus, or oral symptoms such as a "clammy" sensation in the mouth or increase in tooth cavities or necrosis.) In addition, keep in mind that Long Covid can mask fungal infections.
Additional guidelines:
- If you have any allergies or food sensitivities, watch them very closely for awhile. If you notice that you're extra sensitive to particular foods, this could be a clue that your immune system is being hyperactivated, or that you have gut microbiome disruption. These sensitivities may not be permanent.
- Address any irritable bowel symptoms. After Covid infection, these can unravel quickly and cause downstream inflammatory problems. IBS can be a potential warning sign for Long Covid.
- Do what you can to keep your immune system calm. Think of your immune system as a forest during fire season. Err on the side of caution and don't take chances right now. Let your body heal.
- Reduce sugar and carb intake for awhile. Your body may have disruptions to insulin resistance and glucose homeostasis.
- Avoid alcohol for awhile.
More resources
How to prevent Long Covid:
- Tips for the acute phase of a COVID infection that account for potential long-term symptoms (Fiona Lowenstein, author)
- Video: How to avoid Long Covid - 5 Top Tips from latest research
If Paxlovid is not an option:
The information below may be useful if Paxlovid is not available, or if you can't or don't wish to take it. While the science is promising, it is not yet settled. Still, these options are relatively safe and inexpensive.
Emerging scientific studies have shown that certain existing medications can reduce the severity and duration of Covid. These medications are well-established, widely available and safe; many are even available as generics.
Using one of the following medications "off label" can be a reasonable, low-risk, stop-gap solution for treating Covid if Paxlovid is not an option for you:
- Famotidine (Pepcid AC) may lead to faster resolution and reduction of inflammation.
- A combination of Diphenhydramine (Benadryl) and Lactoferrin supplement may reduce viral replication.
- A combination of Xyzal (also known as Levocetirizine, an over-the-counter antihistamine) and Montelukast (prescription allergy medication) may improve symptoms and outcomes of Covid.
- If you have respiratory symptoms, talk to your doctor about a course of Budesonide inhaler, which has been shown to shorten Covid recovery time.
A word about off-label prescription medications
Not all medical professionals are aware of these off-label prescriptions and their potential benefit yet.
If your doctor says "more data is needed:"
- Consider that these are widely available, inexpensive medications with well-established safety profiles.
- You'll only be taking them for a limited period of time.
- Encourage your provider to take a proactive approach. We're in a crisis situation and an off-label medication may be just enough to prevent long term impact to your health.
Consider taking supplements to reduce inflammation
Covid causes an over-response of the immune system. If you've tested positive and are unable to take Paxlovid, consider taking these supplements for 6 weeks to calm your immune system. These are commonly available at stores, vitamin shops or online.