Symptoms

We’re all different, with a lot of overlapping symptoms. Long Covid (LC) is described as over 200 different symptoms — and seems to be a condition of exclusion. Below I note the symptoms I have come to know over the course of this journey, now well past a year.

I’ve noticed that some minor things come up as well (in comparison to the lingering issues below). For example, I had eye and nasal infections in the first few months after COVID (which have since subsided). This really makes it hard to know what is causing what. I also caught influenza in March of 2025, which made my headaches much worse.

When I rebounded from COVID after a third known infection late 2024, early on doctors (PCP, ED, specialists) mentioned Long Covid as a possibility, even before I hit 3 months. I primarily experienced a lot of neurological symptoms, known as neuro-covid. For me the impacts were on the central nervous system (CNS), as well as the peripheral nervous system (PNS), with impact on the somatic nervous system.

Lastly, my sympathetic nervous system (response to fear and danger) was stuck on. It was as if my mind sensed danger (well, I suppose it wasn’t wrong), but had no idea what it was. So, off I went, burning energy and not sleeping for days during the first few months of Long Covid. Eventually the energy burned out, and I crashed hard. I would attempt to go to sleep each night, and wonder if I would even wake up the next day, for most nights (impending doom, night time panic attacks — something I’ve never experienced before).

Most doctors I see explain this as being similar to a severe concussion. I’ve mostly learned to accept this, and try to treat my symptoms as best I can.

One thing I have learned over 15 months is that symptoms which seem unrelated often are not. The body is a connected system, and Long Covid has a way of making that very clear. I have found that the more precisely I can describe what I experience — and when, and what triggers it — the more useful that information becomes for the doctors trying to help me. If you are reading this and recognize something here that you have not been able to name, I hope it helps.

My Symptoms 🦠

Vision 👀

Being a male, my vision has always been great — no color blindness, and great night vision. I have had sensitivity to bright light most of my life, so sunglasses became common on bright summer days. Eye imaging was always normal pre-Long Covid.

In middle age, a slight astigmatism and some reading glasses I would use on rare occasion with blue light filtering before Long Covid. Vision has been one of the most difficult symptoms for me, as I work (including doing this very blog!) on a computer screen. That is a lot of time doing something our eyes probably weren’t meant to do normally, let alone having brain disruption impacting the cranial nerves involved in eye movement.

Symptom	Description
Binocular diplopia	Double vision that resolves completely when either eye is covered individually, confirming it is a misalignment of both eyes working together rather than a problem in one eye alone. Primarily triggered when looking to the right and at distance.
Intermittent alternating esotropia	My eyes visibly cross, particularly to the right.
Escalating prism prescription	I have required new prism prescriptions approximately every two months since early 2025, as each pair stops correcting adequately. The deviation has never stabilized. I had zero prism in my glasses before COVID.
Visual snow	Persistent static-like visual texture across the visual field.
Halos	Visible rings or glow around light sources.
Divergence insufficiency	Eyes can't diverge properly for distance vision; contributes to distance double vision.
Light sensitivity	Photophobia; painful response to normal light levels.
Balance problems	I have had falls on stairs due to spatial disorientation. Balance testing by two independent specialists has been abnormal.
Oscillopsia	My vision bounces or blurs during movement, making activities like walking in busy environments disorienting.

Brain & Nervous System 🧠

Symptom	Description
Severe insomnia	Sleep declined from 5–6 hours to 2–4 hours in the worst months.
Stuck in fight-or-flight	Sympathetic nervous system locked on; sustained sympathetic activation with no resolvable threat.
Headaches	Frontal, occipital, and posterior; mostly subsided after 6 months.
Severe unilateral neck pain	Primarily left-sided, with crepitus; radiates to shoulder, inner ear pain and pressure.
Tinnitus	Left-sided, swooshing sounds triggered by eye movement to the right and occurring randomly. Formally confirmed as left-sided sensorineural hearing loss by audiometry.
Cognitive symptoms	Brain fog, short-term memory problems, lack of focus.
Fasciculations	Internal and external twitches, mostly in the calves. Benign Fasciculation Syndrome (BFS) diagnosis predated Long Covid — came about after first COVID infection.
Paresthesia	Pins-and-needles in the arms and hands, with changing color and temperature in the hands.

Mental Health 💚

Symptom	Description
Mental fatigue	Not so much physical exhaustion — mental exhaustion. Reading, deciding, computing all drain disproportionately.
Mood swings	—
Panic attacks	Never experienced before Long Covid. Most pronounced at night with impending-doom sensation when trying to sleep.
Worsened ADHD, anxiety, depression	Pre-existing diagnoses; all became significantly harder to manage post-infection.

Ear & Vestibular 👂

This category deserves its own section. It has become one of the most prominent and disabling parts of my experience — and one of the least recognized in standard Long Covid discussions. If you are a Long Covid patient with significant ear and balance symptoms, you are not alone, and it is worth pushing for specialist evaluation.

Symptom	Description
Vertigo	Formally diagnosed at an academic medical center emergency department in December 2025 following an acute episode. More recently has included episodes of vomiting; worst with standing, improves with sitting.
Autophony	I hear my own voice amplified and distorted, with a hollow kazoo-like quality. Multiple times daily.
Pulsatile tinnitus	I can hear my own heartbeat and pulse as a swooshing sound in my left ear, distinct from the eye-movement triggered tinnitus.
Bone conduction hypersensitivity	I hear internal sounds most people do not: saliva moving, teeth lightly touching, neck crepitus internally. My TMJ night guard dampens the teeth sounds by reducing bone conduction.
Tullio phenomenon	Certain sounds — high-pitched or close-range voices — trigger ear pain in my left ear and provoke vestibular symptoms.
Hyperacusis	Sound sensitivity. Loud environments are genuinely painful, not just uncomfortable.
Ear fullness and pressure	Left-sided, persistent.
Left myringotomy tube	Placed by my ENT in late 2025 — some relief of pressure, core symptoms ongoing.
Positional dizziness	Dizziness triggered by head movement and position changes.
Post-exertional vestibular symptoms	Sustained exercise feels manageable during activity, but immediately after stopping I experience ear pain, sinus pressure, and dizziness as the suppression lifts all at once.

Asthma & Allergies 🤧

I have had on and off hives very sporadically since my 20s, and asthma since a teenager. These all got way worse, and additionally, spring-time allergies are a thing for me now (they were not in the past — now I know what many people experience annually). A lot of Long Covid groups talk about the link to Mast Cell Activation Syndrome (MCAS). I have not been diagnosed with this, but have found taking mast cell stabilizers to be helpful for me.

Symptom	Description
Asthma	Mild became moderate before Long Covid; ongoing.
Chronic spontaneous urticaria	Large hive clusters triggered by sunlight, friction from a watch (regardless of material), or tight clothing. Now managed with a monthly injectable biologic which has been one of the more effective treatments I have found.
Epistaxis	Nosebleeds, mostly clotting in the nose without external bleeding.

Autonomic & Metabolic 🫀

Long COVID’s impact on the autonomic nervous system is well documented in the research, and my experience reflects that. Some of these findings only emerged through testing over time — they were not obvious early on. I include them here because they are part of the full picture, and because I suspect many Long Covid patients have similar findings that have not yet been identified.

Symptom	Description
Masked hypertension	Blood pressure runs elevated even without stimulant medication, reflecting chronic autonomic dysregulation.
Chronic hypokalemia	Persistently low potassium requiring ongoing medication.
Prediabetes	Developed during the course of this illness, not present before.
Metabolic syndrome	Emerged around month 13, after over a year of disrupted sleep, chronic sympathetic activation, and corticosteroid exposure.
Heart rate / HRV changes	Wearable data shows sustained autonomic disruption since the triggering infection.
Mild distal hypohidrosis / anhidrosis	Thermoregulatory sweat testing showed reduced sweat response distally. Findings called nonspecific by the provider and potentially medication-related, but worth noting as part of the autonomic picture.

Musculoskeletal 🦴

Some of these findings predated COVID, some have worsened, and some were only discovered through imaging done as part of the broader diagnostic workup.

Symptom	Description
Cervical spine disease	Imaging has confirmed multilevel disc disease, nerve root compression, and vertebral changes at multiple levels. Contributes to vestibular symptoms through the cervico-vestibular connection — neck and inner ear talk to each other more than most people realize.
Lumbar radiculopathy	Nerve pain radiating from the lower back, worse on the left.
First rib pain	Intermittent, left-sided.
TMJ	Longstanding condition predating COVID, worsened during this illness. Managed with a custom night guard.
Generalized joint pain	Fluctuating.

Recent & Emergent 🚨

These have surfaced or worsened in the most recent months, mostly documented across ED visits and a neurology consult in May 2026. They may or may not stabilize into ongoing symptoms.

Symptom	Description
Tremor	Noted during recent neurology evaluations; worsened by Strattera, which was discontinued.
Dysphagia	Difficulty swallowing — among the complaints during recent ED visits.
Facial numbness	Intermittent; among the complaints during recent ED visits.
Worsening bowel incontinence	Newer symptom contributing to functional decline; documented at recent neurology visit.
Phantom lighting	Seeing flashes of light when closing eyes at bedtime. Provider noted this can be a normal phenomenon.
Episodes of confusion / disorientation	Entering the wrong apartment; getting lost while running. Documented at neurology follow-up; contributing to safety concerns and family assistance needs.
Knee buckling on exertion	Knees intermittently collapse during use of the elliptical; treadmill use no longer tolerated due to dizziness; cane required for balance.