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.

As time has gone on, the picture has become more complex — and more specific. Some of what I originally attributed purely to long COVID may have a more precise structural explanation that is still being worked out. I’ll write more about that when there is more to share. For now, here is the full picture of what I’ve been living with.

My Symptoms 🦠

Neurological 🧠

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 something impacting the cranial nerves involved in eye movement.

• Binocular diplopia — double vision that resolves when either eye is covered individually, confirming it is a misalignment of both eyes working together rather than a problem in one eye. Primarily triggered looking to the right and at distance.
• Intermittent alternating esotropia — my eyes visibly cross, particularly to the right
• Escalating prism glasses — 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 started with no prism at all before COVID.
• Visual snow, halos, divergence insufficiency
• Balance problems and falls — I have had falls on stairs due to spatial disorientation. Balance testing by specialists has been abnormal.
• Oscillopsia — my vision bounces or blurs during movement, making activities like walking while looking around disorienting
• Brain and nerve issues
  • Severe insomnia — sleep declined from 5-6 hours to 2-4 hours in the early months
  • Stuck in fight or flight mode
  • Headaches (front, back, occipital) - mostly subsided after 6 months
  • Severe unilateral (primarily left) neck with crepitus, shoulder, and inner ear pain and pressure
  • Tinnitus — left sided, swooshing/pulsing sounds triggered by eye movement to the right and occurring randomly. Formally diagnosed with left-sided sensorineural hearing loss.
  • Brain fog, short term memory problems, lack of focus
• Mental health
  • Fatigue (not so much physical, very mental)
  • Mood swings
  • Panic attacks, which I’ve never experienced before
  • Worsened ADHD, anxiety, depression
• Other issues
  • Fasciculations internal and external, mostly in the calves
    • Benign Fasciculation Syndrome (BFS) diagnosis before long covid - came about after first covid infection
  • Paresthesia in the arms and hands, changing color and temperature in hands

Ear & Vestibular 👂

This category deserves its own section because 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.

• Vertigo — formally diagnosed at an academic medical center emergency department in December 2025 following an acute episode
• Autophony — I hear my own voice amplified and distorted, with a hollow kazoo-like quality. This happens multiple times daily.
• Pulsatile tinnitus — I can hear my own heartbeat and pulse in my left ear, distinct from the swooshing tinnitus triggered by eye movement
• Bone conduction hypersensitivity — I hear internal sounds that most people do not: saliva moving, teeth lightly touching, neck crepitus. The night guard I wear for TMJ actually reduces the teeth sounds by dampening bone conduction, which is a strange thing to notice about yourself.
• Tullio phenomenon — certain sounds trigger ear pain and vestibular symptoms. My children’s voices — they are 8 and 10 — can cause pain in my ear. I have had to explain to them that dad’s ear is injured, like a bruise on the inside, and that it is not their fault. That has been one of the harder parts of this.
• Sound sensitivity (hyperacusis) — loud environments are genuinely painful, not just uncomfortable
• Ear fullness and pressure — left sided, persistent
• Left myringotomy tube placed by ENT in late 2025 following an acute episode — some temporary relief of pressure, core symptoms ongoing
• Dizziness triggered by head movement and position changes
• Spatial disorientation in busy visual environments

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 long covid link to something called Mast Cell Activation Syndrome or MCAS. I have not been diagnosed with this, but have found taking mast cell stabilizers to be helpful for me.

• Asthma (mild became moderate before long covid)
• 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 (Xolair), which has been one of the more effective treatments I’ve found.
• Epistaxis (nosebleeds that mostly just clot in the nose)

Autonomic & Metabolic 🫀

This category also deserves its own section. 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.

• Masked hypertension — my blood pressure runs elevated even without stimulant medications, reflecting chronic autonomic dysregulation
• Chronic hypokalemia — persistently low potassium requiring ongoing medication, likely related to the stress hormone and autonomic dysregulation pattern
• Prediabetes — existing a couple of years before
• Metabolic syndrome onset — emerged around month 13
• Heart rate and HRV changes — wearable data shows sustained autonomic disruption since the triggering infection

Musculoskeletal 🦴

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

• Cervical spine — MRI has shown multilevel disc disease, retrolisthesis at multiple levels, and nerve root compression. Some of this was likely pre-existing but has become symptomatic.
• Lumbar radiculopathy — nerve pain radiating from the lower back, worse on the left
• First rib pain — intermittent, left sided
• TMJ — a longstanding condition predating COVID, worsened during this illness. I wear a custom night guard.
• Joint pain — generalized, fluctuating