I just got over Covid but still feel terrible

Q: It’s been a week since I tested negative for Covid, but I’m not feeling any better. Why am I still sick?

The rapid test is finally, blissfully, negative after a week of dark red positives. Technically you’re over Covid – but the virus doesn’t seem to be over you yet, as fatigue, coughing or a general feeling of “blah” persists.

If symptoms persist for four or more weeks after a negative test, that is the point at which they may first appear identified as long Covidaccording to the Centers for Disease Control and Prevention.

But for some people, there’s a dark middle phase: Your Covid test is negative and you still feel sick, but you’re not technically in long Covid territory yet, said Dr. Peter Chin-Hong, an infectious disease doctor at the University of California, San Francisco.

“Many people recover very quickly” after a Covid infection, said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis. But for many people, “it takes two, three, four weeks to fully recover,” he said.

Here’s what might be going on.

Why do I still feel sick?

In most people, the immune system settles down quickly after fighting Covid. However, for some it remains active.

Researchers aren’t entirely sure why this happens. It could be because low levels of the virus still persist, or because the immune system acts as if the virus is still there even when it’s gone, said Dr. Chin-Hong.

Either way, it’s certainly not unusual symptoms linger after any viral infection, said Dr. Joseph Khabbaza, a pulmonologist and critical care physician at the Cleveland Clinic. Inflammations can linger; People’s airways can swell, causing wheezing or coughing, or their sinus passages can swell, causing congestion.

Covid fatigue can last for weeks in some people, even after testing negative. Covid can also continue to disrupt your sleep, which can leave you feeling even more exhausted.

“You’re left with almost paralyzing exhaustion,” said Dr. Chin-Hong. “You’re not quite right, and you’re just dragging yourself along, and you’re trying to go to the gym and you can’t go.”

The more severe your symptoms were during your illness, the longer they could last, said Dr. Chin-Hong.

And Covid symptoms that had previously disappeared can return – or ‘rebound’ – for a week or so after a negative test, a phenomenon also sometimes linked to the antiviral therapy Paxlovid. But even if you haven’t taken Paxlovid, exhaustion, coughing and aches and pains can resurface, said Dr. Chin-Hong, possibly because your immune system is still in defense mode.

However, not everyone with persistent symptoms will go on to develop Covid-19 for a long period of time, said Dr. Al-Aly – most people will recover before reaching that monthly limit.

How can I feel better?

There is no simple solution to post-Covid recovery – most of the time it’s just a matter of time. But experts say there are a few things you can do to make the recovery process more manageable.

Try to rest as much as possible, said Dr. Al-Aly. Your body may still be trying to maintain the energy needed to fight the virus, he said. Getting enough sleep can help you feel less exhausted during the day.

Likewise, if you’re eager to get back into exercise, you should start slowly, said Dr. Chin-Hong – especially if you still feel exhausted or if your other symptoms get worse during exercise. Listen to your body and don’t try to push through, he said.

If you still feel bad after 30 days, contact a doctor, who may be able to offer you strategies to manage your symptoms. You may also want to see if there is a medical facility in your area, such as a research hospital, that specializes in long-term Covid recovery, Dr. advised. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago.

For many people, however, symptoms will subside within days or weeks, said Dr. Chin-Hong. Unfortunately, he said, they may not “go away immediately.”