Dr Muiris Houston: Why we need more research into long and mid-Covid-19

Readers have helpfully cast light on debilitating effects of persisting Covid symptoms such as fatigue, breathlessness and chest pain

“Mid Covid is definitely a pandemic within a pandemic” was the succinct conclusion by one of our readers in response to the call-out in my last column for peoples’ experiences of the infection between the acute and long Covid stages.

I’d like to thank everyone who took the trouble to email us in response. And it is fair to say, from this limited piece of anecdotal research at least, that “mid Covid” exists. Just to recap, I defined it as the persistence of symptoms after the acute phase of Covid (the first two weeks) until week 10 post-infection. These symptoms continue on from the acute period and typically wax and wane but are never completely resolved.

I have qualitatively analysed your responses looking for themes that run through the stories of mid-Covid. Unsurprisingly, fatigue features prominently – it is the number-one symptom reported by over 90 per cent of respondents.

“I certainly had to deal with serious fatigue for at least two months after having Covid. That is, making it through the workday but essentially needing to go to bed straight after work every day and also sleeping most of the day on Saturdays” was how one reader described their exhaustion.


“My Covid started one day at the end of June 2022… I was extremely tired for the next month and I don’t think I’m back to my normal yet” was one woman’s experience.

Stress or exertion

A reader who describes themselves as “usually a fit person” is experiencing “excessive tiredness brought on by any stress or exertion”.

“Seven weeks ago I was a fit and healthy 21 year old who had just returned home from a study [period abroad]. Today, my reality is very different. I have crippling fatigue,” says one of our youngest respondents.

“I’m finding that I can’t get through my day without having a sleep in the afternoon,” a nurse reports.

And there was one fatigue story with a positive outcome. “It’s seven weeks since my positive test – and today was the first day I’ve had where I’ve worked, exercised and feel generally positive.”

There is a broad range of respiratory symptoms throughout your mid-Covid stories: shortness of breath, difficulty breathing, cough, sore throat, chest pain and sinus infection. One reader says she recognises the “lump in the throat” that I described in the original column. Several describe having a coarse or hoarse voice that persists beyond the acute phase of infection.

Insomnia and brain fog

Somewhat surprisingly, there was just one report each of insomnia and “brain fog”. Muscle aches/cramps and heaviness in the limbs were only slightly more prevalent. And no one reported persistent smell or taste problems.

There was one striking story about mid-Covid menstrual symptoms. “Speaking to a group of women yesterday (all midwifery students age range 22-52) and all of us have had disruption of menstrual cycles post-Covid. All had extended cycles, all with heavier than normal flow and associated with extreme fatigue and cramping not usually experienced.”

Many readers with symptoms and signs of long Covid were also in touch. Their stories reflected an angst and sense of hopelessness as Covid continued to grip them. There is clearly a need for more long Covid clinics and other appropriate treatments.

The same can be said for the mid-Covid “warriors”. In the words of one of our respondents, “public guidance is sparse and quite frankly, unhelpful. Furthermore, I have lost hope of treatment or a reasonable timeframe for recovery. The scariest part is that even the scientists themselves seem to be left puzzled.”

My response to this is that scientists and doctors appear to have a “blind spot” for people with mid-Covid symptoms. It means there is little research focus on the two- to 10-week period after acute infection with Sars-CoV-2. This must change.

Once again, a sincere thank you to all who responded to our call-out.