The presence of more than five symptoms of Covid-19 in the first week of infection is significantly associated with the development of Long Covid, irrespective of age or gender, according to a new review published by the Journal of the Royal Society of Medicine. 

The ten most common symptoms of Long Covid are shortness of breath, muscle pain, cough, headache, joint pain, chest pain, altered smell, diarrhoea, and altered taste.

The review by the University of Birmingham-led Therapies for Long Covid (TLC) Study Group, summarises current research on symptom prevalence, complications, and management of Long Covid. Pooled prevalence data in the review highlights the ten most common symptoms of Long Covid. These are fatigue, shortness of breath, muscle pain, cough, headache, joint pain, chest pain, altered smell, diarrhoea, and altered taste.  

The researchers identified two main symptom clusters of Long Covid: those comprising exclusively of fatigue, headache, and upper respiratory complaints; and those with multi-system complaints including ongoing fever and gastroenterological symptoms.  

Lead author Dr Olalekan Lee Aiyegbusi, Deputy Director at the University of Birmingham’s Centre for Patient-Reported Outcomes Research (CPROR), said: “There is evidence that the impact of acute Covid-19 on patients, regardless of severity, extends beyond hospitalisation in the most severe cases, to ongoing impaired quality of life, mental health, and employment issues. People living with Long Covid generally feel abandoned and dismissed by healthcare providers and receive limited or conflicting advice. More than one-third of the patients in one of the studies included in the review reported they still felt ill or in a worse clinical condition at eight weeks than at the onset of Covid-19.”  

Dr Shamil Haroon, Clinical Lecturer in Primary Care and co-Principal Investigator of the University of Birmingham NIHR/UKRI funded TLC Study, further commented: “Neither the biological or immunological mechanisms of Long Covid, nor the rationale for why certain people are more susceptible to these effects, are yet clear, limiting the development of therapies. It is essential we act quickly to address these issues.”  

In a comparison with other coronaviruses, the researchers suggest that in the longer term, patients with Long Covid may also experience a similar disease trajectory to that of patients who had SARS or MERS, pointing to analysis showing that six months after hospital discharge, approximately 25% of patients hospitalised with SARS and MERS had reduced lung function and exercise capacity.  

TLC Study’s Co-Principal Investigator Melanie Calvert, Professor of Outcomes Methodology at the University of Birmingham and NIHR Senior Investigator, said: “The wide range of potential symptoms and complications patients with Long Covid may experience highlights the need for a deeper understanding of the clinical course of the condition. There is an urgent need for better, more integrated care models to support and manage patients with Long Covid to improve clinical outcomes.”  

Congestion and facial pain and symptoms that don’t dissipate after about ten days and can last for about four weeks.  

Chronic sinusitis is diagnosed when the sinusitis lasts for eight weeks and longer and recurrent sinusitis presents when a person has a few attacks a year. Chronic sufferers may have facial swelling, bad breath, pus in the nasal cavity, as well as all the symptoms of acute sinusitis.  


A painful condition that will leave sufferers weary and miserable, it is always better to treat the sinusitis as soon as possible. Timeous treatment will probably prevent a bacterial infection from developing and thus solve the problem much sooner. In addition, it can reduce the possibility of it becoming a chronic condition.  

Cleveland Clinic recommends a simple sinusitis infection is treated with decongestants, OTC cold and allergy medications, nasal saline irrigation, and drinking fluids (sinusitis is a viral infection and fluids will help). If symptoms of sinusitis don’t improve after 10 days, a doctor may prescribe antibiotics, oral or topical decongestants, or prescription intranasal steroid sprays. Long-term or chronic sinusitis may be treated by focusing on the underlying condition (typically allergies). This is usually treated with intranasal steroid sprays, topical antihistamine sprays or oral pills, leukotriene antagonists to reduce swelling and allergy symptoms, and rinsing the nose with saline solutions that might also contain other types of medication.  

However, there is a concern that antibiotics are often unnecessarily prescribed for sinusitis, potentially contributing to the problem of antibiotic resistance. Instead of using antibiotics, patients with sinusitis may want to consider herbal remedies to reduce symptoms.  

Made up of several different combinations of ingredients, when recommending a herbal remedy there are two ingredients, in particular, to look out for – Pelargonium Sidoides and Echinacea Purpurea. While Pelargonium Sidoides has been shown to improve recovery time and relieve symptoms of acute sinusitis, studies have found that Echinacea not only possesses potent antiviral and anti-inflammatory activities but that it may help to boost the immune system and reverse the excessive mucus secretion so common in sinus infections too. The benefit of herbal treatments is of course that compared to pharmaceutical treatments, they’re generally associated with minimal adverse effects.