Clear medical guidance for people with ongoing symptoms after a SARS-CoV-2 infection. Assessment is tailored to the individual clinical picture, considers alternative explanations, and takes post-exertional malaise seriously.
Long COVID is an umbrella term for symptoms that continue, recur, or begin after the acute infection. The World Health Organization uses the term post-COVID-19 condition when symptoms usually begin within three months of infection, last for at least two months, and cannot be explained better by another diagnosis.
The condition can affect energy, concentration, breathing, sleep, circulation, pain, or digestion. Some people experience post-exertional malaise (PEM): a disproportionate and often delayed worsening after physical, cognitive, emotional, or social effort. When specific criteria are met, there may be an overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but the terms are not interchangeable.
No single blood test can confirm or exclude Long COVID or ME/CFS. A structured history, examination, and focused tests help identify treatable factors and avoid overlooking other causes of symptoms.
These names are sometimes used interchangeably. A careful definition helps guide assessment without turning a label into an automatic explanation for every symptom.
A broad term for health problems that continue, return, or first appear after a SARS-CoV-2 infection and affect everyday life.
A clinical definition used when symptoms have persisted for a defined period and are not explained better by another condition.
A distinct multisystem illness in which PEM, substantial functional impairment, unrefreshing sleep, and cognitive or autonomic symptoms are central features. It can follow various infections, not only COVID-19.
Symptoms after vaccination require the same careful medical assessment: timing alone does not establish causation, and other explanations need consideration.
Presentations differ widely. Some people have one predominant symptom; others experience a combination that varies from day to day.
Marked fatigue, PEM, reduced stamina, muscle weakness, or pain.
Concentration problems, memory difficulties, headaches, or unrefreshing sleep.
Breathlessness, palpitations, dizziness, chest discomfort, or orthostatic symptoms.
Changes in smell or taste, gastrointestinal complaints, rashes, or altered temperature regulation.
New or severe chest pain, pronounced shortness of breath, fainting, one-sided neurological symptoms, confusion, or rapid deterioration require urgent medical assessment. This page cannot replace emergency care.
Our consultation starts with the time course of symptoms, previous infections and vaccinations, daily function, medication, known conditions, and available reports. We ask specifically about PEM, sleep, orthostatic symptoms, mood, nutrition, and the impact on work and family life.
Examination and tests are selected according to the symptoms. They may include basic laboratory tests, ECG or other cardiac assessment, lung function testing, evaluation of orthostatic intolerance, and referral to appropriate specialists. The aim is to identify conditions that need specific treatment, such as anaemia, thyroid disease, asthma, sleep disorders, cardiac disease, or a new neurological condition.
We review existing results critically and avoid indiscriminate testing. Abnormal results are interpreted in context; isolated laboratory values do not by themselves explain a complex symptom pattern.
There is no universal treatment that cures Long COVID or ME/CFS. Care is therefore based on symptoms, functional capacity, safety, and the person's goals. It may include treatment of identified conditions, management of sleep or pain, hydration and compression strategies for orthostatic symptoms where appropriate, and referral for specialist care.
For people with PEM, pacing and energy management are central. Activity should be adapted to individual limits; a fixed programme of graded exercise is not appropriate when it triggers delayed deterioration. Any rehabilitation plan needs review and should stop if symptoms worsen.
We discuss benefits, uncertainty, risks, and practical follow-up openly. Dietary supplements, off-label medicines, and experimental procedures are not substitutes for an individual medical assessment.
Seek medical advice if symptoms persist, limit daily life, or are new after COVID-19. Seek urgent help for severe breathing difficulty, chest pain, fainting, or acute neurological symptoms.
No single test proves or excludes it. Diagnosis is clinical and includes assessment for alternative explanations and complications.
PEM is a worsening of symptoms after effort that is out of proportion to the activity and can begin hours or a day later. It is a key feature in ME/CFS and may also occur in Long COVID.
A video consultation may be suitable for selected follow-up or initial discussions. Whether an in-person examination is necessary is decided individually.
Please send available reports and a short description of your main symptoms when requesting an appointment. This helps us plan the visit appropriately. Consultations can take place in Munich; video follow-up may be possible in selected cases.
