Long Covid & Gut Health: A Starting Point for a Path to Recovery

July 7, 2023

At least 10% of people who have had Covid-19 suffer from long-term symptoms, called Long Covid or Post-Covid Conditions. Due to the fact that Long Covid affects multiple systems in your body, those who develop it can suffer from a myriad of debilitating symptoms. Research in the field of gut health – where 70% of your immune system is located – has shown that poor gut health plays a role not only in the development of Long Covid but also in the recovery from Long Covid.

Long Covid: What Is It

Long Covid is defined by the presence of symptoms 3 months after an initial Covid-19 infection and which persist for at least 2 more months. 

As a chronic inflammatory condition affecting many organs, Long Covid symptoms include: chronic fatigue, shortness of breath, brain fog, skin rashes, digestive disorders, poor sleep, tinnitus, chest pain & palpitations, dizziness, heart rate changes upon changing position (POTS), post-exertional malaise, abnormal blood clotting, erectile dysfunction, and irregular periods.

Although the exact causes of Long Covid have not yet been established, several physiological mechanisms are believed to be involved which produce the wide range of symptoms:

  • Chronic inflammation & neuroinflammation
  • Persistence of the Covid 19 virus or antigen in the body leading to chronic immune activation
  • Abnormal immune response 
  • Abnormal mitochondrial function
  • Reactivation of latent viruses such as EBV, HHV-6, CMV
  • Vascular dysfunction and abnormal clotting
  • Poor gut health with gut dysbiosis (unhealthy gut bacterial composition)

Long Covid: Who Gets It?

Long Covid can occur in all age groups, but has been found primarily in individuals between the ages of 36 and 50 years of age. It is more commonly seen in those individuals who had a mild Covid-19 infection which did not require hospitalization. 

Recent research into the mechanisms involved in Long Covid has shown that those individuals with a healthy lifestyle prior to their Covid-19 infection had a significantly lower risk of developing Long Covid. In one prospective study, having 5 or 6 healthy lifestyle factors, including getting enough sleep and having a healthy weight, correlated with a 49% reduction in the risk of developing Long Covid.

In contrast, potential predisposing factors for Long Covid include:

  • Severe acute Covid-19 infection & persistent viral infection
  • Gut dysfunction/dysbiosis
  • Cardiometabolic illnesses like Type 2 Diabetes, obesity
  • Asthma
  • Immune system dysregulation/Autoimmunity
  • Neuroinflammation

Poor gut health is a significant underlying factor in many chronic physical and mental illnesses due to the presence of both immune system and nervous system tissue in the gut. It has now also been found to be a key predisposing factor for Long Covid. Those individuals who had persistent symptoms one year after infection with Covid-19 were found to have lower amounts of healthy gut bacteria and reduced diversity among their healthy gut bacteria populations. 

Ways You Can Improve Your Long Covid Symptoms

In light of the fact that 70% of your immune system is located in the gut and the connection between the gut and the brain as well as the skin and the lungs, improving gut health is an important starting point for recovery from Long Covid. 

Specific steps that you can take include:

  • Eating a whole foods diet that includes:
    • Prebiotic foods such as:
      • Artichokes, asparagus, garlic, leafy greens, and onions.
      • Berries, apples, pears, and mangoes
      • Legumes like lentils, chickpeas, beans & gluten-free grains like quinoa & buckwheat (a seed)
    • Probiotic foods such as:
      • Fermented vegetables (cucumbers), sauerkraut, kimchi, kefir,  and yogurt (including dairy-free sources)
    • Foods rich in polyphenols such as:
      • Green tea 
      • Cocoa powder & dark chocolate (70% or higher)
      • Ground flaxseed
      • Dried herbs: rosemary, sage, sweet basil & thyme
      • Olives
      • Nuts
  • Seeing a functional medicine practitioner:
    • The functional medicine approach to any health issue involves identifying the specific triggers or root causes of your symptoms. It also views all of your body’s systems as interconnected so that a shift in one system will impact another system. This approach can make all the difference in restoring your health due to the fact that Long Covid affects multiple systems. 
    • A one-size fits all approach that simply addresses symptoms does not take into account your unique health history prior to infection with Covid-19 and the unique root causes that underlie your symptoms.

If you are struggling with Long Covid, ask your healthcare practitioner about additional steps you can take to improve the health of your gut.

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If you are interested in learning more about the functional medicine approach to Long Covid, please contact us.


Ancona, G. et al. Gut and airway microbiota dysbiosis and their role in COVID-19 and long-COVID. 2023 Mar 8;14:1080043.

Davis, HE et al. Long COVID: major findings, mechanisms and recommendations. Nature Reviews Microbiology | Volume 21 | March 2023 | 133–146.

Gang, G. et al.Microbiota and COVID-19: Long-term and complex influencing factors. Front. Microbiol., 12 August 2022.Volume 13 – 2022.

Giannos, P. & Prokopidis, K. Gut dysbiosis and long COVID-19: Feeling gutted.J Med Virol. 2022 Jul;94(7):2917-2918. 

Koj HC, et al. Long COVID and its Management. Int J Biol Sci. 2022; 18(12): 4768–4780.

Published online 2022 Jul 11. doi: 10.7150/ijbs.75056

Müller et al. Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional intervention.Immunity & Ageing (2023) 20:17.

Negi, S. et al. Potential Role of Gut Microbiota in Induction and Regulation of Innate Immune Memory. Front Immunol. 2019; 10: 2441.

Ramesh Pothuraju, et al. Mucins, gut microbiota, and postbiotics role in colorectal cancer. GUT MICROBES 2021, VOL. 13, NO. 1, e1974795 (17 pages).

Sheriff, ZA et al. Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC).. eLife 2023;12:e86002.

Soriano, JB, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. 2022 Apr;22(4):e102-e107. doi: 10.1016/S1473-3099(21)00703-9. Epub 2021 Dec 21. WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. https://pubmed.ncbi.nlm.nih.gov/?term=Soriano+JB&cauthor_id=34951953

Wang, S. et al. Adherence to Healthy Lifestyle Prior to Infection and Risk of Post–COVID-19 Condition.JAMA International. 2023 Mar; 183(3): 232–241.

Zhang, D et al. Gut Microbiota Dysbiosis Correlates With Long COVID-19 at One-Year After Discharge.J Korean Med Sci. 2023 Apr 17;38(15):e120.

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