What Should You Eat and Drink to Manage Long COVID-19 Symptoms?
Even though COVID-19 has been impacting the world since March 2020, we continue to learn more about COVID-19 and how it affects us. Due to its rapid mutation, there's much more to discover about this coronavirus, like the long-term health impacts of being infected with it.
Related: How Having COVID Has Changed My Diet
What we know for sure: More than 595 million people across the globe have tested positive for COVID-19, as of August 2022, and more than 6 million have died, per the World Health Organization. And of those who have recovered from COVID-19, not everyone feels back to 100%.
Approximately 13.3% of Americans who've had COVID-19 experience prolonged symptoms, per July 2022 estimates from the Centers for Disease Control and Prevention. This means that more than 1 in 10 COVID-19 survivors may fit the criteria for having "long COVID-19."
Ahead is your complete guide to long COVID, plus your nutrition prescription if you have the condition yourself.
What Is Long COVID-19?
"Some people who have been infected with COVID-19 experience lingering symptoms that don't go away even after the person no longer tests positive. Some people may never be able to get rid of symptoms, they linger for weeks, months or even years," says Roxana Ehsani, RD, CSSD, a registered dietitian nutritionist in Miami and a national media spokesperson for the Academy of Nutrition and Dietetics.
The CDC reports that, as of July 2022, about 2.5% of COVID-19 survivors have reported having symptoms for three months or longer after testing negative again. Some risk factors (such as high blood pressure, lung conditions, smoking and diabetes) have been correlated with increased risk for severe cases of COVID-19. Johns Hopkins Medicine experts confirm that the same link doesn't hold true for long COVID. The lingering symptoms can happen in people who even have mild cases at the time they test positive. That said, more than 30% of those who say they have long-haul COVID symptoms six months post-positive test were hospitalized during their recovery, so severity seems to make a difference.
"Some people may develop new health problems or conditions after being infected that last a long time post-infection as well. There's no test to check if you are experiencing long COVID or not; it can be difficult to diagnose," Ehsani adds.
Health experts at the California Department of Public Health confirm that the symptoms of post-COVID-19 conditions can vary by person, but may include one or more of the following:
- Trouble breathing, shortness of breath and/or lightheadedness
- Heart palpitations
- Tiredness or fatigue
- Symptoms that get worse after physical or mental activities
- Brain fog
- Changes in ability to smell or taste
- Chest pain
- Stomach pain and/or diarrhea
- Joint or muscle pain
- Sleep problems
- Mood changes
- Irregular menstrual period cycles
What Should You Eat and Drink to Manage Long COVID Symptoms?
The answer to this question varies widely per person; Ehsani says: "It depends on what type of symptoms you are experiencing."
As a general rule, though, here are six best practices for what to eat and drink if you have long COVID, according to the Hospital for Special Surgery and Ehsani.
Eat Enough Calories So Your Body Has Fuel to Heal
So how much is "enough"? This is based on body size, the HSS confirms. Try to consume about 35 to 47 calories per kilogram of body weight, according to a study published in the November 2019 Critical Care journal, which works out to 2,000 to 2,650 calories per day for a 125-pound person. See what 2,000 calories per day looks like, then tack on snacks accordingly to meet your personal energy requirements. "An energy-supporting snack is one that contains a high-fiber carbohydrate (such as a fruit, veggie or whole grain) along with a source of protein (Greek yogurt, cottage cheese, almonds, walnuts, chia seeds or edamame)," Ehsani says.
Prioritize Protein to Stimulate Muscle Repair
Shoot for 25 to 35 grams of protein at each meal and between 10 and 20 grams at each snack. For reference, an egg has 6 grams, ½ cup cottage cheese packs in 14 grams and 5 ounces of salmon will fuel you with 28 grams of protein. Score more inspiration via our month of Mediterranean diet dinners that are high in protein.
Don't Forget about Carbs
Yes, protein is vital, but healthy fats and carbs—all part of a balanced diet—play important roles too. Carbs are especially important if one of your long-haul symptoms relates to poor energy or fatigue, Ehsani says. If that's the case, she says, "Make sure you're consuming carbs every three to four hours at a meal or snack to help get your energy levels back up. Consuming sufficient complex carbohydrates throughout the day and spreading them out throughout the day can make a big impact." That's because carbs are our brain and body's preferred source of energy. Complex carbs like fruits, veggies and whole grains (brown rice, whole-wheat bread, whole-wheat pasta) are all strong sources.
Feed Your Gut
While no food or drink can prevent or cure a medical condition, a whopping 70% to 80% of our immune system actually resides in our gut, per a 2021 article published in Nutrients. So as part of your overall long COVID treatment strategy, it can be wise to focus on foods that promote good gut health, such as probiotics, prebiotics and fiber.
Drink Plenty of Water
If your symptoms are gastrointestinal, say, diarrhea or vomiting, or if you're running a fever, you are likely losing fluids and electrolytes. "Stay hydrated and try to replace those depleted electrolytes with foods rich in both sodium and potassium," Ehsani says. Sip on enough water and broth, and snack on pickles, pretzels, saltines, salted nuts or seeds for a sodium boost. To amp up your potassium intake, nosh on potatoes, yogurt, beans, oranges and bananas.
Taste the Rainbow
A September 2021 review in the journal Current Nutrition Reports found that a plant-based diet can be beneficial for those with long COVID symptoms. No need to go all-in if a full vegan diet feels too extreme. Even just eating a more plant-forward diet can move the needle, Ehsani says. "Start with what you already enjoy eating. So if you love scrambled eggs in the morning, can you add spinach leaves in there, tomato slices or mushrooms? Or if you prefer to have a sweet breakfast like a whole-grain waffle, can you have it with a cup of blueberries and raspberries or top your waffle with banana slices?" Adding more color into your diet means that you're also cranking up your consumption of essential vitamins, minerals, antioxidants and dietary fiber. "All these nutrients will help support your immune system and become the best defense to help fight off any other types of illness or conditions or symptoms that may develop and help reduce inflammation in the body thanks to fruits' and veggies' rich antioxidant profile," Ehsani adds.
The Bottom Line
Most COVID-19 survivors appear to bounce back fully after six months, but not all. So know you're not alone if you're experiencing long COVID symptoms. And know that certain foods and drinks—and experts—are here to help.
After recovering from a COVID-19 infection, some people may experience residual damage to their organs that can increase the risk for permanent health challenges including chronic conditions like diabetes or heart disease, Ehsani says.
Talk to your health care provider and a dietitian if anything feels off. And, Ehsani says, "Focus on what you can control, like trying to consume a well-balanced healthy diet, which can nourish your body with nutrient-rich vitamins and minerals that help support your entire body and can prevent further disease and health conditions."