Healthcare professionals in India are facing challenges diagnosing and treating patients with long Covid due to insufficient guidelines and a lack of comprehensive research. Researchers have raised concerns about the scarcity of studies on the condition, further complicating efforts to manage it.  

After the World Health Organization (WHO) ended the Covid-19 global health emergency in May last year, countries began focusing on assessing the impact of long Covid—a condition where individuals experience persistent symptoms long after recovering from acute infection. These symptoms include fatigue, cough, joint and muscle pain, brain fog, and concentration issues, resulting from the SARS-CoV-2 virus.  

While studies suggest that around one-third of those with moderate to severe infections develop long Covid, the incidence varies by region. Research from Harvard Medical School, published in the *International Journal of Infectious Diseases* in September, estimated that 31% of individuals in North America, 44% in Europe, and 51% in Asia suffer from long Covid. The study highlights the strain on healthcare systems due to limited treatment guidelines.  

In India, the availability of data on long Covid remains limited. A study by Maulana Azad Medical College, New Delhi, conducted between May 2022 and March 2023 on 553 patients, found that 45% experienced lingering symptoms, with persistent fatigue and dry cough being the most common. The study, published in the journal *Cureus* in May, noted a need for more exploratory research on the long-term outcomes of the condition.  

Dr. Rajesh Sagar, Professor of Psychiatry at the All India Institute of Medical Sciences (AIIMS), New Delhi, commented that it is still too early to fully understand or establish standardized diagnostic and treatment methods for long Covid.  

According to Animesh Samanta, Assistant Professor at Shiv Nadar University, Greater Noida, while Indian research points to an increase in neurological symptoms, more studies on neuroinflammation are required. Doctors report an uptick in unusual symptoms such as post-viral asthma, where patients develop chronic cough and wheezing, requiring inhalers or nebulizers. 

 Dr. Arun Garg, Chairman of Neurology at Medanta-The Medicity, Gurugram, noted a rise in stroke cases among young patients without common risk factors like diabetes or hypertension. He also observed an increase in encephalopathy—brain inflammation without clear cause—resulting in mental confusion following mild fevers, with MRI scans showing no abnormalities.  

The lack of standardized diagnostic tools forces doctors to rely on broad health assessments and inflammatory markers like C-reactive protein (CRP) for guidance. Dr. Neetu Jain, a senior consultant at Pushpawati Singhania Hospital, New Delhi, explained that long Covid is diagnosed based on clinical observation, especially when patients fail to regain their pre-Covid quality of life. Some patients even exhibit rare antibodies not seen before the pandemic.  

Inflammation persisting after recovery from acute Covid is believed to play a crucial role in long Covid, but specific tests to measure this immune response are still under development. At Shiv Nadar University, Samanta’s team has created a fluorescent probe to detect inflammation in brain cells. This probe tracks nitric oxide levels in microglia cells—immune cells responsible for brain health—which produce nitric oxide during immune responses to infections.  

While such innovative tools show promise, there remains a pressing need for more research and well-defined protocols to effectively diagnose and treat long Covid patients in India.