Long Covid Treatment in Marylebone, London

Long Covid describes symptoms that persist for twelve weeks or more after a Covid-19 infection and are not explained by another diagnosis. The commonest pattern is fatigue with a crash in the days after ordinary activity, brain fog that slows recall and word-finding, and autonomic symptoms such as palpitations, breathlessness or light-headedness on standing. Sleep is often disturbed. Many people have been well investigated and told everything looks normal.

The mechanism is not settled. Several are under active investigation: persistent immune activation after the virus has cleared, autonomic dysregulation that can present as postural tachycardia, microvascular and clotting changes affecting oxygen delivery, and the deconditioning and disrupted sleep that keep symptoms going once they are established. Different people may have different combinations of these.

Here is the position on treatment, stated before you read anything else on this page. Published evidence for rTMS in long Covid specifically is early and small. There are pilot studies and case series. There is no large sham-controlled trial we can point you to, and no NICE guidance recommending magnetic stimulation for this condition. That is a materially weaker position than the one on our depression page, and it should change what you expect.

What is true is that the symptom picture overlaps heavily with conditions where there is more to go on, particularly the fatigue, cognitive and autonomic elements. That overlap is a reason to assess you carefully. It is not a licence to transfer results from one diagnosis to another, and any clinic quoting you a percentage for long Covid should be asked which population the figure came from.

If you can get into an NHS long Covid service, do that as well. Specialist services can investigate cardiac and respiratory causes that we do not, and having those ruled out first is the right order. If you then want to try a short course of stimulation with a review point built into it, your clinician will design one and will tell you honestly what it may not touch.