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The original was posted on /r/covidlonghaulers by /u/GA64 on 2023-07-30 19:58:03.

Do you find that your long COVID symptoms such as brain fog and fatigue constantly get better then worse again in a repeated cycle, over a period of around 3 or 4 days?

I find that that I will suddenly get a good day, where my brain fog and fatigue seem much improved, and then I think I have left LC behind to an extent, only to find that a day or two later I get substantially worse again. And this cycle of getting better then worse keeps repeating.

This cycle has nothing to do with PEM, since my daily exertion is very similar every day. And in any case, I am always aware when excess exertion has triggered a worsening of symptoms leading to PEM.

The cycle I experience is not PEM, and does not appear to be linked to any external factors or medications. This cycle seems like some intrinsic phenomenon of my long COVID itself.

I wish I could uncover the mechanism of the cycle, and figure out the reason why I get these up and down swings in symptom severity, over a repeating cycle of around 3 or 4 days.

Prior to catching COVID over a year ago, I had had ME/CFS for a number of years (originally triggered by an enterovirus infection), and so I am used to the brain fog and fatigue of ME/CFS. But I never had any ups and downs with my pre-existing ME/CFS; my ME/CFS symptom severity would normally remain constant from day to day (except if I had PEM, of course, or if I took some new medication that made me better or worse).

This cycling of symptom severity only appeared once I developed long COVID on top of my pre-existing ME/CFS.

Do any other long COVID patients experience a similar cycle of symptom severity over several days? And if so, do you have any theories about what might cause the cycles?