#29 Long Covid: what has six years taught us?

Mar 6, 2026

Joseph Breen, Section Chief for Adaptive Immunity at NIAID who coordinates Long Covid research priorities, reflects on six years of Long Covid science. He outlines prioritized clinical trials like antivirals, low‑dose naltrexone, GLP‑1 agents and stellate ganglion block. The conversation covers patient partnership in research, international trial coordination, and balancing urgent treatments with careful study design.

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ANECDOTE

Hosts Share Their Six Year Long Covid Milestone

Emily Kate Stephens and Jez Medinger mark six years since their first COVID infections and reflect on varied onset/timing of long Covid diagnosis.
Emily notes her formal post‑viral diagnosis came 13 months after initial infection.

INSIGHT

Foundations Are Ready But The Picture Is Unclear

Research progress has built solid foundations but hasn’t yet produced agreed mechanisms or universally effective treatments.
Early hypotheses (persistent virus, autoimmunity, reactivated viruses, microbiome) remain plausible and currently all have supporting evidence.

INSIGHT

Specialists Have Pivoted And Found Viral Residue

Multiple specialists pivoted to study Long Covid, bringing infectious disease, rheumatology and neuroimmunology expertise.
Researchers are finding residual SARS‑CoV‑2 antigen/RNA in some patients, implicating persistence plus host response variability.

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SCIENCE: Long Covid awareness, understanding and research.

Long Covid Awareness Day (15th March 2026) marks six years since the COVID-19 pandemic unleashed its long tail of Long Covid on millions around the world.

In this week’s episode Emily Kate Stephens and Gez Medinger review the science and progress that has been made over the past six years in our understanding of this complex chronic condition.

Through interviews with some of the most prominent experts in the Long Covid and complex chronic illness field: Dr Avindra Nath, Dr Binita Kane, Joseph Breen PhD, Professor Mark Faghy and Dr Alba Azola, Emily Kate and Gez examine the medical, scientific and political landscapes and ask:

What have we learned over the last six years?
What are the current leading theories on what drives the condition?
What are the approved treatment strategies?
What are the latest and most exciting scientific studies that could have impact for those living with the disease?

Including personal reflections as Emily Kate and Gez approach their six year anniversary of contracting COVID-19 for the first time, they provide an overview of the condition and research landscape to assess how far we have come and the work still to be done.

About the experts

Avindra Nath is the Clinical Director of National Institute of Neurological Disorders and Stroke (NINDS) at the NIH in the United States. A neuroimmunologist specialising in the impact of viruses on the brain, he led the Deep Phenotyping of ME/CFS Study which investigated the biological mechanisms of post-infection ME/CFS and chronic fatigue syndrome.

Binita Kane is a Consultant Respiratory Physician and founder of The Long Covid Clinic. After working on the front line in the NHS during the COVID-19 pandemic and supporting her daughter through Long Covid, she became a leading advocate, collaborating with organisations including Long Covid Kids, Long Covid Support, and #ThereForME, and advising parliamentary committees.

Joseph Breen is Section Chief for Adaptive Immunity specialising in Long Covid and ME/CFS at the National Institute of Allergy and Infectious Diseases (NIAID) at the NIH. He co-chairs RECOVER TLC workshops and contributes to the Trans-NIH ME/CFS Working Group.

Mark Faghy is Professor of Clinical Exercise Physiology at Loughborough University, specialising in respiratory physiology, rehabilitation, and Long Covid recovery. He contributes to multiple global initiatives including the World Health Network Long Covid Advisory Group, Long Covid Physio, and Long Covid SOS.

Alba Azola is a rehabilitation physician at Johns Hopkins University and leads the ME/CFS and Related Disorders Program. She is also a lead author of the Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID, helping clinicians develop evidence-based care pathways.

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