New Sportmates in the Post-COVID Aftermath
My heart and blood vessels have become the fragile frontiers of aging. For more than three years a coronary angiography showed my arterioles letting through less blood than normal and that the peripheral resistance in the heart’s vascular tree was high. Lisbeth, 87, has traded her once-fierce long runs for afternoons spent with pensioners playing walking football. Bengt, 78, and I share a common burden: angina that makes us cautious defenders rather than reckless opponents. We carry nitro sprays in our pockets, and Bo, 68, has trained in cardiopulmonary rescue through the home front so he could save us if something goes wrong. These two—and the rest of the group—are my new sportmates, and after our matches we sit down for fika, exchange jokes, and try to make sense of this new rhythm of life. The TV networks have not discovered our tiny corner of the world yet, but that will change only when the story becomes more than a curiosity.
Understanding Post-COVID Long-Haul
In the spring 2025, I underwent overseas examinations for microprothrombi—tiny clots that appear to be part of the post-COVID pathophysiology. In the plasma of sick participants they show up differently than in healthy controls. For me, these biological whispers translate into real, daily pain: a swollen MCP joint that makes simple tasks hard, a persistent dry cough, chronic nasal wounds, teeth that seem to crack, and a general slowness of thought and concentration. Post-exertional malaise (PEM)—the rebound after even modest activity—has become a constant companion. If I push past my limit, I pay a price for days. This isn’t laziness or stubbornness; it is a biological response that reshapes how I move through a day.
Microthrombi, Autonomic Change, and the Body’s Aftermath
Medical theories accumulating over the past years point to several overlapping mechanisms: persistent immune activation, remnants of the virus that keep triggering immune responses, autonomic dysfunction such as POTS, and autoimmunity that may damage tissues long after the initial infection. Biomarkers remain elusive and vary between people, but the pattern is real enough for clinicians to consider long COVID as a biological condition rather than a purely psychological one. Vaccination and early antivirals like Paxlovid appear to reduce the risk of long-term symptoms when used promptly, though the full landscape remains imperfect and uneven across regions.
The Medical and Social Tug-of-War
In Sweden, as in many places, there is a troubling divergence between what science suggests and how care is delivered. It’s common to hear that post-COVID is diffuse and difficult to prove, while institutions struggle to budget for a new, pervasive illness. Regions differ: one emphasizes lifestyle changes; another launches cognitive-behavioral therapy trials; some clinicians label the condition as “functional” or even “hysterical.” Such framing undermines patient experiences and can silence those who are genuinely sick. An AI-assisted review of the literature reflects a consensus from WHO, CDC, NIH, and other authorities that post-COVID is a medical condition with a biological basis, not a purely functional syndrome, but clinical practice lags behind the science.
AI, Evidence, and Caution
Using an AI tool to survey thousands of studies is tempting, but it’s not a substitute for compassionate care. The tool can summarize patterns that align with established science, yet it cannot replace the clinician who must listen to a patient’s personal story, assess fluctuating symptoms, and navigate limited resources. The risk is that care becomes about ticking boxes rather than healing relationships.
Moving Forward with PEM and Personal Truth
PEM has forced me to rethink my life trajectory. I now recognize when to push, when to pause, and how to balance activity with recovery. The friendship of the walking-football gang is a lifeline—shared jokes, gentle accountability, and mutual support. It is clear that long COVID will not vanish with the next vaccine, but a confident, patient-centered system can make a real difference. We need better recognition, more targeted research, and clinics that treat long COVID as a legitimate medical condition with a biological basis—one that respects lived experience and offers practical paths to resilience.
A Call for Solidarity and Better Care
Sweden has a chance to translate knowledge into care, to acknowledge that a virus can leave a long tail, and to build pathways that don’t blame the patient for their limitations. If we can learn from the science of microthrombi, PEM, and autonomic changes, we can design care that reaches beyond hospitals—into parks after a game, into clinics that listen, and into policies that fund honest, evidence-based treatment. A compassionate, evidence-driven response is not a luxury; it’s a public good that benefits not only the Lisbeths and Bengts of the world, but all of us who carry a post-COVID tail from a global event we are still learning to live with.
A Note on AI and Information
While AI can help process vast amounts of research, human judgment remains essential. Patients deserve care that respects their voice, supports them through PEM, and anchors treatment in solid science rather than stigmatizing labels. The long tail of COVID demands a long-term, empathetic commitment from healthcare, researchers, and communities alike.
