Long COVID’s hidden toll: the South Africans still battling fatigue, anxiety and memory loss

Long COVID is not only a biological condition; it is a deeply human problem shaped by physical changes and the realities of people’s daily lives.

Key idea

Long COVID affects both body and mind, with lingering symptoms that continue well after the initial infection and alter how people function in everyday situations.

Human experience of long COVID

Many South Africans who had COVID-19 face ongoing exhaustion, trouble concentrating, mood changes and forgetfulness that interfere with work, relationships and their sense of self. These lasting issues can make people feel unlike their “old selves”, as if recovery from the acute infection never truly ends.

Research findings

A cohort study in Cape Town followed people who had been hospitalised with COVID-19 and found that more than half still reported at least one persistent symptom six months later. Common problems included fatigue, concentration and memory difficulties, with some participants experiencing these challenges for up to two years after infection.

Neurocognitive and mental health impact

Tests showed that a substantial share of participants had measurable cognitive or memory impairments, while over half reported noticeable memory problems in daily life. Moderate to severe fatigue was frequent, and around one in four people showed elevated anxiety, with use of psychiatric medication almost doubling after COVID-19.

Biology and unanswered questions

Severity of the initial illness did not reliably predict who developed long‑term symptoms, and standard blood markers during acute infection did not identify those at risk. The lack of clear biological predictors suggests that persistent mental and cognitive effects may involve complex mechanisms, such as possible viral effects on the brain or subtle ongoing immune activation, but no single explanation has been confirmed.

Social context in South Africa

In South Africa, unemployment, inequality and limited access to health care intensify the burden of long COVID and make recovery more difficult. Stress, financial strain and higher rates of distress in disadvantaged communities likely worsen the psychological and cognitive consequences of long COVID.

Global picture

Findings from this South African research align with international evidence showing high rates of long‑term symptoms months after infection. Worldwide analyses estimate that roughly one in five people may experience persistent issues such as fatigue, depression, anxiety or memory problems six months after COVID‑19.

“Long COVID isn't purely a biological problem; it's a human one, shaped by both physiology and lived experience.”

Author’s summary

Long COVID quietly reshapes lives in South Africa, blending lingering physical symptoms with mental, cognitive and social pressures that stretch recovery far beyond the initial illness.

The Conversation — 2025-11-25