Paper:
Symptom Experiences and Management of Long COVID Among Older Adults in the Community: A Phenomenological Study
Khunatpakorn Makkabphalanon*
, Nattiya Peansungnern*
, Jutamast Wongjan*
, Pramote Thangkratok**,
, and Natchaya Palacheewa**

*Boromarajonani College of Nursing, Nakhon Ratchasima
177 Changpuak Phueak Road, Muang District, Nakhon Ratchasima 30000, Thailand
**Srisavarindhira Thai Red Cross Institute of Nursing
Bangkok, Thailand
Corresponding author
Long COVID has emerged as a persistent health challenge, particularly among older adults. Its diverse symptoms often affect physical, psychological, and social well-being, making effective management strategies essential. This study aims to explore the symptoms experienced by older adults with Long COVID, examine their impact on daily life, and identify the strategies employed for symptom management within a community setting. A phenomenological design was applied. Data were collected between January and April 2024 through in-depth interviews with a purposive sample of 14 older adults with Long COVID residing in a rural community in Thailand. Content analysis was used to interpret the data. Six categories of symptom experiences were identified: (1) neuropsychiatric (insomnia), (2) sensory (ageusia), (3) musculoskeletal (muscle pain), (4) upper respiratory (cough), (5) lower respiratory (dyspnea), and (6) general symptoms (fatigue). To manage these symptoms, older adults reported strategies including praying and taking medication for insomnia; using supplements for ageusia and fatigue; taking Thai herbs for muscle pain and cough; and using oxygen therapy, breathing exercises, lung exercises, and rest for dyspnea. Older adults with Long COVID experience multiple symptom categories and employ diverse management strategies that combine traditional and modern approaches. These findings emphasize the importance of personalized clinical care and the integration of cultural and alternative remedies in supporting older adults with Long COVID.
- [1] J. B. Soriano, S. Murthy, J. C. Marshall, P. Relan, and J. V. Diaz, “A clinical case definition of post-COVID-19 condition by a Delphi consensus,” The Lancet Infectious Diseases, Vol.22, No.4, pp. e102-e107, 2022. https://doi.org/10.1016/S1473-3099(21)00703-9
- [2] S. Rajan, K. Khunti, N. Alwan, C. Steves, T. Greenhalgh, N. MacDermott et al., “In the wake of the pandemic: Preparing for Long COVID,” European Observatory on Health Systems and Policies, Policy Brief No.39, 2021.
- [3] World Health Organization, “Post COVID-19 condition (Long COVID),” 2025. https://www.who.int/news-room/fact-sheets/detail/post-COVID-19-condition-(long-COVID) [Accessed September 1, 2023]
- [4] S. Lopez-Leon, T. Wegman-Ostrosky, C. Perelman, R. Sepulveda, P. A. Rebolledo, A. Cuapio et al., “More than 50 long-term effects of COVID-19: A systematic review and meta-analysis,” Scientific Reports, Vol.11 No.1, Article No.16144, 2021. https://doi.org/10.1038/s41598-021-95565-8
- [5] H. E. Davis, L. McCorkell, J. M. Vogel, and E. J. Topol, “Long COVID: Major findings, mechanisms and recommendations,” Nature Reviews Microbiology, Vol.21, No.3, pp. 133-146, 2023. https://doi.org/10.1038/s41579-023-00896-0
- [6] World Health Organization, “A clinical case definition of post COVID-19 condition by a Delphi consensus,” 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 [Accessed September 21, 2023]
- [7] H. I. Kemp, E. Corner, and L. A. Colvin, “Chronic pain after COVID-19: Implications for rehabilitation,” British J. of Anaesthesia, Vol.125, No.4, pp. 436-440, 2020. https://doi.org/10.1016/j.bja.2020.05.021
- [8] National Center for Immunization and Respiratory Diseases (NCIRD), “Long COVID or post-COVID conditions,” Division of Viral Diseases, Centers for Disease Control and Prevention, 2021.
- [9] T. Greenhalgh, M. Knight, C. A’Court, M. Buxton, and L. Husain, “Management of post-acute COVID-19 in primary care,” BMJ, Vol.370, Article No.m3026, 2020. https://doi.org/10.1136/bmj.m3026
- [10] M. Dodd, S. Janson, N. Facione, J. Faucett, E. S. Froelicher, J. Humphreys et al., “Advancing the science of symptom management,” J. of Advanced Nursing, Vol.33, No.5, pp. 668-676, 2001. https://doi.org/10.1046/j.1365-2648.2001.01697.x
- [11] V. Nittas, M. Gao, E. A. West, T. Ballouz, D. Menges, S. W. Hanson et al., “Long COVID through a public health lens: An umbrella review,” Public Health Reviews, Vol.43, Article No.1604501, 2022. https://doi.org/10.3389/phrs.2022.1604501
- [12] M. Heidegger, J. Macquarrie, and E. Robinson, “Being and time,” Harper, 1962.
- [13] M. B. Miles and A. M. Huberman, “Qualitative data analysis: An expanded sourcebook (2nd ed.),” Sage Publications, 1994.
- [14] E. G. Guba and Y. S. Lincoln, “Competing paradigms in qualitative research,” N. K. Denzin and Y. S. Lincoln (Eds.), “Handbook of Qualitative Research,” pp. 105-117, Sage Publications, 1994.
- [15] H. E. Davis, G. S. Assaf, L. McCorkell, H. Wei, R. J. Low, Y. Re’em et al., “Characterizing Long COVID in an international cohort: 7 months of symptoms and their impact,” EClinicalMedicine, Vol.38, Article No.101019, 2021. https://doi.org/10.1016/j.eclinm.2021.101019
- [16] A. Nalbandian, K. Sehgal, A. Gupta, M. V. Madhavan, C. McGroder, J. S. Stevens et al., “Post-acute COVID-19 syndrome,” Nature Medicine, Vol.27, No.4, pp. 601-615, 2021. https://doi.org/10.1038/s41591-021-01283-z
- [17] V. O. Puntmann, M. L. Carerj, I. Wieters, M. Fahim, C. Arendt, J. Hoffmann et al., “Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19),” JAMA Cardiology, Vol.5, No.11, pp. 1265-1273, 2020. https://doi.org/10.1001/jamacardio.2020.3557
- [18] N. V. Lam, S. Sulo, H. A. Nguyen, T. N. Nguyen, C. Brunton, N. N. Duy et al., “High prevalence and burden of adult malnutrition at a tertiary hospital: An opportunity to use nutrition-focused care to improve outcomes,” Clinical Nutrition Open Science, Vol.40, pp. 79-88, 2021. https://doi.org/10.1016/j.nutos.2021.11.003
- [19] D. Ayoubkhani, C. Bermingham, K. B. Pouwels, M. Glickman, V. Nafilyan, F. Zaccardi et al., “Trajectory of Long COVID symptoms after COVID-19 vaccination: Community based cohort study,” BMJ, Vol.377, Article No.e069676, 2022. https://doi.org/10.1136/bmj-2021-069676
- [20] D. T. Arnold, F. W. Hamilton, A. Milne, A. J. Morley, J. Viner, M. Attwood et al., “Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: Results from a prospective UK cohort,” Thorax, Vol.76, No.4, pp. 399-401, 2021. https://doi.org/10.1136/thoraxjnl-2020-216086
- [21] M. Mendelson, J. Nel, L. Blumberg, S. A. Madhi, M. Dryden, W. Stevens et al., “Long-COVID: An evolving problem with an extensive impact,” South African Medical J., Vol.111, No.1, pp. 10-12, 2020. https://doi.org/10.7196/samj.2020.v111i11.15433
- [22] M. W. Tenforde, S. S. Kim, C. J. Lindsell, E. Billig Rose, N. I. Shapiro, D. C. Files et al., “Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network – United States, March-June 2020,” Morbidity and Mortality Weekly Report, Vol.69, No.30, pp. 993-998, 2020. https://doi.org/10.15585/mmwr.mm6930e1
- [23] A. Oumtanee, P. Numsang, R. Sananok, S. Kurat, S. Kraichan, P. Sarapoke et al., “Health awareness as a motivator: A grounded theory analysis of diabetes self-management in Northeastern Thailand,” Asian J. of Social Health and Behavior, Vol.8, No.2, pp. 90-96, 2025. https://doi.org/10.4103/shb.shb_299_24
- [24] N. Sowattanangoon, N. Kotchabhakdi, and K. J. Petrie, “The influence of Thai culture on diabetes perceptions and management,” Diabetes Research and Clinical Practice, Vol.84, No.3, pp. 245-251, 2009. https://doi.org/10.1016/j.diabres.2009.02.011
- [25] M. Stuart, D. A. Spencer, C. J. McLachlan, and C. Forde, “COVID-19 and the uncertain future of HRM: Furlough, job retention and reform,” Human Resource Management J., Vol.31, No.4, pp. 904-917, 2021. https://doi.org/10.1111/1748-8583.12395
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