Emma Grant's life has fundamentally changed since she caught COVID-19 in July 2020.
In the past year and a half, she has dealt with migraines, fatigue, breathlessness, chest pain and even vocal chord dysfunction.
"I've spent so long not being able to do a lot of things," she said.
Ms Grant is just 25, and her case highlights the serious impacts long COVID can have — even for the young.
She said small tasks that used to be easy were now exhausting.
"Just walking from your car into the office, that kind of thing, you do just have to take that extra moment to give your body that recovery that it wouldn't necessarily have had to have previously," she said.
After contracting COVID, Ms Grant took three months to get back to work.
She is a nurse, but for now is working in an office role to steer clear of the hospital ward's exhausting environment.
Initially she was only able to manage two four-hour shifts per week, which slowly ramped up as she recovered.
"It took a massive amount of effort for me to get back anywhere close to where I am."
A long road to recovery
After a bout of COVID that involved hospitalisation and severe breathing difficulties, Ms Grant knew she would not be able to recover on her own.
She started off by seeing an exercise physiologist to build her exercise tolerance.
Then in January last year, she was contacted by the Royal Melbourne Hospital about its post-COVID clinic.
It was there that she was diagnosed with and treated for vocal chord dysfunction.
"I'm doing a lot of music therapy with them to help with vocal chord dysfunction," she said.
"Because of the initial cough, my vocal chords just fell out of sync, and I was having these episodes where they would just close over when I'm trying to breathe."
Many migraine treatments she tried did not work, but the hospital put her in touch with a specialist who suggested a new therapy that involved receiving monthly injections.
"Within the first month I noticed a significant difference in not just my migraines, but the chest pains as well; the breathlessness, the fatigue — all of that started to fade."
University of Queensland infectious diseases specialist Paul Griffin said a substantial number of people infected with COVID-19 reported some form of long-term symptoms.
He said exactly what caused the condition known as long COVID was still unclear.
"In terms of exactly how it arises, we still don't know," he said.
"There's a lot of thoughts that it relates to the body's immune system potentially being overstimulated in response to the virus and then causing a variety of symptoms thereafter."
He said the most common symptoms were fatigue, shortness of breath and headaches.
Dr Griffin said for a long time the "jury was out" but the evidence was building that vaccines do protect people from the long-term effects of the virus as well.
"Increasingly it does appear that vaccines do reduce your chance of getting all forms of this infection, including the long-term manifestations that we've come to know as long COVID," he said.
He said while more research was being done into effective treatments, focusing on prevention through vaccination was crucial.
Life-changing support
Dr Megan Rees, the interim head of the Royal Melbourne Hospital's respiratory department, said the post-COVID clinic has seen almost 500 patients since it was launched about two years ago.
She said the clinic focuses on a range of COVID symptoms including fatigue, breathlessness, sleeplessness, brain fog and anxiety.
Given the range of symptoms patients experience, she said the clinic took a multidisciplinary approach, employing a psychologist, a psychiatrist, a neurologist, an exercise physiologist, a neuropsychologist, and general practitioners.
"We can tailor the care that we give the patient to their particular needs and symptoms," she said.
She said a good way to avoid getting long COVID was to get vaccinated against the virus.
"We know from international data and also from our own experience that people who are fully vaccinated against COVID-19 are less likely to present with long-term symptoms after they've become infected.
Ms Grant said the hospital's help had been life-changing.
"I probably wouldn't be where I am today without their support."
But despite the progress in her recovery, many days are still a struggle.
