Researchers reviewed 82 studies to understand how lifestyle choices affect long COVID (also called post COVID-19 syndrome). They found that smoking and stress increase your risk of developing long COVID, while getting enough sleep and maintaining healthy habits can protect you. Exercise programs and therapy helped people feel better. The research shows that what you do every day—how much you sleep, whether you smoke, your stress levels, and your overall health habits—really matters for both preventing and recovering from long COVID. However, scientists still need more research to fully understand how these lifestyle factors work together.
The Quick Take
- What they studied: How everyday lifestyle choices like exercise, sleep, smoking, alcohol use, diet, and mental health affect whether people develop long COVID and how well they recover from it.
- Who participated: Researchers looked at 82 different studies involving thousands of people who had long COVID. Most studies focused on adults who were hospitalized, though some included people who weren’t hospitalized.
- Key finding: Smoking and poor mental health increase your chances of getting long COVID. Getting enough sleep and maintaining multiple healthy habits appear to protect you. Exercise programs and therapy helped people with long COVID feel better and improve their quality of life.
- What it means for you: If you’ve had COVID or are worried about long COVID, taking care of your mental health, getting good sleep, not smoking, and staying active may help prevent it or recover faster. However, more research is needed to understand exactly how much each factor helps.
The Research Details
Scientists conducted a ‘scoping review,’ which means they searched through thousands of published research papers to find what scientists already know about a topic. They looked at studies published between January 2022 and December 2024 from three major medical databases. Out of 4,665 articles they found, they carefully selected 82 that directly studied how lifestyle factors affect long COVID.
They organized the research by looking at seven different lifestyle areas: exercise, smoking, alcohol use, diet, mental health, sleep, and overall lifestyle habits. For each area, they examined whether these factors affected three things: (1) whether people developed long COVID in the first place, (2) how the illness progressed, and (3) how well people recovered.
This type of review is useful because it brings together what many different studies have found, giving us a bigger picture of what works rather than relying on just one study.
A scoping review is important because long COVID affects millions of people worldwide, and we need to understand what helps them recover. By looking at many studies together, researchers can identify patterns and see where we have strong evidence and where we need more research. This helps doctors give better advice to patients about what lifestyle changes might help them.
This review is strong because it looked at many studies (82) from reputable medical databases. However, the researchers found that the quality of evidence varies—some lifestyle factors have strong evidence while others don’t. Most studies focused on hospitalized adults, which means we don’t know as much about children or people who weren’t hospitalized. The researchers were honest about these limitations, which is a good sign of quality research.
What the Results Show
The research found clear evidence that smoking and poor mental health increase the risk of developing long COVID. People who don’t smoke and who manage their stress and mental health better appear to be more protected.
Getting enough sleep appears to be protective—people who sleep well seem less likely to develop long COVID. When people with long COVID did exercise programs that were carefully designed for them (not too intense, gradually increasing), they felt better and had fewer symptoms.
Cognitive behavioral therapy (a type of talk therapy that helps change thought patterns) was shown to help people with long COVID feel better and improve their quality of life. Some specific foods and mind-body therapies like yoga or meditation may also help, though the evidence is less clear.
Interestingly, maintaining multiple healthy habits together seemed more helpful than any single habit alone, suggesting that overall lifestyle matters.
The research also looked at other factors like alcohol use and specific diets, but the evidence was mixed or unclear. Some studies suggested certain foods might help, but scientists need more research to be sure. The research showed that combining several healthy lifestyle changes together may be more effective than trying to change just one thing at a time.
This review builds on earlier research about long COVID by specifically looking at lifestyle factors. It confirms what many doctors suspected—that healthy habits matter—but also shows that we still have significant gaps in our understanding. Previous research focused more on medical treatments, so this review adds important information about what people can do themselves.
The biggest limitation is that most studies looked at people who were hospitalized with COVID, so we don’t know if the same findings apply to people who had milder cases. There’s very little research on children with long COVID. The evidence for some factors (like specific diets and alcohol) is weak or unclear, meaning scientists need more studies. Many studies were small or didn’t compare groups in the best way possible. The researchers couldn’t always tell if lifestyle factors caused the differences or if other things were responsible.
The Bottom Line
Based on moderate evidence: Don’t smoke (or quit if you do), manage stress and mental health, and get 7-9 hours of sleep per night. Based on good evidence: Try gentle, gradually increasing exercise programs designed for long COVID recovery. Consider talking to a therapist, especially cognitive behavioral therapy. Based on weaker evidence: Eat a balanced diet with whole foods and try mind-body practices like yoga or meditation. Talk to your doctor before starting any new exercise program, especially if you have long COVID.
Anyone who has had COVID and is worried about long COVID should pay attention to these findings. People currently recovering from long COVID should especially consider exercise programs and therapy. Healthcare providers should use this information when advising patients. However, these findings don’t replace medical treatment—they work alongside it. People with severe long COVID should work with their doctors before making major lifestyle changes.
Sleep and stress management improvements may help you feel better within weeks. Exercise programs typically show benefits within 4-12 weeks, though some people improve faster. Therapy benefits often appear within 8-12 weeks. Overall lifestyle changes may take 3-6 months to show their full effect. Everyone is different, so results vary.
Want to Apply This Research?
- Track three key factors daily: (1) Sleep hours and quality (rate 1-10), (2) Stress/mood level (rate 1-10), and (3) Exercise minutes (gentle movement counts). Monitor whether symptoms improve as these factors improve.
- Set one specific goal: either commit to 7-9 hours of sleep, do 10-15 minutes of gentle movement daily, or practice a 5-minute stress-reduction activity (breathing exercises, meditation, or stretching). Start with whichever feels easiest, then add others gradually.
- Weekly check-in: Review your sleep, stress, and activity logs. Rate your long COVID symptoms (fatigue, brain fog, shortness of breath) on a 1-10 scale weekly. Look for patterns—do symptoms improve when you sleep better or exercise? Share this data with your doctor to track your recovery progress over months.
This review summarizes research about lifestyle factors and long COVID but is not medical advice. Long COVID is a complex condition that varies greatly between individuals. Before making significant lifestyle changes, especially starting new exercise programs, please consult with your healthcare provider who knows your medical history. This information should complement, not replace, professional medical care. If you’re experiencing severe symptoms, seek immediate medical attention. The evidence for some recommendations is still developing, and individual results may vary.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.