The Overlapping Syndromes
One of the most significant scientific developments in the understanding of Long COVID is the recognition that the condition shares substantial overlap with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Postural Orthostatic Tachycardia Syndrome (POTS) — two chronic conditions that were poorly understood and frequently dismissed by the medical establishment long before the pandemic.
In March 2026, Emerge Australia reported that almost 50% of Long COVID patients are known to transition to ME/CFS, with an additional 250,000 Australians already living with the condition. This transition rate has profound implications for how healthcare systems must be designed, as ME/CFS requires a fundamentally different approach to care than acute post-viral syndromes — one that emphasises energy management, pacing, and avoidance of post-exertional malaise.
The POTS Discovery
Perhaps the most striking clinical finding to emerge from Australian research in 2026 was the revelation that nearly two-thirds (62.5%) of Long COVID patients meet the formal diagnostic criteria for POTS. The study, conducted by researchers at Adelaide University, found that 58.3% of Long COVID participants had not returned to work following their infection.
POTS is a disorder of the autonomic nervous system characterised by an abnormal increase in heart rate upon standing, often accompanied by dizziness, fatigue, brain fog, and exercise intolerance. In Australia, an estimated 800,000 people are living with POTS, a figure that underscores the scale of the challenge facing primary care practitioners.
The research has prompted calls for POTS to be included in the diagnostic criteria for Long COVID and for routine autonomic assessment in patients with persistent post-viral symptoms. As one of the study’s authors noted, the data argue for “recognizing POTS within the diagnostic framework of long COVID”.
The Immune Signature of Long COVID
Beyond clinical phenotyping, Australian researchers are making strides in understanding the biological underpinnings of Long COVID. A study published in Communications Medicine in April 2026 examined plasma samples from the COVID PROFILE cohort in Victoria, collected 6–9 months after first infection, and identified divergent inflammatory and neurology-related protein levels in Long COVID patients following primary versus breakthrough SARS-CoV-2 infections.
Another key observation from the study was that vaccination did not worsen inflammation in individuals with Long COVID, with levels of inflammatory proteins either stabilising or decreasing. This finding provides reassurance that vaccination remains safe for people with Long COVID while also highlighting the complex immunological landscape of the condition.
Toward National Clinical Guidelines
In a significant policy development, the Australian Government’s National Health and Medical Research Council (NHMRC) is currently developing national clinical best-practice guidelines for ME/CFS, which are expected to be released by the end of 2027 and will also reference Long COVID and related conditions. This represents an important milestone in standardising care and ensuring that clinicians have evidence-based guidance for diagnosing and managing these complex, multi-system conditions.
However, as the BMC Health Services Research review noted, diagnostic coding is essential but insufficient on its own — it must be paired with clinical guidelines, workforce training, and sustainable funding for care coordination. The review also emphasised the importance of shifting to a patient-centred approach and patient-practitioner collaborative model of care to prepare the health system for managing Long COVID and future complex conditions.
The Path Ahead
Australia’s research community has made remarkable progress in characterising the clinical and biological dimensions of Long COVID. The identification of POTS in nearly two-thirds of patients, the recognition of the ME/CFS transition pathway, and the emerging understanding of immune signatures all represent important steps toward better diagnosis and treatment. Yet as Emerge Australia CEO Anne Wilson has emphasised, these scientific advances must be matched with clinical education, enhanced patient and carer support, and improved access to vital services if they are to translate into meaningful improvements in patients’ lives.
