Dr Nilihan Sanal-Hayes
14th May 2026
The COVID-19 pandemic has reshaped how we understand infectious disease, but one of its most important legacies is the renewed attention on what happens after the acute infection ends. For many individuals, recovery is not linear. Instead, it is marked by persistent and often debilitating symptoms lasting months or even years. This condition, widely known as long COVID, has brought post-viral illness into global focus.
From my perspective as a researcher in this field, long COVID is not entirely new. It shares significant overlap with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a condition that has historically been underfunded, misunderstood, and frequently dismissed. What the pandemic has done is amplify something that patients and researchers in this field have known for decades, post-viral illness is real, complex, and deeply impactful.
One of the most striking aspects of both long COVID and ME/CFS is the inequality experienced by those affected. Many individuals report feeling unheard, dismissed, or unsupported within healthcare systems. This is not simply about awareness, it reflects deeper structural issues in how certain conditions are prioritised, funded, and researched. Conditions that are difficult to measure, that predominantly affect women, or that do not fit neatly into existing biomedical models are often deprioritised.
In my research, I have seen how these inequalities shape not only patient experience but also the direction of scientific inquiry. Historically, ME/CFS has received limited funding relative to its burden, and while long COVID has brought renewed attention, there is a risk that this momentum may not be sustained. For me, this raises an important question: how do we ensure that this moment leads to lasting change rather than temporary visibility?
A key focus of my work has been on developing digital health approaches to better understand and support individuals living with post-viral conditions. In particular, I have explored how wearable technologies and digital tools can be used to monitor symptoms and activity in real time. In my recent work published in Nature Communications, I examined digital and behavioural approaches to fatigue management in post-viral conditions (Sanal-Hayes et al., 2026). This research highlights the potential of combining digital monitoring with behavioural strategies to support individuals in managing their symptoms more effectively.
However, technology alone is not the solution. A central principle of my research is co-production, working closely with individuals who have lived experience of long COVID and ME/CFS. These individuals are not passive participant, they are experts in their own condition. Their insights shape how we design studies, what outcomes we measure, and how interventions are developed. Without this collaboration, there is a risk that research will fail to address the realities of living with these conditions.
Another area I am currently exploring is the development of novel interventions for fatigue including digital therapies and emerging approaches such as transcranial magnetic stimulation (TMS). While these are still in early stages, they represent an important step towards addressing the lack of effective treatment options. At the same time, it is crucial that any intervention is carefully evaluated, particularly given the potential for symptom exacerbation in conditions characterised by post-exertional malaise.
The pandemic has also underscored the importance of interdisciplinary research. Long COVID sits at the intersection of multiple domains, including digital health, neuroscience, behavioural science, and public health. In my collaborations, I have seen how bringing together these perspectives can lead to more innovative and impactful research.
Despite these advances, significant challenges remain. In a recent project I led as Principal Investigator, we found that access to appropriate healthcare, recognition in the workplace, and the availability of social support systems remain inconsistent (Thornton et al., 2025). Looking ahead, my aim is to build on the momentum created by the pandemic to drive meaningful change. This includes developing scalable, evidence-based interventions, strengthening collaborations, and ensuring that research is inclusive and patient-centred. It also means continuing to challenge the stigma associated with chronic, invisible illnesses.
Ultimately, long COVID has created a window of opportunity. It has forced us to confront gaps in our understanding and to listen more closely to patient voices. The question now is whether we will act on these lessons. For me, the answer is clear. This is not just about advancing research, it is about addressing long-standing inequalities and ensuring that individuals living with post-viral conditions are no longer overlooked.
Dr Nilihan Sanal-Hayes is a Lecturer in Psychology at the University of Salford and a Chartered Psychologist and Fellow of the Higher Education Academy. She is co-chair of the BRC/UoM Fatigue and Cognitive Group, UKRN Open Science Local Network co-lead, an Editorial Board Member for PLOS Digital Health, and serves on the Early Career Editorial Board of Healthcare (MDPI). She is also a member of YoungEMERG, a board member of IACFS/ME, and a guest editor for a special issue on Long COVID in COVID. She additionally acts as a grant reviewer for several European science funding bodies. Her research interests focus on chronic disease management, particularly fatigue-related conditions, digital health, cognitive and physical wellbeing, psychological wellbeing, and interventions for pain and fatigue in comorbid conditions. She is also actively involved in research leadership and teaching, including supervision across undergraduate, postgraduate, and PhD levels.
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