COVID-19 has created a vast catastrophic effect on the health and economy. It resulted in billions of infections and millions of deaths. The healthcare and hospital facilities were facing substantial financial challenges. Several countries’ economy has been ruined during the COVID-19 crisis, although they are trying to turn around [1], [2]. The crisis in every country started after the first infection case. One example can be reflected in the first case of Spain. The first case of the new SARS-CoV-2 infection was on March 23, 2020, in Tenerife, Canary Islands, Spain. The first polymerase chain reaction (PCR) test was negative for the patient on invasive mechanical ventilation affected by acute pneumonia. Surprisingly, the patient improved, even with the second PCR test being positive the next day [3]. After that, the country went through the extreme crisis of the pandemic. Similarly, most countries throughout the world are experiencing a huge pandemic crisis. After a prolonged crisis, the situation was entirely normalized, and WHO declared the end of the COVID-19 pandemic [4], [5]. The impact of COVID-19 so far has been unmatched.

However, during the pandemic, COVID-19 causes massive pulmonary problems for the infected people. Therefore, several researchers have studied pulmonary rehabilitation occasionally for COVID-19 infection and long COVID. Meléndez-Oliva et al. observed how pulmonary rehabilitation influences patients suffering from subacute and long COVID-19 infections and also evaluated enhancements in dyspnea, physical function, altered psychological state (anxiety and depression), fatigue by a meta-analysis [6]. Another study conducted a systematic review and meta-analysis of post-acute patients with SARS-CoV-2 and long COVID cases undergoing pulmonary rehabilitation. The study aimed to evaluate the efficacy of pulmonary rehabilitation through subgroups analysis, and it found positive results in favor of pulmonary rehabilitation [7], [8]. Moreover, a study assessed the effects of a multicomponent exercise program (MEP) in improving instant sequelae of COVID-19. Besides, it also assessed the cardio-respiratory performance, health status, incapacity for dyspnea, endurance after intervention, and increased health status. It was carried out and showed positive effects by pre-post evaluation at the 2-year follow-up [9]. Additionally, a retrospective cohort study was carried out to assess the effects of a short multicomponent exercise program (<4 weeks) on enhancing ill health conditions in post-COVID-19 older adults later in the intensive care units [10]. Such rehabilitation program helps several patients. Another example of this program is early physiotherapy in the ICU patient. The viability of early physiotherapy in the ICU patient with acute respiratory failure secondary to SARS-CoV-2 infection was also improved without any adversarial effects [11].

Among these billions of infected individuals, some have long-term symptoms, which is now a cause of concern. Furthermore, it might cause devastating consequences [12]. After the clearance of the acute infection, several evidences indicate that a plethora of symptoms can remain in many individuals who suffer from COVID-19. This condition of health is presently known as long COVID (LC) or PASC (post-acute sequelae of COVID-19). It is a multisystemic condition that follows a SARS-CoV-2 infection. Mild or asymptomatic SARS-CoV-2 infected individuals, in addition to those with severe infections, have been found to experience long COVID. Multiple organizations have provided definitions for long COVID.

Long COVID was defined by the US CDC as the symptoms that might persist for over 28 days following the initial SARS-CoV-2 infection. Long COVID encompasses many signs, symptoms, and conditions that endure or emerge after an initial COVID-19 infection [13].

Simultaneously, the World Health Organization (WHO) established the long COVID (LC) definition as necessitating the persistence of symptoms for over 12 weeks following the initial infection [14]. According to WHO, approximately 10–20 % of infected individuals may develop long COVID, with over 17 million cases reported in the WHO European Region. Prevention measures include vaccination, mask-wearing, maintaining hygiene, and improving ventilation [15]. The American Academy of Physical Medicine and Rehabilitation (AAPM & R) estimates that approximately 29 million people in the United States live with long COVID by December 2022. Reports indicated that ten to thirty percent of individuals who contracted COVID-19 experienced at least one lingering symptom for up to six months after their recovery. AAPM&R has undertaken various initiatives to support the call for a national strategy to address the RASC infection, which impacts millions of Americans. Not only in millions of Americans, it has affected millions of other individuals in different countries. Davis et al. stated that about 65 million people suffers from long COVID worldwide, and the long COVID cases are increasing regularly [16]. Hence, there is a pressing demand for therapeutics to address long COVID, making it imperative to initiate immediate therapeutic research and clinical trials. A month ago, an editorial published in The Lancet Infectious Diseases asked: Where are the long COVID clinical trials? [17]. However, some clinical trials for long COVID have been initiated occasionally, such as Stanford Medicine’s STOP-PASC, NIH’s RECOVER, etc. Recently, we reported on some of the long COVID clinical trial initiatives through editorials [18]. Thus, it is an urgent need to understand the detailed scenario of the long COVID clinical trials worldwide.

In this direction, the article mapped the total landscape of the long COVID clinical trials worldwide. To understand the total landscape of the long COVID clinical trials, we illustrated the overview and symptoms of long COVID, some significant symptoms and related clinical trials, different challenges, and recommendations for long COVID.