Am Fam Physician. 2022;106(5):online
Related article: Long COVID: Rapid Evidence Review
What is long COVID?
A wide range of new, returning, or ongoing health problems may happen four or more weeks after getting COVID-19. These health problems are sometimes called long COVID.
What are symptoms of long COVID?
You may have one or more of the following symptoms:
Trouble breathing or shortness of breath
Tiredness or low energy
Symptoms that get worse after physical or mental activities
Trouble thinking or concentrating (sometimes called brain fog)
Chest pain or chest discomfort
Fast-beating or pounding heart
Joint or muscle pain
A tingling, pins-and-needles feeling
Dizziness when standing (light-headedness)
Change in smell or taste
What should I do if I have long COVID?
Ask for support from family and friends. Your symptoms might come and go, and they could take months to get better. Be sure to let your family and friends know you may need a lot of help for a while.
Many people find that joining a support group is helpful. The following are support groups for people who have long-term effects of COVID-19:
Body Politic: https://www.wearebodypolitic.com/covid-19
Survivor Corps: https://www.survivorcorps.com
Long COVID Alliance: https://longcovidalliance.org
Long COVID Kids: https://www.longcovidkids.org
How is long COVID treated?
Breathing exercises can help if you have lung problems. Do one or more of the following exercises five to 10 times a day and whenever you feel short of breath:
Belly breathing: Lie flat on your back. Place one hand on your stomach and the other on your chest. Expand (push out) your stomach, but not your chest, while breathing in for four counts. Breathe out for four counts (you will feel your stomach go back down).
Pursed-lip breathing: Sit down and relax. Breathe in through your nose for two counts. Form a tight circle with your lips, and blow out slowly for four counts.
Boxed breathing: Breathe in for four counts, hold your breath for four counts, breathe out for four counts, and hold your breath again for four counts.
Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises
Pulmonary Wellness Foundation: https://www.pulmonarywellness.org/covid-bootcamp
Stasis smartphone app: https://www.stasis.life (free version available)
TROUBLE THINKING (BRAIN FOG)
Trouble thinking is a common symptom after COVID-19. Be patient and slowly return to school or work while your brain recovers. Take as many breaks as you need. You’ll need to balance rest with mental activity.
National Health Service England: https://www.yourcovidrecovery.nhs.uk/i-think-i-have-long-covid/effects-on-your-mind/memory-and-focus
LOW ENERGY OR TIREDNESS
Getting better after any illness, especially after COVID-19, can make you more tired than normal. Thinking tasks can be just as tiring as physical tasks. The most important thing is to listen to your body. Use an easier pace, and plan ahead for rest time. Make sure you rest before you get tired.
Try the four P’s:
Plan your activities for the day and week ahead of time as much as possible. Set up your work area so you don’t have to use extra energy trying to complete something. Plan rest times throughout the activity.
Pace yourself. Break larger tasks into smaller, easier steps. Try to rest for five to 10 minutes each hour.
Prioritize the most challenging activities of the day so that they are done when you have the most energy.
Position and posture are important. Sit down to work when you can. Practice deep breathing exercises while you work to help you stay relaxed and get more air into your lungs.
Homerton University Hospital: https://www.hackneycitizen.co.uk/wp-content/uploads/Post-COVID-19-information-pack-5.pdf
Royal College of Occupational Therapists: https://www.rcot.co.uk/conserving-energy
Dysautonomia (dis-saa-tuh-NO-mee-uh) is when your nervous system (brain, spinal cord, and nerves) has trouble working properly. This can make your heart race, cause dizziness, or make you tired.
Lifestyle changes like eating more salt, staying hydrated, and eating smaller meals more times a day can help. Sometimes medicine is needed.
Dysautonomia International: https://www.dysautonomiainternational.org/page.php?ID=36 and https://www.vimeo.com/442593497
CHANGES IN SMELL OR TASTE
Ongoing changes in smell or taste often happens after COVID-19. Smell retraining exercises can help you get your smell back.
Fifth Sense: https://www.fifthsense.org.uk
Keep a diary to track what causes your headaches, how often you get them, and how painful they are. This can help you avoid things that trigger your headaches. Do not take over-the-counter pain medicine like acetaminophen (brand names: Tylenol, Excedrin) or ibuprofen (brand names: Advil, Motrin) for more than 10 to 15 days per month.
National Health Service England: https://www.yourcovidrecovery.nhs.uk/i-think-i-have-long-covid/effects-on-your-body/headache-2/
BODY AND MIND
Eating well, managing stress, moving your body, and getting enough sleep are the most important things you can do to help with long-term COVID-19 symptoms.
Exercise can help your body and mind feel better. Talk with your doctor about the right level of activity before getting started. The wrong kind or amount of activity can make your symptoms worse.
Sleep helps with physical, emotional, and brain health. Sleep can be more difficult if you have long COVID, but you can take steps to help you sleep better. For example, follow a bedtime routine, and make sure you have a comfortable and quite place for sleeping.
National Health Service England: https://www.yourcovidrecovery.nhs.uk/your-wellbeing/sleeping-well
Sleep Foundation: https://www.sleepfoundation.org
U.S. Department of Agriculture: https://www.nutrition.gov
Many people recovering from COVID-19 have anxiety, depression, and panic attacks. If you are worried about your mental health, talk to your doctor. Therapy, medications, and other solutions can be helpful.
Where can I get more information about long COVID?
Centers for Disease Control and Prevention: Caring for People with Post-COVID Conditions
National Health Service England: Your COVID Recovery
RECOVER: Researching COVID to Enhance Recovery