Long CovidMartynas Zilinskas
What is Long covid and what are the symptoms?
Recently growing evidence from patients’ experience has shown that a significant part of people that suffered from COVID 19 struggle to shake off the unwanted side effects from the disease. These include difficulty breathing, trouble concentrating (brain fog), chest pain, fatigue. Most people report difficulty in engaging with normal activities of daily living and reduced energy levels.
However, long covid is still a fairly unknown condition with no clear diagnostic criteria nor universal management plan (ref).
How long does the long Covid last?
There is no clear answer here. This is very individual.
The British Medic Journal (BMJ) furthermore splits long covid into post-acute covid-19 as extending beyond three weeks from the onset of first symptoms and chronic covid-19 as extending beyond 12 weeks.
What is the treatment for long Covid?
The complexity of needs in some people with Long Covid mirrors the needs of people with multiple long-term conditions who benefit from a holistic, integrated approach rather than symptom by symptom management (ref).
The use of exercise as a therapy in Long Covid is contested. On one hand, many have noted the similarities between some of the symptoms of Long Covid and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) which can include exercise intolerance.
NICE issued a new draft guideline on ME/CFS for consultation in November 2020, recommending that exercise should be personalised and overseen by a physiotherapist or occupational therapist with specialist training and expertise. It recommends that fixed incremental increases in physical exercise, for example, graded exercise therapy should not be used.
Physical activity is a well-established rehabilitation intervention for people who have become deconditioned, including those who have been bedridden for some time. Whilst exercise should be approached with caution in ME/CFS, it may be helpful in other viral conditions(ref).
Exercise tolerance/intolerance should not be seen as a binary concept. A better term might be “symptom-titrated physical activity”. In simple terms, using day-to-day activities as a type of exercise. Pacing activities also is recommended to avoid a boom and bust cycle. (ref)
Useful links and recommendations if you suffer from long Covid
If you have recovered from COVID-19 but are experiencing any of the following symptoms then we recommend you contact your GP in the first instance. We expect the NHS and public health commissioners to make full use of all available resources and capacity across the health sector in England, Scotland, and Wales to fulfill your needs and reduce the long term impact of chronic illness caused by the infectious disease
At the AMR physiotherapy we can help with pacing, light exercises with supervision, soft tissue work and overall education on recovery. All three of us work at the NHS service as well as the private sector. Therefore, we try to provide the best of two worlds – premium and immediate intervention with the NHS values.
The latest information on the Covid-19 vaccination programme in Nottingham and Nottinghamshire can be found here.
In order to help with guiding local healthcare services to provide the best up-to-date care, please consider participating at The Nottingham Recovery from COVID-19 Research Platform (NoRCoRP). It brings together projects examining the impacts and lasting effects of COVID-19. It aims to translate findings from patients who are known to have contracted the virus into new approaches to treatment to support their recovery.