How to recover from “Long COVID”
-Marelize Maritz & Adrien Dannhauser
The COVID-19 pandemic has turned life as we know it upside down and doctors, therapist and scientist have worked around the clock to figure out how this virus works and what the long term side effects of COVID are.
What is COVID 19?
COVID-19, caused by the SARS-CoV-2 virus, is a virus that spreads rapidly through airborne particles or through contact with an infected person or contaminated surfaces.
In humans, symptoms range dramatically. Some individuals experience no symptoms, while others (approximately 81%) experience mild-to-moderate illness.
This group of individuals recover well with rest and symptom management, without the need for hospitalisation.
However, some people (approximately 14%) may develop severe ill
ness, which may last weeks to months. These people may develop what is known as “Long COVID”, where symptoms linger for weeks to months after the initial infection. People who develop severe illness usually requires hospitalisation. They usually need support during their recovery, especially in terms
of physical therapy, respiratory rehabilitation, and even mental health support.
Since the virus affects the body in many ways, and may manifest in any part of the body, each individual may experience symptoms that are different and unique to them.
Common symptoms of “Long COVID”
A small group of COVID-19 survivors may experience symptoms that last much longer than would be expected. “COVID long haulers” symptoms vary form individual to individual but some of the common symptoms according to the World Health Organisation (WHO), includes:
- Lung damage
- Heart damage or inflammation
- Conditions affecting blood vessels such as clotting, which increases the risk for heart attack, stroke or pulmonary embolism
- Muscle or joint pain
- Chronic fatigue
- Problems with memory and concentration
- Anxiety, depression or psychological trauma
Even the former Olympian runner Zola Bud reported on social media the other day that her recovery heart rate after running is 4 times slower than usual after a run. Zola said she only experienced mild COVID symptoms.
Researchers are still baffled as to why certain people suffer with long term effects. But what we do know is that people who suffer from long term symptoms need to seek medical care and advice to avoid more serious complications like:
- heart attack
- anoxic brain injury
- Guillain-Barré syndrome
- pulmonary embolism and
- DVT (Deep Vein Trombosis)
What should you do if you still have symptoms after 2 weeks or months down the line?
Physiotherapists around the globe play a huge role in the treatment of COVID-19 patients. They help with the critical care of the ICU patient, as well as helping the patient return to home and now they are playing a huge role in the rehabilitation of COVID long haulers.
COVID rehabilitation focusses on:
Helping someone with long term symptoms or complications:
- Regain their physical capabilities and functionality
- Improve their breathing ability and capacity
- Prevent further complications such as immobility and deconditioning
- Managing fear of symptoms aggravation
- And providing support throughout the journey of recovery
Who may require or benefit from COVID Rehabilitation?
- People who end up spending weeks in the hospital and ICU, especially those who required Intensive care and mechanical ventilation during their hospital stay. Severe respiratory disease that develops during COVID-19 infection may require external support to op
timise or maintain a person’s breathing. However, external support in the form of mechanical ventilation may cause injury to airways. The prolonged immobilisation during the person’s ICU stay also leads to severe loss of muscle mass and deconditioning. It is estimated that approximately 2% of muscle mass is lost daily during ICU stay , with significantly higher rates in people with multi-organ failure.
- Mild COVID-19 survivors that have Long standing symptoms can also develop loss of muscle mass and deconditioning.
What is the aim of Physical rehabilitation:
The aim of physical rehabilitation is to help you resume your daily activities and return to your normal living.
Just Physio will help you to:
- Start moving more, by giving you advice and how and to do so safely.
- Regain your muscle strength and function, and improve your stamina or endurance.
- Develop a personalised and safe exercise plan for you, including aerobic exercise, resistance or strengthening exercises and balance training that is developed according to your unique needs, capabilities and goals.
- Continually re-assess, progress or adjust your program as you move from one stage in your recovery to the next.
A great additional benefit of being physically active and regaining your functional independence is the mental stimulation and joy you will experience. We share the joy of movement with you.
A word of caution
It is important to note that some people may experience post-exertional malaise (PEM), where exercise can temporarily exacerbate symptoms. its therefore important to take rehabilitation slowly with guidance from a physiotherapist. We assist in guiding you through the signs and symptoms of PEM, and can recommend management strategies thereof. We will guide you through each treatment carefully using the 4 Ps of Energy Conservation:
Planning, Pacing, Prioritizing and Positioning. This strategy will decrease any long-term effects that may result in permanent damage to tissues.
The aim of respiratory rehabilitation is to:
- Manage symptoms such as shortness of breath, persistent coughing or wheezing
- Improving lung capacity and function
- Managing complications such as blocked airways or lung collapse
- To reduce the impact lung problems may have on mental health
We achieve these aims through:
- Improving the strength and endurance of your breathing muscles by teaching you breathing control techniques and respiratory muscle strengthening exercises
- Teaching you techniques to assist in clearing mucus from airways
- Ribcage mobility exercises
- Helping you increase your level of activity in a safe way and so improve your ability to breathe better
Give us a call today if you struggle with symptoms of long COVID. Our professional team will take your hand and walk with you every step of the way. Empowering you with effective techniques towards healing and return to quality of life.
You can either visit us at our rooms in Pretoria East of we can help you via Telehealth/Online consultation for your convenience.
 Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Centre for Disease Control and Prevention. JAMA. 2020 Feb 24;323(13):1239-42. doi:10.1001/jama.2020.2648
 Wandrag L, Brett SJ, Frost GS, Bountziouka V, Hickson M (2019) Exploration of muscle loss and metabolic state during prolonged critical illness: Implications for intervention?. PLOS ONE 14(11): e0224565