COVID-19 has infected almost half a billion people worldwide with just over 6 million deaths. Fortunately, most COVID-19 patients survive especially following complete vaccination. However, some may suffer from what is known as long COVID or post-acute sequelae of SARS-COV2 infection (PASC) whereby fatigue is a predominant symptom affecting as many as 87%.
COVID fatigue may also refer to a person’s emotional reaction to the ongoing pandemic. This could range from anger, exhaustion, frustration, and, feeling fed-up. This is due to the pervasive nature of the pandemic on our daily activities, be it restrictions or changes to our lifestyle. However, in this article, we will be reviewing COVID fatigue as part of the long COVID syndrome.
How long does it take to recover from COVID-19 and what is long COVID-19?
Recovery from COVID-19 illness depends on multiple factors such as age, presence of existing medical conditions including diabetes and heart disease, the severity of COVID-19 illness especially those requiring hospitalization or intensive care, and complications of COVID-19.
Those with mild diseases usually recover in 2 weeks but those with severe illnesses may take months. Symptoms persisting beyond 2 months are called long COVID.
Long COVID may follow asymptomatic, mild or severe illness. It covers a broad range of symptoms from physical to neuropsychological. Some common physical symptoms include cough, breathlessness, chest pain, fatigue, body and joint aches and pains, loss of smell and taste, and difficulty sleeping. Cognitive and psychological symptoms include poor memory and concentration, also known as brain fog, as well as anxiety and depression.
The symptoms of long COVID are debilitating. They affect a person’s functional ability, not just going to back to school or work but also simple tasks such as self-care.
What is COVID-19 fatigue and what are the symptoms?
COVID-19 fatigue is characterised by extreme tiredness, weakness and exhaustion which are not relieved by rest or sleep. Fatigue following viral illnesses has been well described even before COVID-19 such as in chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME).
COVID-19 fatigue symptoms are divided into two - physical and neuropsychological. Physical symptoms include feeling sleepy and tired, exhaustion after simple activities, performing simple tasks poorly or difficulty in multi-tasking, and, performing tasks automatically without thinking. Neuropsychological symptoms include poor memory and concentration, feeling irritable and frustrated, and, being less communicative.
How do I manage COVID-19 fatigue?
Following COVID-19 infection, adequate rest and good sleep hygiene are important to combat fatigue. Strategies to manage fatigue formulated by occupational therapists to manage other chronic illnesses have been adopted in COVID-19 fatigue management. They are called the 3-Ps - pace, plan, and priorities.
Pace means to break down an activity into smaller tasks with breaks in between to recharge. The idea is to avoid exhaustion which will take longer to recover. The plan is to spread different activities throughout the day or week, plus the option to obtain help from family or friends where possible. And finally, to prioritise - what needs to be done today, and what can be postponed.
Relaxation techniques such as mindful meditation and yoga have also been adopted to manage COVID-19 fatigue but their efficacy is unknown.
When should I see a doctor for COVID-19 fatigue?
A doctor’s assessment is warranted when despite the above strategies, the symptoms persist, or are progressively worsening, and affecting the quality of life. A formal evaluation is important because serious complications of COVID-19 can manifest as fatigue.
Your doctor will begin with a series of questions regarding symptoms and functional status, and physical examination followed by relevant investigations such as chest imaging, lung function testing, and ECG. They would also assess for other factors that can worsen fatigue such as medications, deconditioning, muscle weakness, pain, sleep disturbance, mood disorders, endocrine disease, and cardiopulmonary disease.
How is COVID-19 fatigue managed?
The principle of COVID-19 fatigue management is to gradually build up a tolerance and eventually resume activities as tolerated. These activities include self-care such as bathing, dressing, walking, stair-climbing, housekeeping, and finally returning to school or work. Your doctor will formulate an individual plan, or you may work with physiotherapy and occupational therapy to achieve these goals.
A person may start at a different level depending on the severity of their fatigue and escalate as tolerated. Therapy normally begins with breathing exercises, gentle stretching, and light muscle strengthening before aerobic activities.
If a person is unable to progress, they may be enrolled on a formal rehabilitation program. Those with specific cardiac or pulmonary complications of COVID-19 will benefit from formal cardiac or pulmonary rehabilitation.
Conclusion
COVID-19 is a new illness, and we are learning more and more each day regarding its recovery process including long COVID. So far, research has shown that long COVID tends to be less severe in vaccinated versus unvaccinated individuals.
As with any illness, prevention of COVID-19 infection and therefore long COVID is important. Strategies such as masking, social distancing and practising hand hygiene remain paramount even with widespread vaccination.
This article is written by Dr Liza Ahmad Fisal, Internal Medicine at Pantai Hospital Cheras (PHC).
Disclaimer: You are not allowed to share this article on any other website or on Facebook without providing proper credit and the original article link on theAsianparent Malaysia website
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