Fatigue after COVID is much more than feeling tired. Here are five tips on what to do about it

How big is a problem?

Because there is no agreed definition of post-COVID fatigue, it is impossible to give exact figures on how many people suffer from it.

Estimates vary widely around the world. A review of 21 studies found that 13-33% of people were fatigued 16-20 weeks after their symptoms started. This is a worrying and widespread problem.

When should I see my GP?

There are many potential causes of fatigue. Even before the pandemic, fatigue was one of the most common reasons to see a GP.

More serious causes can be ruled out when your GP asks about your symptoms and examines you. Sometimes your GP will investigate further, perhaps ordering blood tests.

Symptoms that should be of particular concern include fevers, unexplained weight loss, unusual bleeding or bruising, pain (anywhere) that wakes you from sleep, or profuse night sweats.

If your fatigue is getting worse instead of better, or if you can’t take care of yourself properly, you really should see a doctor.

Is it like a long COVID?

At the start of the pandemic, we realized that some patients had a debilitating cluster of symptoms that dragged on for months, what we now call long COVID.

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Some 85 percent of long COVID patients experience fatigue, making it one of the most common symptoms of long COVID.

However, people who have had COVID for a long time experience a range of other symptoms, such as “brain fog”, headaches and muscle aches. Patients with long COVID therefore experience more than fatigue, and sometimes have no fatigue at all.

Is it like chronic fatigue syndrome?

We knew about chronic fatigue syndromeotherwise known as myalgic encephalomyelitis, long before COVID.

This often develops after a viral infection (for example after an infection with Epstein-Barr virus). So naturally there have been concerns about the coronavirus possibly triggering chronic fatigue syndrome.

There are striking similarities between chronic fatigue syndrome and long COVID. Both involve debilitating fatigue, brain fog, and/or muscle aches.

But at this point, the researchers are still untangle any link between post-COVID fatigue, long COVID and chronic fatigue syndrome.

For now, we know that many people will experience post-COVID fatigue, but fortunately they will not develop long COVID or chronic fatigue syndrome.

1. Go at your own pace: adjust the return to normal activities to your energy level. Choose your priorities and focus on what you can do rather than what you can’t.

2. Resume the exercise gradually: a gradual return to exercise can help you recover, but you may need help managing or avoiding fatigue afterwards. Some therapists – occupational therapists, physiotherapists and exercise physiologists – specialize in this area. So ask your GP for a referral.

3. Prioritize sleep: rather than feeling guilty for sleeping so much, remember that while you sleep, your body conserve energy and heals. Disrupted sleep patterns are an unfortunate symptom of COVID. Having a strict bedtime, while also resting when you feel tired during the day, is important.

4. Eat a range of nutritious foods: loss of smell, taste and appetite due to COVID can make this tricky. However, try to think of food as a way to provide your body with both energy and the micronutrients it needs to heal. Be careful not to spend a fortune on unproven “cures” that often look good in small studies, but more robust research finds make little difference.

5. Monitor your fatigue: keep a diary to monitor your fatigue and look for gradual improvement. You will have good days and bad days, but overall the recovery path should be slow. If you go back, seek the advice of a medical professional, such as your GP.


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