Link Between Post Covid Syndrome and Fatigue

Everything You Need to Know About Post-Covid Fatigue

While COVID-19 is a short-lived disease in most people, others experience lingering symptoms, including fatigue, for months after their first infection. So what should you do if you are suffering with post covid fatigue, following COVID-19 or a different virus?

Many of us are currently aware of the idea of “prolonged COVID-19”, a persistent post-covid disease which might follow COVID-19 infection. Most people who contract the coronavirus heal within two to three weeks. Although, we now know there is a subset of patients for whom that is not the case.

The British Medical Journal describes 'long COVID' as "disease in people who have either healed from COVID-19 but are still reporting lasting effects of the infection or have had the typical symptoms for far longer than would be expected". However, we do not know exactly how many people it applies to, the total could be as high as one in ten infected persons.

As mentioned in the UK's COVID-19 symptoms application data, approximately 300,000 people in the UK have reported symptoms that have persisted for more than a month. More than 60,000 (1.5% of the study participants) remained symptomatic after 3 months.

What is post-covid fatigue?

While many of these 'long truckers' suffer only mildly, others experience a series of debilitating symptoms, including shortness of breath, muscle aches and a persistent cough. One of the most common long-term symptoms is excessive fatigue or exhaustion.

Post-viral fatigue is completely different to 'regular' tiredness. As well as total exhaustion, people with post-covid fatigue feel usually unwell. This is sometimes found in patients who are recovering from other viruses, such as the flu or mumps. Add to this unexplained muscle and joint pain, poor concentration, sore throat, headaches and inflamed lymph nodes and it is hardly surprising it could be extremely debilitating.

Unfortunately, anybody could be affected by the long-term effects of the coronavirus - whether or not their first infection was serious.

What causes it?

The trigger for post-covid fatigue looks like a reaction to the virus itself and the symptoms are very similar, or identical, to those of people with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME). Sleep is non-restorative, you do not wake feeling at all refreshed, and the tiredness could intensify after very minor mental or physical exertion.

Although, while the factors which cause a patient to have myalgic encephalomyelitis (ME) are sometimes impossible to identify, post-covid fatigue always manifests after suffering from a virus. Specific viruses, like coronavirus, rubella and HIV, are more likely to cause post-covid fatigue than others.

It is possible that many more or possibly even all cases of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) are also caused by the body's reaction to a viral infection, but the virus has not been identified.

We are not quite sure why post-covid fatigue can happen. Though it may be related to the body's immune response to the first infection. When you are fighting off a virus, the immune system releases chemicals known as cytokines, which promote swelling and cause many of the classic symptoms of viral infection (for example, tiredness, aches and pains, malaise).

This is part of its frontline attack on the invading virus, and generally it stops once the virus itself has been dealt with. But recent studies recommend that in some cases, cytokine levels fail to return to normal, causing permanent symptoms.

Other reasons for post-covid fatigue might include swelling of the nervous tissues, or an individual's own unusual response to the virus which has remained inactive within their body for some time, says Jarvis.

How to alleviate symptoms

So what should you do if you are suffering from post-covid fatigue? While there are no exact treatments, there are many things you could do to relieve your symptoms and aid your recovery.

Taking over-the-counter pain relief medication like paracetamol might help relieve any lingering pain. By managing pain, you might also be able to improve the quantity and quality of your sleep at night, thereby lowering fatigue throughout the day. Going to bed at the same time each night and setting your alarm for the same time each morning will help your body slowly relieve itself into a sleeping schedule.

While resting throughout the day is crucial, too much rest could actually cause sufferers to feel more fatigued. It is sensible to take small, repeated naps during the day, if you feel exhausted, rather than sleeping for several hours at a time.

For many conditions, including depression and cancer associated tiredness, exercise could actually improve tiredness. Although, if you have post-covid fatigue it is crucial to take things very gently - as we have heard, in some people even minor physical exertion could cause rebound worsening of fatigue.

What to do if you are worried

Recovery from post-covid fatigue could vary a lot from one person to the next. Some people come back to normal in one or two months, while others have symptoms that last for years. Although, there is some evidence to recommend that getting an early diagnosis might improve recovery.

If you are worried you might be suffering with 'long COVID', or that you have developed a disease similar to chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), it is crucial to speak with your primary care physician as quickly as you can. They could investigate further and, if required, refer you to specialist services. The National Health Service (NHS) has recently set up the Your COVID Recovery programme, but while there is extensive advice on their website, there are as yet few clinics where personalized treatment could be provided. In addition, some patient groups criticised the website for setting unrealistic goals for exercise and activity.

Although, the number of National Health Service (NHS) clinics is slowly increasing and they might be able to offer a more customized approach to recovery than the more general advice on the Your Covid Recovery site.

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