Long Covid

Overview

The World Health Organisation (WHO; 2021) defines long COVID as a condition occurring “in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.” This condition requires careful management to enable individuals to return to their daily activities.

Physical Activity & Long COVID

Since long COVID is a new condition, specific treatment methods do not exist as of yet and so it has required a transfer of knowledge from other conditions that have similar symptoms including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and pulmonary conditions like chronic obstructive pulmonary disorder (COPD). 

Symptoms of long COVID can make daily tasks, such as doing the washing or walking up the stairs, really difficult for individuals with the condition. Fatigue, characterised as debilitating exhaustion, is a symptom of various health conditions including CFS/ME, COPD, cancer, cardiovascular diseases (CVD), and type 2 diabetes. Fatigue is extremely common following viral infections such as COVID-19 and whilst it usually settles within 2 to 3 weeks, it appears to linger for weeks or months in those suffering from long Covid. Experiencing these high levels of fatigue can be extremely debilitating, with the impact spanning a variety of domains across work life, social life and general wellbeing.

During recovery from COVID-19 and long COVID, physical activity is important to help relieve ongoing symptoms, restore the body to its healthy condition, and help people get back to their normal routine, which includes daily activities at home and at work. WHO recommend that, during their rehabilitation, people should be provided with the education and support to improve self-management, reduce breathlessness and resume everyday activities. As such, the management of long COVID needs to be tailored to the individual, accounting for their own experience of symptoms.

The Benefits of Physical Activity for Long COVID

Respiratory Symptoms:

It is known that inactivity is detrimental to patients with a respiratory diagnosis. The respiratory symptoms present in COVID-19 and long COVID overlap with COPD, in particular shortness of breath which can occur doing daily tasks.

In the context of COPD, physical activity has numerous benefits, including:

  • improving breathing and respiratory muscle strength
  • reducing other symptoms of COPD
  • benefitting mental and physical wellbeing, and quality of life.

Many people find being active helps them more than inhaled drugs.

Fatigue:

Managing fatigue is to ensure those experiencing long COVID retain the highest quality of life throughout their recovery. Physical activity plays an important role in management of fatigue, optimisation of energy levels, and improvement in quality of life.  However, the consensus in the literature is that focus should be on optimising physical activity rather than increasing it through techniques like pacing, activity management, sleep management and relaxation techniques.

How do we Help Long COVID?

KiActiv® Health is a digital service that provides people with a personalised understanding of their everyday physical activity to empower behaviour change in the context of their health and capacity, enabling people to make the right choices for them.

In the context of fatigue, understanding how physical activity impacts on energy balance and how to maintain a level of movement within their energy envelope, is key to self-management. Crucial to this understanding is that physical activity is more than just exercise and sport, and that every move you make counts. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure and, as such, it is important that all of the movement in our lifestyles are accounted for – not just exercise.

Indeed, for many people living with symptoms of breathlessness and/or fatigue, physical activity is something that is often dreaded or feared, and there is a common misconception that for physical activity to be valuable it must be vigorous. As such, understanding that physical activity is more than just exercise and sport, and that every move matters, is vital for empowering effective self-management. Focusing on movements they enjoy or feel comfortable with, and learning how to pace themselves, can help alleviate fear and deliver the numerous benefits of physical activity and promote self-care.

Moving away from exercise to personalised, everyday physical activity is essential in the management of fatigue, as it opens the therapy window to ~112 hours/week. It acknowledges that every individual is unique and that their symptoms will present differently, including how different activities impact their symptoms, as well as finding enjoyment in different activities.

Here at KiActiv®, we have worked with patients who have been hospitalised with COVID-19 and those diagnosed with long COVID to ensure patients have a smooth recovery and empower individuals to self-manage their health and gradually improve their physical activity in a personalised way.

Importantly, by providing individuals with the knowledge, tools and support to self-manage, they can ensure they take it at their own pace, incorporating more activities into their daily routine as they feel ready, unlocking the numerous benefits to their health beyond recovery from COVID-19 and/or long COVID.

Client Quotes

“KiActiv has helped me to set boundaries of activity I can manage to do without adverse effects. I am feeling more at ease with my limitations.”  –  64, Female, COVID-19 Rehabilitation  

“I found the programme to be very useful in monitoring the progress of my recovery. I have been able to set achievable goals and the programme enables me to check how well I am doing in achieving these targets. This, in turn, gives me the motivation to increase my activity levels.” 67, Male, COVID-19 Rehabilitation

“I became aware that the stuff I do sitting down makes a difference, like when I dance along to my music.” 46, Female, COVID-19 Rehabilitation  

“When I first came out [of hospital], it was a struggle to walk up the stairs, now I can as much as a I want.” 46, Male, COVID-19 Rehabilitation

“The KiActiv® Health programme empowers/encourages one to stay active once the 12-week course has finished. The programme has helped me manage my muscle pain and other symptoms of Long Covid. It has also been helpful to have someone willing to listen to you and encourage one to keep going. One of the things I have learnt from this, is that it is about pacing oneself and not pushing yourself too much so that you do not create more issues for yourself.” – 58, Male, COVID-19 Rehabilitation & Type 2 Diabetes