An estimated 1.1 million people in the UK have experienced ongoing symptoms following infection with COVID-19. “Different groups of people have very different symptoms”, says Dr Toby Hillman, a consultant in respiratory and general medicine at UCLH.
“We are trying treatments based on empirical reasoning, that we reasonably feel could help, because the evidence base is not yet fully formed,” says Dr Paul Glynne, consultant physician and former medical director at UCLH. Many trials are planned or under way, and anecdotal study has found that some things, such as antihistamines, have proven beneficial. Guidelines by the National Institute for Health and Care Excellence (NICE) recognise symptoms of post-COVID-19 syndrome (the official name for long COVID) as those that develop during an infection consistent with COVID-19 and continue for more than 12 weeks.
The key advice is to:
- pace yourself, especially between acute COVID, which can last up to four weeks, and long COVID (from week 12 onwards)
- seek medical help if you are experiencing troublesome symptoms like ongoing breathlessness or chest pains.
While trials are being undertaken, there is a range of private treatments and online advice that may help alleviate some of the symptoms associated with long COVID. While private physicians “may not have the range of specialisms needed to treat a multisystem illness, nor the experience of those in dedicated [long COVID] clinics,” says Dr Hillman, “specialists do have experience with various isolated symptoms such as brain fog, turbulent gut or poor sleep. And these other treatment approaches may encourage a virtuous cycle of recovery.”
Over-exertion is associated with the relapse of long COVID symptoms, explains Dr Hillman. “Pacing is difficult, but if you manage not to ‘overcook’ it when you feel good, you can avoid getting into a boom and bust cycle.”
Many long COVID patients have low carbon-dioxide levels. Breathing programmes, such as that provided at stasisperformance.com, can improve breathing patterns and stabilise symptoms. An Audible audiobook containing breathwork exercises is also available.
Singing or swimming, which Dr Hillman recommends, can both help promote diaphragmatic breathing. He refers some patients to the English National Opera’s Breathe programme, which uses singing techniques to aid recovery.
“One of the most striking symptoms we see following COVID infection is brain fog,” says Dr Hadi Manji, a neurology consultant at UCLH. “Concentration may be reduced or memory impaired; headaches, dizziness and fatigue are also a huge problem.”
“It is as important not to overdo it cognitively as it is physically,” he says, suggesting sufferers ease back to work with one or two half-days a week. While there are no proven treatments as yet, possible diagnostic tests include an MRI of the brain to look for evidence of inflammation or strokes that can occur as a complication of COVID-19. Good hydration is also important.
“Suffering from an unexplained illness is incredibly distressing,” says Dr Hillman. “Approaching this long-term illness without paying attention to the psychological aspect is like going into a fight with one hand behind your back.” A number of studies connect transcendental meditation (TM) with a reduction in symptoms of trauma, anxiety and depression. There are courses and apps available to help develop meditation skills and routine.
“A major barrier to recovery is sleep disruption,” says Dr Glynne. “People think it might be nice to get a good night’s sleep – in fact, it is crucial.” The Pzizz app (free, with in-app purchases) uses musical ‘dreamscapes’ to calm the mind and help you fall asleep.
This page is based on an article written by Rebecca Newman and published in the Financial Times on 5 May 2021.