Long Covid: What do we know?

18 September 2020

As the pandemic continues, people are reporting persistent symptoms following a Covid-19 infection. These symptoms can include:

  • Fatigue, weakness and poor sleep
  • Muscle aches
  • Clotting disorders and thrombosis
  • Skin rashes
  • Headaches
  • Mental health problems including depression and anxiety
  • Cognitive difficulties such as difficulty concentrating
  • Liver and kidney dysfunction
  • Other generally recognised symptoms of Covid-19 such as respiratory disorders and changes in taste and smell¹.

These problems have been seen to go on for many weeks and months. In the obviously serious and medical cases, of course doctors will be consulted and advise on treatment. If you’re not sure whether to seek medical help the NHS website has a helpful guide.

In this article, we will focus on fatigue and weakness, symptoms that can be mistakenly attributed to other causes. Particularly in people who haven’t suffered acute symptoms from Covid-19 itself but some weeks later feel persistently fatigued. This has been a typical pattern particularly in younger people². We will look at what we know about it and how to get support.

What do we know about post-viral fatigue?

Post viral fatigue is fairly common and can occur after any viral infection, from a minor virus or flu to more serious illnesses like glandular fever. The large majority of cases are short-term with recovery within a few weeks, but in some cases it can take months.

The main symptom is complete physical and mental exhaustion (different to every day tiredness,) and isn’t dispelled by sleeping. The cause of the fatigue is thought to be the body’s response to fighting an infection, that continues even after the virus is no longer present.

In rare cases, when additional symptoms are present, such as muscular aches and pains, difficulty with balance or standing for long periods, sometimes it is diagnosed as post-viral fatigue syndrome, and a small number of these cases may become ME (Myalgic Encephalomyelitis)/CFS (Chronic Fatigue Syndrome).

Does post-Covid fatigue fit this pattern?

The reported symptoms of people with post-Covid fatigue match this pattern, with extreme tiredness, an inability to resume normal activities, with activity leading to renewed fatigue.

Research so far also agrees that it could be related to the body’s continued response to the virus.

There is past evidence of post-viral fatigue coming about due to novel viruses like Covid-19. Perhaps the closest example is the SARS epidemic of 2003. They have two similarities: both viruses are forms of coronavirus, and they both seem to cause a higher proportion (around 5-10%³) of people suffering from post-viral fatigue than happens with other viruses.

Research is ongoing as more cases of this are reported, so we cannot be certain that the facts won’t change.

How to cope with fatigue?

Post-Covid fatigue is still relatively new and there’s not yet a known and agreed programme of management. Exact symptoms also vary from person to person so there is not just one pattern or rule to follow. The learning from other post-viral fatigues is that good management in the early stages is important in helping natural recovery to take place, to prevent it developing into a more long-term illness.

The reports from people recovering from Covid-19 so far agree with this, saying that they have found they really needed to slow down, and in some cases it has taken a long time before they were able to get back to normal activities⁴.

The recommendations for dealing with fatigue are:

  • The 3 Ps: Pace, Plan and Prioritise, use these principals to ensure you don’t push yourself too far and take good rest between activities
  • Eating well
  • Sleep: the body uses sleep to heal, so try to maximise your quality sleep
  • Maintain your mental well-being
  • Return to work should be taken very gradually.

For more information about these strategies, see the Support Resources below.

If you would like help with how to implement these suggestions in your life, call the Guideposts Information Service on 0800 048 7035. Lines are open Monday to Friday, 9am-5pm, and calls to this number are free.

Support resources

The NHS advice for recovery from Covid-19 includes Your Covid Recovery, an online resource. Although you need to be referred to this programme by a health care professional from your hospital or primary care team, there is useful information freely available on the website.

ME Association leaflet on PVFS following Coronovirus Infection is very thorough and useful. The association has a lot of experience advising people with these symptoms.

Do you have experience of Long Covid?

Have you noticed these symptoms in those you know or do you have them yourself? Is it as described above or different?

If you have personal experience please let us know, so that we can help support more people, by calling the Guideposts Information Service, posting on our Facebook page, or email us at info@guideposts.org.uk.



¹https://www.gov.uk/government/publications/covid-19-long-term-health-effects/covid-19-long-term-health-effects

²https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6930e1-H.pdf

³https://www.topdoctors.co.uk/medical-articles/post-viral-fatigue-covid-19-update-what-we-have-learnt

⁴ https://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/