Post Covid-19 Syndrome (Long Covid)

There is mounting evidence of prolonged symptoms following Covid infection, including profound fatigue, ongoing breathlessness, fluctuating symptoms, or disabling anxiety. NICE guidelines have been published, which we adhere to, regarding the intervention required for those suffering from long Covid which it defines in this way:

• Acute COVID-19: signs and symptoms of COVID-19 for up to 4 weeks.

• Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from 4 to 12 weeks.

• Post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks, and are not explained by an alternative diagnosis.

There are many people who have had COVID-19 who have now been diagnosed with Post Covid-19 Syndrome or Post-Viral Fatigue Syndrome (PVFS). At Vitality360 we regularly treat people with PVFS caused by a wide range of infections and illnesses, such as Epstein-Barr virus (Glandular Fever).

We feel we are very well placed to work skilfully and collaboratively with clients and to offer them the reassurance of having an experienced clinician walk beside them as they get back on their feet and resume their lives. In the meantime, we can keep an open mind, design studies, take an active interest in outcomes (negative as well as positive), keep updated with research, and share ideas generously with other professionals. But most importantly, remind ourselves that whilst we don’t know the answers yet, we can proceed confidently utilising the wide-ranging therapy skills that we possess in service of those detrimentally impacted by this novel illness.

Read more from our clients on our programmes with Covid-related post-viral fatigue & The NICE rapid guidelines (Nov 2021) on managing the effects of long term Covid.

Rather than a one-size-fits-all approach, we consider each individual’s presentation: their specific symptoms and how these affect their activity levels and overall wellbeing.

Fatigue can interfere with every aspect of day-to-day life, so learning how to cope with it, and feeling confident with helpful strategies, may help to reduce its impact.

We are now successfully supporting those with long Covid to return to work through our early intervention referral processes, and for those with symptoms that have been going on a year of more we offer a rehabilitation programme.

84% success with return to work (actual and predicted) with our Early Intervention Programmes.

Firstly, specialist fatigue clinicians are well trained in biopsychosocial assessment and are able to assess people broadly. These assessments take into account:

• the medical and biological factors of any condition (such as medical history and test results)

• psychological factors (such as recovering from the ordeal of being ill, or fears about returning to work)

• social issues (e.g. financial stressors and stigma)

Secondly, we are highly experienced in working collaboratively with clients: working in a way that allows for mutual decision-making and direction-finding, listening, and caring about their journey.

Thirdly, we are experts in the management of fatigue which is often accompanied by other chronic symptoms (such as pain, poor sleep, low mood, headaches). We work within a clear rehabilitative structure involving evidence-based therapy tools such as:

• establishing helpful routines

• activity analysis

• setting realistic goals

• activity management to maximise everyday function and minimise symptomatic response.

Fatigue can interfere with every aspect of day-to-day life, so learning how to cope with it, and feeling confident with helpful strategies, may help to reduce its impact.

Our early intervention programmes have seen improvements in fatigue, breathlessness, anxiety, pain, depression and overall health.

84% of those on our early intervention programmes have returned to work or are predicted to.

The number of people with Post Covid-19 Syndrome symptoms beyond 12 months is 1.5 million (2.4% of the population (2021)).

Early studies into Post Covid-19 Syndrome symptomatology suggest many overlaps with clinical presentation of ME/CFS. An estimated 10% of patients with Covid-19 may develop chronic illness meeting the definition of ME/CFS.

In our experience there are some similarities such as extreme fatigue, cognitive dysfunction and joint pain. There are also some key differences too, such as respiratory issues such as persistent cough or hoarse voice that are particular to those with Post Covid-19 Syndrome.

We are able to utilise our expertise to support people with these ongoing symptoms in our assessments and recommendations.

Most people who experience prolonged fatigue after an infection will make a full recovery. However, some people will go on to experience significant fatigue for a long time (a year plus) and may also develop lots of additional symptoms alongside the fatigue. In a small number of people, post-viral fatigue can develop into a longer-term or chronic illness known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

For detailed advice see our blog and this article from the British Medical Journal Management of post-acute COVID-19 in Primary Care

Our Specialist dietician offers her perspective and advice here.

It is variable depending on presenting symptoms and the nature of the job. We would recommend negotiating a graded return with your employer, and we can help by writing a personalised return to work plan if required. Please see our blog written by our Specialist Career & Employment Consultant.

It’s very important that this is done in a gradual, timely and appropriate way, and according to the particular situation of each person. Read our blog by one of our Specialist Physiotherapists for some general recommendations.