Long COVID rehabilitation can be a long road, especially since we have limited information about this relatively new syndrome. You may have long COVID if you have new or recurring symptoms at least four weeks after your initial diagnosis, and it can last for up to a year. People who develop this disorder typically struggle with fatigue, brain fog, cough, shortness of breath, fever, and other troublesome health concerns. Explore the evidence about strategies that help with long COVID recovery.
11 Evidence-Based Strategies for Long COVID Rehabilitation: What the Research Says About Recovery
1. Pacing Technique for Chronic Fatigue
Research has highlighted the similarities between long COVID and a multisystem autoimmune disease called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The journal Nature Reviews Microbiology reported that a technique called pacing used for ME/CFS therapy also holds promise for treating the fatigue associated with long COVID. You can use the pacing framework to conserve your energy for when you need it most. Journal about your daily activities, noting when you experience exhaustion or fatigue.
This process helps identify your “energy envelope,” the amount of stamina you tend to have each day. Using this information, you can pace yourself to ensure you don’t wear yourself out. For example, don’t plan to run errands on a day when you want to have lunch with a friend. The National Institutes of Health is currently running a clinical trial to look at the effects of pacing on energy and fatigue for long COVID patients.
2. Inhalers and Biologic Treatments for Breathing Difficulties
According to Yale Medicine, inhalers and other asthma treatments can help with shortness of breath and other pulmonary symptoms of long COVID. Researchers have also seen some success in treating long COVID’s breathing symptoms with biologic medications.
These drugs are formulated to target molecules that cause inflammation, which can reduce the severity and frequency of asthma attacks. Your pulmonologist may recommend biologics or inhalers if you have long COVID symptoms that mimic those of asthma.
3. Exercise for Fatigue and Pain
The Yale report also indicates that exercise may resolve fatigue and other symptoms for some people with long COVID. In addition, a study published by the Scandinavian Journal of Medication and Science in Sports found that patients saw improvement in fitness, fatigue, and quality of life after an eight-week program of exercise three times a week.
However, researchers caution that individuals should work closely with their healthcare providers to determine a beneficial amount of exercise. Long COVID can cause post-exertion malaise, which means symptoms get worse after periods of physical activity. A physical therapist can help you modify activities so you can safely and effectively exercise. For example, many people with long COVID do better with sitting exercises, such as cycling.
4. Medications and Therapy for Anxiety and Depression
The physical and cognitive symptoms of long COVID can dramatically impact your quality of life, which increases the risk of mental health disorders such as anxiety and depression. Talk therapy and prescription medications can effectively treat these symptoms if they arise. Support group participation may also help manage the impact of coping with a long-term chronic illness.
A Penn Medicine study published in the journal Cell found that serotonin depletion could contribute to the cognitive symptoms of long COVID. Researchers suggest that selective serotonin reuptake inhibitors (SSRIs) used to treat depression and other mental health conditions may also have benefits for people experiencing the impact of long COVID.
5. Physical Therapy for Pain and Breathing Issues
A professional physical therapist can teach you exercises to reduce pain and improve strength and mobility. If you struggle with breathing issues because of long COVID, you could benefit from pulmonary rehabilitation. This type of physical therapy helps you learn to breathe more effectively and manage symptoms such as shortness of breath.
The journal Diseases published a systematic review of research about physical therapy and long COVID. Study authors found that patients had improved breathing, enhanced quality of life, and less fatigue when they participated in a supervised physical activity program for at least six weeks. Effective programs combine breathing exercises and therapeutic movements. A clinical trial by the National Institutes of Health is also studying the effects of an exercise-based cardiopulmonary rehabilitation program on long COVID symptoms.
6. Good Sleep Hygiene for Insomnia and Daytime Fatigue
A Journal of General Internal Medicine Study reported that 40% of long COVID patients experience insomnia or don’t feel refreshed after a night of sleep. Practicing good sleep habits can help alleviate these symptoms. For example, you may need to cut out caffeine in the afternoon or avoid using screens for a few hours before bedtime. Many people find relief with meditation, mindfulness, deep breathing exercises, and other relaxation techniques.
7. Stellate Ganglion Block for Sensory Loss
Some research shows that a treatment called a stellate ganglion block could restore your lost sense of smell and taste. With this treatment, a doctor injects pain medication into the bundle of nerves in the front of the neck on both sides of the voice box. In addition to reducing pain, this technique also increases circulation and blood flow. Scientists aren’t exactly sure yet why this technique may help people with long COVID who experience sensory loss.
8. Medications for Brain Fog
Long COVID often causes cognitive symptoms collectively known as brain fog. You may experience difficulty communicating, remembering, focusing, or thinking clearly. The Yale Medicine NeuroCovid Clinic treats these symptoms with medications called guanfacine and N-acetylcysteine, respectively used for ADHD and traumatic brain injury. The team is pursuing further clinical trials to investigate the potential widespread use of these drugs for long COVID.
9. Paxlovid for General Long COVID Treatment
Although investigations remain ongoing, some evidence suggests that the COVID drug Paxlovid may also help resolve long COVID. Yale researchers are currently taking blood samples from volunteers who have long COVID to conduct labs before, during, and after administration of the drug. This clinical study will play a valuable role in determining whether Paxlovid could provide relief for some long COVID patients.
10. Prescription Drugs for Hypersomnia
The NIH recently funded $515 million in long COVID research initiatives. One trial will look at the efficacy of the drugs modafinil and solriamfetol to treat hypersomnia in people who have long COVID. These individuals struggle to stay awake during the day and may have trouble sleeping at night. The study participants will take either the study drug or a placebo for eight to 10 weeks.
11. Melatonin and Light Therapy for Sleep Disturbances
In another ongoing NIH study, participants experiencing long COVID-related sleep disturbances will take either over-the-counter melatonin or a placebo for eight weeks. They’ll also be assigned to either high-intensity or low-intensity light therapy, which can potentially help reset the sleep cycle. These treatments can potentially provide relief for the complex sleep issues that often arise with long COVID.
Clinical studies will help us understand more about what causes long COVID and what recovery strategies help people with this condition. The NIH notes that one in nine adults who contract COVID will experience ongoing symptoms for months. If you have long COVID, lifestyle changes and other evidence-based treatments can support your recovery.
