How to overcome fatigue after a Covid?

Fatigue is common after an infectious disease. In the case of Covid-19, it is sometimes intense and can last for several months. Some patients have to undergo exercise rehabilitation sessions.

Fatigue persists very frequently after the acute phase of Covid-19 . It is logically found in patients who leave the hospital after having presented a severe form of the disease, but also in some people who have suffered only mild symptoms. “  Six weeks after infection, half of the patients have not regained their full capabilities, ” said Prof. Pierre Tattevin, president of the French-speaking Society for Infectious Pathology. 

Why this post-Covid fatigue?

All infectious diseases can put the body down for several weeks; and this is especially true with Covid-19. “The disease puts a lot of stress on the immune system , which could explain why fatigue is so marked after infection, especially in young and healthy patients initially, whose immune system is very reactive. This fatigue does not surprise us in patients who have been ventilated (placed on respiratory assistance, Editor's note) and who come out of intensive care . It is more surprising in young people who have presented a non-serious form of Covid. We do not see such a situation after the flu, ”observes the infectious disease specialist. 

Is this fatigue any different?

The High Authority for Health (HAS) delivered its recommendations on the management of Covid-longs in February 2021. In this practical document intended for doctors, it describes fatigue as "one of the most prevalent symptoms which can persist throughout of the initial episode of Covid-19 or reappear suddenly after an improvement phase  ”. 

The HAS encourages us not to neglect this seemingly banal symptom, and to seek the cause as much as possible. "We must not put everything on the account of the Covid-19", warns Professor Tattevin who invites patients to talk to their doctor. 

Fatigue on exertion and persistent shortness of breath are common. They can indicate a breathing problem that has not been fixed, or a heart defect.

But other factors can trigger, or worsen, this feeling of exhaustion: non-restful sleep, stress, anxiety, even depression ... 

Why should we fight this fatigue?

In consultation, patients tell their doctor that they “can't take it anymore”. The risk, in this context, is to fall into a vicious circle. When we are exhausted, we remain seated or lying down, we limit our activities. However, the less you move, the more you lose your muscles and breathing capacity. 

After a Covid it is undoubtedly necessary to rest; but without, however, remaining inactive. On the contrary, it is important to regain good physical condition as quickly as possible by strengthening your muscles and increasing your lung capacity. Another advantage is that by practicing physical activity, we regain self-confidence and the body secretes endorphins, anti-stress hormones, which help to overcome anxiety related to the disease. 

What physical activity after a Covid?

This physical activity must be progressive and adapted to the abilities of each individual, for example walking or cycling. You have to train at your own pace, without trying to do too much.

It can be performed at home or under the supervision of a professional. On its site, the Aprèsj20 association , which brings together patients suffering from Covid-long, recommends a gentle Aprèsj20 , to be done at home, developed by the Pitié Salpêtrière hospital (Paris).

For its part, the French Association for Chronic Fatigue Syndrome  (a disease that has many points in common with Covid-long) offers practical advice for better recovery. 

For people who are particularly hampered in terms of breathing, exercise rehabilitation sessions, supervised by a sports doctor or physiotherapist, are necessary. It is, at present, one of the rare treatments of Covid-long validated by the High Authority of Health. “These rehabilitation programs, which start in the hospital but can then be continued at home , are offered to patients à la carte, after having assessed their difficulties: mainly muscle fatigue or breathing difficulties,” explains Professor Tattevin. 

Post-covid fatigue: getting out of the mental fog

Many patients come out of the Covid ordeal with a feeling of "mental fog". They complain of confusion, memory impairment and a lack of concentration . These different symptoms are often exacerbated by the stress and anxiety generated by the disease. 

To overcome these difficulties, some people need genuine psychological support. But most will get by by respecting simple rules of hygiene of life: avoid stimulants such as tea or coffee, ban screens after 6 p.m. to fall asleep more easily, sleep in a cool room, relax. or even meditate if it is possible ...

Most patients who feel exhausted after a Covid will recover within a few weeks. For others, it will take longer. The evolution is often sawtooth, with ups and downs, at a different pace depending on the individual. As such, Professor Tattevin wishes to convey a message of optimism: “It's long, but it always ends up getting better. Do not be discouraged ! "