Millions of people across Europe are living with long COVID, a condition that has the lingering effects of a COVID-19 infection and is having a major impact on people’s lives.
As it is caused by coronavirus, scientists are still learning more about how it is caused - and how to treat it.
One long COVID rehabilitation programme, however, has shown “impressive” results, according to the scientists behind it.
Based on a gradual increase in a patient’s activity, participants were found to have fewer emotional, physical or cognitive “crashes,” as well as a “moderate improvement” in ability to be active, and a better quality of life overall.
Run by the long COVID service at Leeds Community Healthcare NHS Trust and evaluated by clinicians and scientists at the University of Leeds and Leeds Beckett University, the programme’s findings are now published in the Journal of Medical Virology.
Potentially effective treatment option
The researchers said the programme, which involves a supervised increase in physical activity, has the potential to be an effective treatment option for long COVID.
“Long COVID affects around two million people in the UK and it has an impact on their quality of life and in some cases, their ability to work. It is distressing and disabling,” said Dr Manoj Sivan, Associate Clinical Professor in the School of Medicine at the University of Leeds.
“Post-exertional malaise or post-exertional symptom exacerbation or simply "crashes," as described by patients, is a defining and important symptom of long COVID.
“When patients get a crash, they experience feelings of complete exhaustion and wipe out and are unable to resume activities for hours or sometimes days”.
Prior to taking part in the programme, patients reported an average of three of these “crashes” per week. Following the programme, that was reduced to an average of one a week.
“The findings of this research are exciting because this is the first time that crashing episodes have been used as a marker for the condition and a structured pacing programme has now been shown to substantially reduce symptoms and improve quality of life,” said Sivan, who supervised the study.
Gradual return to physical activity
The study, which lasted six weeks, involved 31 people who had the condition. On average, they had suffered from long COVID for around 17 months before entering the programme.
Symptoms included fatigue, brain fog, breathlessness, headaches, and palpitations.
Their gradual return to physical activity followed the World Health Organizations’ (WHO) CR-10 Borg pacing protocol, which goes through five levels of activity.
The first level involved breathing exercises and gentle stretching, in preparation for returning to activity.
From there, the levels increase in intensity until the fifth, which involved activities the patients took part in before becoming ill, such as regular exercise or sports.
The patients were told to stay at each level for at least a week, and had weekly calls with their long COVID clinician to check on their progress
Results were gathered through questionnaires assessing exertion levels and crashes each week.
The researchers found there was a reduction in the number of crashes amongst the patients, and also improvements in activity levels and quality of life.
The biggest benefit in terms of symptoms was seen in terms of reducing fatigue, breathlessness and headaches.
But the researchers said there is still a lack of awareness among clinicians supporting long COVID patients that a paced or gradual return to physical activity could help with recovery.
“This study adds to the current understanding by demonstrating the potential of a structured pacing protocol to gradually improve activity levels,” the study’s authors noted.
“Yet, current advice on safely returning to physical activity without worsening their symptoms is unclear, with patients reporting receiving differing advice from health care professionals”.