About 7% of US adults report having or having had symptoms of long COVID such as fatigue, heart palpitations and/or dizziness. These are 3 of the 12 symptoms identified as part of the National Institute of Health’s RECOVER initiative that can be reliably used to classify someone as having long COVID.
The good news is that many people experience improvements in their symptoms over time by adopting these strategies, said Andrew Schamess, MD, an internal medicine physician at the Ohio State University Wexner Medical Center and director of its Post-COVID Recovery Program.
1. Pace yourself.
Fatigue and postexertional malaise are 2 of the 12 symptoms used to classify someone as having long COVID.
“There’s mental, or cognitive, fatigue, where people become exhausted after any span of time trying to do complicated cognitive tasks,” said Dr. Schamess. “There’s also general fatigue, or sleepiness, where after a few hours you feel like you could go right back to sleep.”
The third category, he added, is postexertional malaise, where patients are exhausted by exercise, either immediately or up to 24-48 hours later.
That’s where a technique known as “pacing” can help. Pacing is an energy-conservation technique often used among people with other disabling conditions, such as chronic fatigue syndrome, said Ravindra Ganesh, MD, an internal medicine physician at the Mayo Clinic in Minnesota who specializes in long COVID.
“I tell patients that they have to figure out what their energy envelope is, which is the fixed amount of energy that they can use every day without crashing,” he said.
You may be able to handle a daily 30-minute walk, for example, but if you pair it with something cognitively difficult, such as doing your taxes, your fatigue symptoms may flare up.
“It’s hard advice for my patients to follow, as most are real go-getters,” he said. “But I point out to them that if they aim to minimize crashes, it will help them make slow progress.”
Over time, he said, their energy levels should gradually rise so that they can engage in more and more activity.
2. Follow a plant-based, anti-inflammatory diet.
There’s no research to suggest that following a certain eating pattern will help to reverse long COVID, said Dr. Ganesh. But in general, he said his patients anecdotally report that they feel better when they limit refined sugar and follow a plant-based diet that can help to lower inflammation in the body.
“It makes sense, because it prevents dramatic blood glucose changes that can cause their body to crash,” he said. He generally recommends an anti-inflammatory diet like the Mediterranean diet, which is rich in fruits, vegetables, whole grains, and mono-unsaturated fat.
Many people with long COVID take an array of supplements, Dr. Ganesh said, although there’s little research to suggest that they may help. He does encourage patients to take about 2 g of an omega-3 supplement, such as fish oil, as it may help to reduce inflammation associated with long COVID.
He also recommends fisetin, a dietary flavonoid found in fruits such as strawberries and kiwis. Preliminary research suggests that it may help to combat some of the neurologic damage associated with long COVID.
“It appears to maintain mitochondrial function and has anti-inflammatory activities,” said Dr. Ganesh.