Fatigue has remained one of the five most common symptoms of both COVID-19 illness and Long COVID syndrome throughout the pandemic. Tracking hundreds of thousands of U.K. residents via a smartphone app, the ongoing ZOE COVID Symptom Study has shown that 80% of adults with COVID-19 experience fatigue. A recent article in Everyday Health helps long-haulers better understand, and manage, COVID-related fatigue.*

Hard to describe, understand

Unlike other COVID symptoms, however, fatigue can be difficult to describe or to quantify. Sleepiness and having little energy are often involved, but not everyone experiences them the same way. Fatigued people often experience other symptoms such as brain fog, headaches, muscle aches, and poor short-term memory, as well, explains Anita Gupta, M.D. of Johns Hopkins School of Medicine. Dealing with chronic pain can increase stress and sap your energy.

We don’t yet fully understand why COVID-19 causes heavy fatigue in a significant number of people, but there are likely several factors at play, says R. Scott McClelland, M.D., M.P.H of University of Washington School of Medicine. 

One factor is our body’s overreaction to the coronavirus. A flurry of immune molecules called cytokines are released that cause inflammation, leading to fever and tissue death, explains Tania Mucci-Elliot, M.D. of New York University’s Langone Health. Similar to the fatigue felt after a bout of heavy exercise, the fatigue felt after a “cytokine storm” is a natural response. The body needs rest in order to heal.

COVID-19 fatigue particularly intense

People often describe their lingering fatigue from even a mild case of COVID as the worst they’ve ever experienced. McClelland says this is “certainly a unique feature of the illness.” Since COVID-19 affects many organ systems, causing “a remarkable amount of inflammation,” people can be left feeling wiped out as they recover from the infection, and long afterward.

Making matters worse, says Mucci-Elliot, COVID-related mental stress from guilt, fear, and self-blame can trigger even more fatigue.

Pace, Plan, Prioritize

The Centers for Disease Control and Prevention recommends the following to aid recovery:

• Taking over-the-counter nonsteroidal anti-inflammatory medications, like acetaminophen and ibuprofen, for muscle aches and fever
• Staying hydrated by drinking lots of water or receiving intravenous fluids
• Getting plenty of rest

McClelland advises the “3 Ps” strategy to help recover lost energy:

• Pace, rather than push. Exhausting oneself can set back progress. Include periods of rest while performing even small activities such as climbing stairs.
• Plan daily and weekly activities. Consider both times of the day when energy or concentration is lowest and when it is highest.
• Prioritize the most important activities; when fatigued, either put off the non-essential ones or ask for assistance.

What is the recovery period?

While the ZOE Study found that fatigue in most COVID-19 patients lasts about a week or two, the length of time can correspond to COVID severity, says McClelland. Fatigue may last several months in people given intensive care for severe COVID-19.

For people with Long COVID, whose fatigue lasts a month or more after acute infection, McClelland encourages patience. Recovery from fatigue can vary, he says, “but you should expect to get better eventually. I think psychologically it’s good to know that fatigue is something that will go away.”

If symptoms persist or become unmanageable, however, Gupta advises seeking care. She also emphasizes vaccination to reduce the odds of becoming sick or developing severe COVID-19 from a breakthrough infection.

*Upham, B. (2022, February 22). How to Beat COVID-19 Fatigue and Get Your Energy Back. Everyday Health. https://www.everydayhealth.com/coronavirus/how-to-beat-covid-19-fatigue-and-get-your-energy-back