Long-term effects of COVID-19 (long COVID)

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During your recovery from any illness, including coronavirus (COVID-19), you may experience fatigue. Fatigue affects what you’re able to do.

As well as for moving around, you also use energy for:

  • concentration
  • attention
  • problem solving
  • talking
  • making decisions

Fatigue means you have less physical, mental and emotional energy to do these daily activities.

Coping with fatigue

There are ways to help you manage fatigue.

Conserving energy

During your recovery, you may wish to use your energy for things that are important to you. The Royal College of Occupational Therapists have advice on conserving energy. You can use the ‘3 Ps’ to do daily tasks so you have more energy throughout the day:

  • plan
  • prioritise
  • pace

Plan your day and prioritise your activities

Try to break your day into small parts and set easy goals to begin with. Rest between activities and only do what you feel able to do.

You can keep a daily activity diary, where you write down each activity you’ve completed. This lets you track your energy levels and avoid activities that cause setbacks.

Remember to include mental and emotional activities in your activity diary. This can help you plan ahead and prioritise what is important to you.

Pace yourself

Try to avoid doing lots of things one day and then nothing the next few days. Instead, pace yourself and spread out what you’re doing during the week. It’s normal for your energy levels to be different on different days.

If you feel more tired and unwell when you try to build up your activity, do not keep increasing it. Instead, work with what you’re able to do without increasing your fatigue.

Dr Amy Small’s story

Learn about how Dr Amy Small used pacing in her day-to-day tasks to help manage fatigue.

Post-exertional malaise (PEM)

Some people with long COVID experience extreme fatigue, especially after exertion. This is known as post-exertional malaise (PEM) or post-exertional symptom exacerbation (PESE). PEM is feeling unwell after physical, emotional, cognitive or social activity. Activities that you could once manage may now exhaust you. PEM symptoms can:

  • worsen 12 to 72 hours after the activity
  • last for days or weeks
  • sometimes lead to a relapse
  • make other symptoms (such as muscle aches, brain fog, headaches or fatigue) worse

It can help to:

  • manage your energy (pacing) and activity
  • get good rest
  • balance rest with activities

Move around

It’s important to avoid sitting in one position for too long. Get up each hour to have a stretch or get a glass of water.

Remember to use any walking aids you need.

Speak to your GP practice if:

  • your fatigue is not improving
  • you’re worried about your symptoms
  • you’re worried about possible long COVID symptoms in a child or young person under 18

Last updated:
27 November 2023

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