Long COVID Recovery: Improve Your Quality of Life

Tips to Improve Quality of Life with Long COVID  

The term "long COVID” —also called "post-COVID syndrome"— encompasses a set of symptoms that persist or appear after the acute phase of SARS-CoV-2 infection, beyond the initial 12 weeks. Although many patients fully recover within a few weeks, a considerable proportion—estimated between 10% and 30%—continue to experience multifactorial ailments that impact their quality of life, work capacity, and emotional well-being.  

Understanding this phenomenon is essential to offer a comprehensive and personalized therapeutic approach. Therefore, if you have suffered from COVID-19 and experience fatigue, difficulty breathing, brain fog, or other symptoms, schedule an appointment at Mitogenesis for a comprehensive evaluation and to receive the best treatment with a holistic approach.  

Epidemiology and clinical definition

• Duration: Long COVID is defined as when symptoms last more than 12 weeks after the onset of the infection and are not explained by another underlying condition.  

• Prevalence: In population follow-up studies, up to 1 in 4 patients who had COVID-19 present at least one symptom extending beyond three months.  

• Risk factors: Severity of the initial infection, pre-existing comorbidities (obesity, diabetes, COPD), female sex, advanced age, and elevated levels of inflammatory markers in the acute phase.  

Sometimes, its presentation is like the symptoms of other conditions, which makes diagnosis difficult if the appropriate tests are not conducted.  

Although the exact cause is still under investigation, it is believed that factors such as prolonged inflammation and immune system dysfunction may play a fundamental role. Therefore, it is necessary to receive comprehensive treatment that addresses all factors, both internal and external.  

Clinic: symptoms and manifestations

Long COVID is characterized by the presence of symptoms that persist or appear after the initial recovery from SARS-CoV-2 infection. The symptoms vary significantly in intensity and duration and can affect one or multiple systems of the body.  

• Post-exertion fatigue: disproportionate exhaustion after daily activities, slow recovery over days.  

• Mental fog: attention difficulties, slow processing, frequent forgetfulness.  

• Dyspnea and tachypnea: sensation of shortness of breath even with minimal exertion, shallow breathing.  

• Musculoskeletal pain: diffuse myalgias, migratory arthralgias, often with morning stiffness.  

• Mood disorders: anxiety, reactive depression, and post-traumatic stress disorders in those who are required hospitalization.  

• Sleep disorders: sleep-onset insomnia, sleep fragmentation, and feeling of not having rested.  

• Gastrointestinal symptoms: intermittent abdominal pain, nausea, diarrhea, or constipation.  

• Dermatological manifestations: erythemas, "COVID hands and feet" (acral lesions).  

Diagnosis and complementary tests  

The diagnostic approach is based on clinical history and the exclusion of other diagnoses. They can be used:

1. Basic laboratory. Basic laboratory. The basic laboratory tests include a complete blood count, general biochemistry, inflammatory markers (CRP, IL-6), and thyroid function.  

2. Respiratory tests. Spirometry with flow-volume curves, DLCO (carbon monoxide diffusion), and a 6-minute walk test.  

3. Cardiovascular evaluation. Echocardiogram, 24-hour Holter monitor, and tilt-table test if there are symptoms of dysautonomia.  

4. Neurological studies. Neurological studies. These studies include neuroimaging (brain MRI), neuropsychological evaluation, and processing speed tests.  

5. Assessment of body composition and exercise. The assessment focuses on both body composition and exercise. The Cardiopulmonary Exercise Test (CPET) uses bioimpedance to identify muscle mass and fat.  

Management plan: essential strategies  

If you have already been diagnosed with long COVID, in addition to receiving comprehensive treatment at a specialized clinic like Mitogenesis, there are several strategies you can apply to manage your day and improve your quality of life.  

1. Energy conservation (pacing)  

It is essential to learn to manage daily energy to prevent the worsening of symptoms. The "pacing" technique involves balancing activity and rest, avoiding overexertion, and allowing for gradual recovery.  

• Daily planning: Distribute tasks in 20–30-minute blocks with equivalent active breaks.  

• Symptom diary: recording levels of fatigue, pain, and dyspnea to adjust the progressive load.  

• Activity limits: Identify the daily "energy ceiling" and respect it to avoid relapses.  

2. Improving sleep patterns Improvement of sleep patterns  

Maintaining a regular sleep routine and creating a conducive environment for rest can significantly improve sleep quality. Exposing oneself to natural light during the day and avoiding the use of electronic devices before sleeping is recommended practices for resting properly.  

• Sleep hygiene: consistent schedules, avoid screens and blue light 1–2 hours before bedtime.  

• Conducive environment: cool, dark, and quiet bedroom; ergonomic mattress and pillows.  

• Behavioral therapies: cognitive-behavioral therapy for insomnia (CBT-I) in persistent cases.  

3. Multimodal physical rehabilitation  

Conduct periodic activities that help strengthen the entire body and activate the essential systems for recovery.  

• Gradual exercise: physiotherapy with low-impact exercises (tai chi, therapeutic Pilates, swimming).  

• Respiratory training: thoracic expansion exercises, inspiratory muscle training with a resistance device.  

• Occupational therapy: adaptation of domestic and work tasks, use of technical aids.  

4. Nutrition and supplementation  

A balanced diet and adequate hydration are essential to support the immune system and overall recovery. It is suggested to follow a diet rich in fruits, vegetables, lean proteins, and whole grains, avoiding ultraprocessed foods. Always remember to follow your doctor's recommendations and not to add or remove any food from your diet without proper guidance.  

• Anti-inflammatory diet: abundant in fruits, various vegetables, whole grains, blue fish, and nuts.  

• Balanced macronutrients: Distribute low glycemic index carbohydrates, lean proteins, and monounsaturated fats.  

• Hydration: at least 1.5–2 L of fluids per day, preferably electrolyte waters on days of excessive sweating.  

5. Mental health and mind-body  

Practicing relaxation techniques such as meditation, deep breathing, and yoga can help reduce stress and improve emotional well-being. These practices can be beneficial for managing anxiety and depression associated with long COVID.  

• Mindfulness and meditation: daily practices of 10–20 minutes to reduce anxiety and improve stress control.  

• Psychological therapy: support in mourning the loss of health and addressing anxious or depressive symptoms.  

• Relaxation techniques: diaphragmatic breathing, progressive muscle relaxation, and biofeedback.  

Advanced and comprehensive approaches with professional orientation  

Some patients may benefit from pulmonary rehabilitation programs, occupational therapy, and physiotherapy to address specific symptoms. It is crucial to consult healthcare professionals to develop a personalized care plan. Collaboration with doctors, nutritionists, and therapists can provide a comprehensive approach to managing symptoms and improving quality of life.  

Long COVID requires a comprehensive approach that combines energy conservation, physical rehabilitation, nutritional support, and treatment of psychological components. The coordination between doctors, physiotherapists, psychologists, and occupational therapists is key to achieving sustainable improvements. Mitogenesis proposes a personalized program, based on evidence and with continuous follow-up, to restore the functionality and overall well-being of each patient.  

Schedule for an appointment at Mitogenesis

If you are dealing with persistent symptoms after having COVID-19, you are not alone. At Mitogenesis, we offer an integrative approach to help you on your path to recovery. Contact us for more information about our services and how we can support you.

Sources:

A clinical case definition of post-COVID-19 condition by a Delphi consensus (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00703-9/fulltext)

Post-acute COVID-19 syndrome (https://www.nature.com/articles/s41591-021-01283-z)

COVID-19 rapid guideline: managing the long-term effects of COVID-19 (https://www.nice.org.uk/guidance/ng188)

Clinical Overview of Long COVID (https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html)

Reviewed by:

Dr. Mel Schottenstein

Naturopathic Doctor

NMD, MBE, MScN, FICT, FSCT

Disclaimer: The information in this article is provided for informational purposes only and is not a substitute for the advice of your physician or other health care professionals. Do not use the information to diagnose or treat a health problem or disease. Always consult with a healthcare professional before taking any medication or nutritional, herbal, or homeopathic supplement, or using any treatment for a health problem.

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