Long COVID is a complex and disabling condition that occurs following a confirmed or probable infection of COVID-19. Symptoms of long COVID typically present around 3 months following the initial infection. While Long COVID appears to be slightly more common in individuals with serious COVID-19 infections, even those with mild or asymptomatic cases can develop Long COVID. 

The symptoms of long COVID are varied and can fluctuate drastically day to day. Common symptoms include fatigue, shortness of breath, cognitive dysfunction or “brain fog”, and more. These symptoms can have a significant impact on one’s ability to function at home, work, and in school. For some, they are no longer able to live alone or require significant help in their daily activities. 

The underlying cause behind long COVID is not fully known, and research is still being done. Other viruses and infections have been shown to cause similar conditions that are broadly referred to as “post viral syndrome”. Common viruses such as mono, Epstein-Barr, and human Lyme disease have been known to cause post-viral syndromes.  Current theories on the cause of long COVID include inflammatory or autoimmune processes, damage to organs from the initial infection, dysfunction of endothelial tissues, or COVID-19 viral proteins. 

It is also not known exactly how many people have long COVID, but the condition is not uncommon. Recent research in Canada has found that up to 30-40% of individuals who did not require hospitalization for their initial infection are still experiencing symptoms 3 months later. In Nova Scotia, 2000 individuals received follow-up calls 12 weeks after their initial COVID-19 infection, and 50% reported having at least 1 persistent symptom.

The treatment and management of long COVID requires a multi-faceted approach, and physiotherapists can play a vital role in helping individuals manage their long COVID symptoms. First, they can screen forpotentially serious side effects of long COVID that affect the cardiovascular, autonomic, and respiratory system. Second, they can provide safe instruction of exercises to build strength and endurance. Physiotherapists can also provide education on pacing and planning activities to prevent fatigue and crashes of energy.  

Below are resources for more information. If you have had a COVID-19 infection 3 months ago or more, you can complete a symptom survey with Nova Scotia Health here. 

·       Government of Canada Post-COVID-19 page: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html
·       Longcovid.physio: https://longcovid.physio
·       My COVID Recovery NS: https://library.nshealth.ca/CovidRecovery


Scotia’s Emily Coolen, PT has a special interest in Long COVID, and is pursuing further knowledge in the management of Long COVID.