How might I feel after having COVID-19?

You may find that your symptoms last for weeks or possibly months, especially if you have been in hospital or had severe COVID-19 symptoms.

Here, we are sharing information on how to manage the following symptoms:

1. Ongoing breathlessness

2. Post viral cough

3. Severe fatigue

4. Muscle weakness

5. Difficulties with memory/confusion

It may be more difficult to do the things you are normally able to do, such as housework, having a wash, getting dressed or walking up and down the stairs.

The subsequent sections in this information guide address self-management techniques for the above symptoms.

MANAGING BREATHLESSNESS

Breathlessness happens as it takes longer to empty your lungs. The airflow is slower because the disease makes airways narrower or lungs less elastic.

Stay Calm

When it’s hard to breathe, it’s normal to get anxious, making you feel even more short of breath. That is why it is important to keep your cool.

Make sure you have good circulation in the room by opening a window or door.

Positions to Manage Breathlessness

These positions will help ease your breathlessness and can be used when resting.

Exercises to Manage Breathlessness

 The muscles that help you breathe need to be strengthened, as you recover from your lung infection. These muscles include the diaphragm as well as the muscles in the chest wall.

Start with the following exercise on your own.

Place yourself in a comfortable position (sitting or standing). Look for a large rectangle shape around you that is easy to see fully. This could be a TV, fridge, window or a door.
Visualise along the sides of the rectangle, breathing in while your eyes move along the short side and breathing out while your eyes move along the long side. This will help you breathe out longer than how you breathe in and also pace it.

Breathing Techniques

Slow and controlled breathing with specific types of Pranayam and breathing techniques will help you stay calm. You will feel confident to deal with shortness of breath, when it sets in.

Breathing Control

• Take a slow breath in through your nose
• Relax your shoulders and neck
• Feel the air fill into your lungs: from the bottom of the lungs to the top of your chest.
• Breathe out long from the mouth (as if blowing out a candle).

Pace Your Activities

The essence of Pacing is about ‘listening to your body’. Slow down if necessary or take short breaks if needed, to stay in control and manage breathlessness on a day-to-day basis. Remember a certain level of breathlessness is good for you.

Understand your current energy levels and plan your daily activities accordingly. (Read more about this in the section later on Fatigue)

MANAGING YOUR COUGH

Cough is the one of the most common symptoms for Covid-19. You may have dry cough or you may have productive phlegm.

Managing a Dry Cough

• Stay well hydrated
• Drinking warm water with honey will help soothe throat
• Avoid taking large sips. Take small sips one after the other
• When coughing, if you do not have something to drink handy; then try swallowing repeatedly. This will have the same effect as sipping water.
• Do steam inhalation

Managing Productive Cough

You may find that you have a productive cough and mucus in your lungs after COVID-19.

• Stay well hydrated
• Do steam inhalation
• If cough is bothering you while resting, move to lying to your side. This will help drain the phlegm.

Important: Follow hand hygiene & cough etiquette. Dispose used tissue/ napkin safely, in line with WHO recommended Infection Prevention Control guidelines for Covid-19.

Exercises to help clear your chest

There are exercises and positions that can help you clear your chest. Your doctor or Respiratory therapist may recommend these to you. These are best done under supervision as per the specified dosage and frequency based on the severity of your symptoms.

MANAGING FATIGUE

You may find your energy levels fluctuate from day to day. This may be particularly true for those who have just been discharged from the hospital.

Simple activities may seem difficult, including accessing toilet, having a bath, walking around the house, managing your daily routine among others. Strategies to conserve your energy may be particularly beneficial to manage this fatigue.

If you find your activities of daily living difficult, you may need to consult your doctor or a physiotherapist to complete a structured rehabilitation after assessment.

Understanding your energy levels

National Health Services (UK) uses the following example to help understand how tiring different activities may be for you – to understand the fatigue. This awareness will enable you to manage your energy better.

Choose what you do wisely so you have energy to do the activities that are most important to you.

Sleep is important. Calm yourself and get as much rest as you’d like.

Sleep is important. Calm yourself and get as much rest as you’d like.

MANAGING EMOTIONAL HEALTH

Staying isolated after Covid-19, whether in the hospital or at home leaves you with feelings of regret, resentment, loneliness, helplessness and depression.

Recognize that these are natural after what you have gone through and you are not to blame.

Use phones and video calls to engage with family and friends.

Avoid blue light exposure for atleast 1 hour prior to bedtime by turning off your TV, enabling night shift mode on your mobile or laptop.

Aim for atleast 7 hours of sleep every night.

Relaxation Techniques

Relaxation will help you stay calm, sleep better, control anxiety and reduce overall discomfort.

There are many techniques available to help you stay relaxed. Please explore what suits you. You could choose from Meditation, Music Therapy, Prayer and Art Therapy among others.

Doodling, Mandala art, coloring and reading are some of the many non-exertional hobbies that you can take up. These will help divert your attention and help you stay relaxed.

MANAGING WEAKNESS

To recover from weakness, a right mix of diet and physical activity is required.

Diet after COVID-19

Change of taste and sometimes a complete loss of taste and smell for a period of time is common after Covid-19. However, it is important to eat well in order to recover.

• Staying hydrated is important for your body to function well and even more so when it is fighting infection.
• Our body needs more building blocks (Proteins) to repair cells and enough Vitamins and Minerals to help the recovery process along.

How to get enough?

If this is difficult, your doctor may prescribe a supplement to you. If you need more help, you can refer to a dietitian.

Physical Activity after COVID-19

Spending time in the hospital or being at home with Covid-19 can lead to muscle weakness especially in your legs. This may be hospital acquired or due to lack of activity.

Leading health organisations across the world propose that it is not harmful to get out of breath when doing physical activity. This is a normal response.

However, when you’ve been seriously ill, you may feel differently about things and may respond differently to physical activities too. Practice the following strategies.

• If you are too breathless to talk, slow down to catch your breath.
• Understand your current capability and space out your activities accordingly.
• You might have been given some exercises to do in the hospital by a physiotherapist. Make sure you keep doing these regularly.
• Do not overdo it. Try to increase your activity slowly.

If you are unsure, or want to learn what exercises you can do and how much, contact a physiotherapist. Physiotherapists are best suited to guide you with muscle movements and systematically progress you to get back to normal activities.

Your physical capability will gradually improve. A structured rehabilitation program will make the recovery possible in a safe and timely manner.