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What Causes COVID-19 Fatigue?
Fatigue is associated with many illnesses, says R. Scott McClelland, MD, MPH, professor of medicine, epidemiology, and global health and clinical attending physician in infectious diseases at UW Medicine in Seattle. “What it is about COVID-19 specifically that causes a substantial amount of fatigue for a large proportion of people isn’t completely understood; it’s likely a combination of several factors,” says Dr. McClelland.
One of those factors is the body’s immune response, says Tania Mucci-Elliott, MD, an infectious diseases specialist and clinical instructor of medicine at NYU Langone Health in New York City. “With COVID, the immune system goes into overdrive, releasing chemicals called cytokines that trigger inflammation, fever, and tissue death,” she says.
After this type of stress response, your body needs to go into rest-and-recovery mode, which causes fatigue. “It’s similar to what happens after you overly exert yourself with rigorous exercise or a marathon,” Dr. Mucci-Elliott explains.
Dr. Gupta agrees that fatigue is a sign that the body is healing itself. “When you have a sense of tiredness, you should be concerned, but keep in mind that this is the natural state. It’s your body mounting an immune response and telling you to rest,” says Gupta.
She adds: “Fatigue can be like an internal alarm system saying, ‘Hey, you need to sit down and take a break.’”
Is COVID Fatigue Different Than Fatigue Caused by Other Viruses?
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Even a relatively mild case of COVID-19 can wipe you out. “A lot of people who have had COVID-19 describe the fatigue they feel as worse than they have experienced at any time in their lives,” says McClelland. “It’s certainly a unique feature of the illness.”
The amount of fatigue may be related to the extent and type of inflammation triggered by the viral infection. “COVID-19 is a systemic illness; it affects many parts of the body, such as the whole respiratory mucosa, the kidneys, fat cells, parts of the brain. The illness causes a remarkable amount of inflammation — that, as it is resolving, is likely to leave people feeling fatigued,” says McClelland.
COVID-19’s mental toll can make fatigue worse. “The mental gymnastics of contact tracing, guilt and fear about possibly infecting others, self-blame for exposing yourself to infection — all of this triggers a stress response in the body and leads to fatigue,” says Mucci-Elliott.
How Long Does COVID-19 Fatigue Last?
According to data gathered in the ZOE COVID Study, fatigue commonly occurs within the first week of the illness and lasts for an average of five to eight days, though some people may have COVID-related fatigue for two weeks or longer.
The severity of fatigue is often correlated to the severity of illness. “Typically, the worse the illness, the longer the fatigue is likely to last. For people who had to be admitted to intensive care for COVID-19, it might be a few months before they get back to where they were before they got sick,” says McClelland.
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For people who feel bad but are able to ride out COVID-19 at home, it might take just a week or two for the fatigue to abate, says McClelland.
Expert Tips on How to Beat COVID-19 Fatigue
To aid your recovery from COVID-19, the Centers for Disease Control and Prevention (CDC) recommends the following: Take over-the-counter medications like acetaminophen or ibuprofen to reduce fever and muscle aches; drink lots of water or get intravenous fluids to stay hydrated; and get plenty of rest.
McClelland recommends practicing three principles — the “3 Ps” — to manage your fatigue:
Pace. Pace yourself and don’t push yourself to exhaustion. “If you overdo it, it can make recovery harder and set you back in your progress. Make sure you build rest into your activities, even for small things like walking up the stairs,” McClelland says.
Plan. Map out your activities for the day and the week. If you find that your energy or ability to concentrate dips at certain times, strategize accordingly, suggests the United Kingdom’s National Health Service.
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Prioritize. Figure out which items on your to-do list are essential and which can wait. “When you’re fatigued, dump the stuff that doesn’t have to get done, or ask someone to help you,” says McClelland.
What to Do If Your Fatigue Lingers or Gets Worse
A person is considered to have long COVID (also referred to as post-COVID conditions) when symptoms haven’t gone away after four or more weeks of falling ill, according to the CDC.
“It’s estimated that about 30 percent of people with COVID-19, maybe even more, end up having long-term symptoms, and that can include fatigue,” says Gupta.
Try not to get upset if it takes a while for your fatigue to lift. “The time it takes for fatigue to resolve can vary from person to person,” McClellan 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.”
Gupta recommends checking in with your healthcare provider if your symptoms linger. “If fatigue or other symptoms get to a point where you can’t manage them or care for yourself anymore, you definitely need to seek help,” she says.
She also emphasizes the importance of getting the COVID-19 vaccine to reduce your chances of getting sick or developing a severe case if you become infected. “People need to be vaccinated. There’s no substitute for that right now,” she says.