A Covid-19 infection can cause symptoms even weeks after the acute phase. Breathing problems such as shortness of breath and shortness of breath, cognitive impairment, sleep problems and pain and fatigue are among the most common.
This article describes common symptoms and what measures can help.

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Respiratory problems

One of the most common problems following Covid-19 disease is respiratory problems. Shortness of breath, limited physical performance and shortness of breath, i.e. the feeling of not getting enough air, are among the most frequently described symptoms. Shortness of breath can trigger a fear of suffocation, which further increases the subjective feeling of shortness of breath.

The World Health Organization (WHO) suggests some breathing exercises and postures that should make breathing easier. Shortness of breath can be alleviated by doing these exercises:

1. Side position with raised headrest
2. Leaning forward
3. Leaning forward

Basically, it can be said that an erect or raised upper body and supported arms make breathing easier. Because in this position, the so-called respiratory muscles are activated, which help the diaphragm when breathing.

Exercises for respiratory problems

Controlled breathing
‍Place one hand on your chest and one hand on your stomach. It's best to close your eyes to focus on your breathing. Then breathe in slowly through your nose (if that is not possible: through your mouth) and out through your mouth. Try to breathe slowly, relaxed and effortlessly as possible. Pay attention to the movements of your hands as you inhale and exhale. This should make you notice how to relax and control your breathing again.

Pulsed breathing
‍Pulsed breathing can help you correctly manage your breathing during strenuous activities such as climbing stairs. Here, you divide your activity into smaller sections, e.g. individual stages/steps. Breathe in through your nose before taking a step. During activity, exhale through your mouth. And remember: Don't rush, feel free to take a break if you don't feel fit anymore.

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Cognitive Impairments

As part of the disease, you may also have problems with cognition. You may find it difficult to concentrate or you may forget information quickly. These impaired thinking skills are often referred to as “brain fog.” Here, too, WHO recommends a number of methods to keep restrictions in everyday life as low as possible.

Exercises for cognitive impairment

Reduce distraction
‍Try to avoid unnecessary distractions, such as loud noises. Use earplugs when necessary. Create a quiet and tidy workplace. This prevents you from being distracted during an activity.

Plan activities and breaks
‍It can be harder to concentrate when you're exhausted or tired. Therefore, try to schedule important tasks at the time of day when you have the most energy. For example, if you are fit in the morning and tire during the day, plan your most important activities in the morning.
Take breaks in between to relax - and consciously plan them into your day.

scheduling
‍Make a schedule for the next day or week. To do this, you can divide larger tasks into smaller steps and then plan the individual steps in advance. What do you need for that? How long does it take you to do that? Which steps are most important? When can you take breaks?

Realistic goals
‍When you set yourself specific and realistic goals, you are more motivated to work on your tasks. For example, plan to read 5 pages of a book or write a section.

Incentives & rewards
‍It's important to reward yourself when you've achieved something. Be it a cup of coffee, a walk or your favorite meal. At the same time, you add some variety to your everyday life.

cognition exercises
‍Do cognitive exercises regularly to train your cognition. Get back to your pre-COVID-19 levels step by step, but don't be too impatient.
Use puzzles, word and number games, and/or memory exercises. Start with easier exercises and improve as you succeed.

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sleep

Sleep problems are a common side effect of Long Covid. Difficulties in falling asleep and staying asleep are reported. That's why it's important to maintain a good sleep hygiene and routine. Measures that promote healthy sleep include:

A regular sleep schedule

Try to keep a regular sleep schedule. To do this, you can set up notifications on your phone to remind you to get ready for bed. Some smartphones allow you to specify your bedtime. You should turn off push notifications some time in advance to reduce further distractions. Alternatively, you can leave your phone in a room when you go to bed.

A low-irritating sleeping environment

Create a sleeping environment that is poor in external stimuli. This includes all factors that could interfere with sleep, including both bright or blue light and sounds:

1. Darken your room sufficiently before sleeping or use sleeping goggles, for example.
2. Avoid electronic devices about an hour before bed. The blue light from the screens disrupts the natural sleep rhythm.
3. Reduce noise or create silence to help you fall asleep and avoid waking up.

A healthy sleep routine

Limit nicotine and caffeine consumption at least four hours before bed. These substances have a stimulating effect and are therefore counterproductive. Avoid alcohol at least 2 hours before going to sleep. Alcohol counteracts deep sleep.

Relaxation techniques before bed can help block out everyday stress.

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soreness

To deal with pain, there are a few alternatives to painkillers:

1. Sleep and relaxation have a positive effect on pain. Relaxation exercises may include meditations or calming music. Special mindfulness exercises for pain perception can also help to deal with pain.
2. Physical activity can ensure that the body's own messenger substances, so-called endorphins, are released, which can alleviate pain. So try to be active as much as possible — whether it's household activities, walks, or sports.

If pain cannot be controlled with these methods, your doctor can advise you on further options. It is best to document your symptoms, their occurrence, their frequency, their severity and the type of pain (e.g. dull, pointed, throbbing)

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Fatigue

Fatigue is a severe form of chronic exhaustion that often occurs with long Covid. If this exhaustion is handled incorrectly, a crash known as post-exertional malaise (PEM) can occur. After physical or mental exertion, those affected feel severe exhaustion, which only occurs hours to days after the triggering event. The recovery period after one can take days or even weeks.

One method that can be helpful in cases of fatigue is so-called pacing. In doing so, our own energy reserves are consciously divided and managed. As part of pacing, an attempt is made to find out which activities are possible at what intensity without triggering a crash. You can also find out more about pacing in the article What is pacing?

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