Fatigue after COVID-19

Fatigue is common after viral infections like COVID-19. Most people recover after 2 to 3 weeks.

Fatigue is feeling like you lack energy. It is different from usual tiredness because it is not relieved by sleep and rest. Doing things such as washing, dressing or going for a short walk can be exhausting.

Your recovery may take time. Symptoms of fatigue can come and go as you recover.

There are things you can do to help:

  • conserve your energy as you recover
  • manage your fatigue over time

Symptoms of fatigue

Symptoms of fatigue include:

  • feeling exhausted or weak after activities that you used to do with little effort
  • feeling weary or sleepy even after rest or sleep
  • finding it hard to concentrate or do more than 1 thing at a time
  • falling asleep for small amounts of time in a way that is unusual for you
  • becoming more irritable or frustrated than usual
  • feeling other symptoms get worse after activity
  • lacking your usual 'get-up-and-go' or motivation to do your usual tasks

Symptoms of fatigue can change from day-to-day. Some days can be better or worse than others.

You can have fatigue while recovering from COVID-19 even if your illness was mild. If you were in hospital and had to stay in bed, you will need time to rebuild strength in your muscles.

Some people have fatigue for weeks or months after COVID-19. We're still learning about the long-term effects of COVID-19.

Memory and thinking problems after COVID-19

Managing fatigue at the start of your recovery

As you recover from a COVID-19 infection, your energy needs may fluctuate from day to day and hour to hour.

It's important to:

Difficulty sleeping is common when recovering from COVID-19. Talk to your GP if you need help getting better sleep.

Information:

If you feel sleepy or drowsy when driving, stop, park in a safe place and take a nap for 15 minutes.

It is good to do some physical activity if you do not feel worse afterwards. Take your time and talk to a healthcare professional if you are unsure about starting to exercise.

Exercise while recovering from COVID-19

Conserving your energy

To conserve your energy you can try to:

Do

  • organise your home so that the items you use a lot are close to you

  • do activities that you are comfortable doing - if a task is difficult, stop and change what you are doing

  • start with simple activities such as making a sandwich or going for a 5-minute walk

  • break down activities into smaller tasks with rest breaks

  • rest between tasks, even if you think you do not need to

  • spread out tasks over the day or week - plan a routine to avoid doing too much at the same time

  • do a little more each day but avoid overdoing it - focus on things that you have to do or are important to you

  • ask for help with tasks if you need it - this can also give you time to do things you enjoy

  • wait an hour or more after eating before exercising

How to plan, prioritise and pace your activities

There are ways to make day-to-day tasks easier as you recover:

Walking

You may have shortness of breath when you move about. Set short, realistic goals. For example, walking to the toilet at first.

Increase the distance you walk indoors, perhaps to the front door. You can do more when you feel able.

When you start to go outside, keep track of how far you walk. Wherever you walk, you will need enough energy to walk back.

If you were hospitalised or had to spend long periods in bed, you may find walking more difficult at the start of your recovery.

Exercise when recovering from COVID-19

Using stairs

If you find the stairs hard to manage, try to limit how much you use them.

Keep things you need during the day downstairs. Plan your trips up and down during the day.

Talk to your GP if you find it difficult to move around your home.

A physiotherapist or occupational therapist can visit and assess your home. They can suggest changes to support you to live as independently as possible.

Getting out of bed

If you get out of bed too quickly, you may become dizzy. Before standing up, sit on the edge of the bed for a while. This will help you to get your balance.

When you are out of bed, have a rest before starting another task. 

Getting dressed

Before you get dressed, collect all the clothes you need. Give yourself plenty of time to get dressed.

You might want to wear things that are easy to put on such as slip-on shoes.

Try to sit down when you get dressed. Take your time and take a rest when you need to.

Limit bending where possible. Use long-handled equipment such as a shoehorn.

Have a rest after if you need it.

It's OK to ask for help if you need it. Ask someone in your household to help you if possible. Additional supports to help with everyday tasks like washing and dressing may also be available.

Going to the toilet

Going to the toilet is one of the many daily activities that can affect your energy levels.

Try to avoid constipation. Straining to poo can use more of your energy. Drink fluids and eat plenty of fibre, fruit and vegetables.

How to eat well

Washing and showering

Rest before and after a shower if you need to.

To conserve your energy you can:

  • make sure the room is well ventilated
  • use a cooler temperature - hot showers may make you feel more tired
  • have your back to the shower jet - facing the shower can make you more breathless
  • use a seat in the shower and a non-slip mat
  • use a towelling bathrobe instead of a towel to dry yourself

Do not have a shower if you feel too tired. Sit by the sink to have a wash instead. Gather all your wash items before you start, so you have everything nearby. Make sure your seat is in a safe position.

Cooking and shopping

Buy foods that are easy to prepare. Prepare food in larger amounts if you can. This means you do not have to cook every day.

Try to avoid overly processed foods. But healthy ready meals can help on days when you are very tired.

Plan rest breaks before and after shopping. Shop online or ask for home delivery if you need to.

You can also ask someone to help you shop or prepare your meals if possible.

Housework

Do not try to do all the housework at once. Spread out heavy activities over the week.

Think about how you can make tasks easier. For example, sitting down to do the washing up or load the dishwasher.

Take rests before, during and after housework.

Managing fatigue over a longer time

Some people experience fatigue for weeks or months after COVID-19.

If you were in hospital and had to stay in bed, you may need more time to recover. But you can have severe fatigue even if you were not in hospital.

Non-urgent advice: Talk to your GP if your fatigue:

  • gets worse instead of better
  • does not improve after 4 weeks
  • is worrying you or affects your day-to-day life
  • lasts a long time after light activities

They can rule out any other condition that could be causing your tiredness. They may refer you to an occupational therapist or physiotherapist to help you manage your fatigue.

Using an activity diary

If you are finding it difficult to recover from fatigue, keep an activity diary for 1 or 2 weeks.

Note what you do during the day and how you feel afterwards. Include when you have good days too.

Mental and emotional activities can have an impact on fatigue as much as physical activities. So include all types of tasks such as completing a form or dealing with a child's temper tantrum.

Sometimes fatigue can happen a day or 2 after an activity.

The activity diary will help you to:

  • understand the effects of different activities on your fatigue - for example, you may feel tired after preparing a meal but have more energy after talking to a friend
  • get to know signs that you should slow down or stop before becoming exhausted
  • plan, prioritise and pace your activities and create a routine that works for you
  • explain to others what you can do and what happens if you do too much
  • monitor your level of activity over time
Examples of signs you should slow down or stop an activity

While you are recovering it's important not to try and 'push through' and do too much.

Recognising early signs that your fatigue is getting worse can help you know when to rest and avoid becoming exhausted.

These signs are different for everyone, but some examples include:

  • physical changes such as your limbs feeling heavier, muscle twitches, aches, or nausea
  • difficulty processing information such as having to re-read sentences or being unable to find words
  • feeling irritable or wanting to be alone
  • feeling more sensitive to light or noise
  • zoning out or not hearing what others are saying
  • feeling tired but having trouble sleeping

Resting effectively

You will need less total rest if you take short and frequent rest breaks. If you wait until you are exhausted to rest, it will take much longer to recover.

Naps can disrupt your sleep at night. Try to have more effective rest breaks during the day instead of naps.

Some people may need naps during the day if they cannot get enough sleep at night. Talk to your GP, occupational therapist or psychologist if you are having trouble sleeping.

It is also important not to get too much rest. Getting too much rest over time can affect your motivation, sleep and muscle strength.

You can talk to your employer about what reasonable changes can help you find rest at work.

Even short breaks like going to get a glass of water after a meeting or video call can help.

Increasing your activity levels

Information:

If you were referred to an occupational therapist or physiotherapist, talk to them before increasing your activity. They will help you to plan any increases in a safe way.

Matching your level of activity to your energy level and feeling confident is more important than how much you can do.

Progress may feel slow but be patient with yourself. Increase the length or intensity of your activities at your own pace.

Only increase when you:

  • can maintain a level of activity without getting symptoms
  • are confident you can do a bit more

To manage increases in activity:

  1. Plan - use your activity diary to plan, prioritise and pace your everyday activities.
  2. Do - slowly add small increases into your routine, for example, making a more complicated meal or reducing a rest break between a standing and sitting task.
  3. Check - note any impact the increase has on you during the activity or in the 2 days after.