While the World Health Organization has advised people with long Covid to avoid intense exercise, a recent study found that different types of exercise were not harmful for people diagnosed with long Covid.
The study, published in JAMA Network Open, included 31 patients with long Covid (also known as post Covid condition) who were matched with a control group of 31 healthy participants. All of them completed several sessions of strength training, high-intensity interval training, and moderate-intensity continuous training across a span of several weeks.
“What we can generally see is that the post-COVID patients do just as well as the controls, even though they had more symptoms to begin with. By equally well, I mean that they did not worsen their symptoms or negatively affect their body during the 48 hours we observed them,” the first author of the study, Andrea Tryfonos, said in a press release.
Tryfonos and colleagues observed that patients with long Covid who opted for high-intensity interval training (HIIT) experienced more muscle pain than the control group. Whereas moderate-intensity continuous training was associated with concentration problems and 62% of the 31 long patients had myopathy or inflammation in the muscles.
“People with post-COVID had generally lower levels of fitness and muscle strength, which could be due to both the infection and lower activity. After two years of prolonged symptoms and being discouraged from exercising, it’s not surprising that you have lost some of your work capacity,” added Tryfonos, who is a researcher at Karolinska Institutet in Sweden.
People who suffer from long Covid experience debilitating symptoms like fatigue, brain fog, shortness of breath, headaches, sleep problems, dizziness, impaired sense of smell and taste, depression, and anxiety. These symptoms last for month than three months and in some cases, can continue for longer than one year. The WHO estimated that anywhere between 10% to 20% of people who have Covid-19 are affected by long Covid.
The WHO and other key public health organizations said that long Covid symptoms could worsen after physical exertion and defined the phenomenon as postexertional malaise (PEM).
“This has led many healthcare professionals to be reluctant to incorporate exercise into rehabilitation programs for patients with post-Covid condition. However, there is ample evidence that physical inactivity negatively impacts health, including functional impairment within weeks and increased risk of cardiometabolic disease in the long term. The latter represents a significant burden on health care systems worldwide,” the researchers wrote in the study.
“While several plausible factors have been proposed to explain exercise intolerance in individuals with post-Covid condition, including muscle atrophy, physical deconditioning, dysautonomia, and increased inflammation, current data from studies are limited,” they added.
To investigate further, the team recruited study participants aged between 18 to 64 years from September 2022 to July 2023 via advertisements. They closely monitored each participant’s exercise sessions and took continuous measurements of their oxygen saturation, heart rate, and blood pressure.
“The main finding was that participants with post Covid condition generally tolerated all exercise sessions without significant worsening of symptoms or decline in aerobic performance after 48 hours,” the researchers concluded.
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