Exercising with Long-COVID: Safe, Researchers Assert

Reassessing Exercise Guidelines for Long COVID Patients

Current advice suggesting that patients suffering from Long COVID, or Post-COVID Condition (PCC), should avoid intense exercise may be overly cautious. This is the conclusion of a recent study conducted by the Karolinska Institutet in Sweden, published in JAMA Network Open.

The Impact of Exercise on Long COVID Symptoms

People with Long COVID are often asked to stay away from activities that might worsen their symptoms such as fatigue, shortness of breath, and pain, due to reports of exercise intolerance and symptom ‘flares’ post-exercise.

Exercising with Long COVID: Study Details

31 PCC patients with no other diagnoses were observed in this study, as they performed three varying training sessions – High-Intensity Interval Training (HIIT), Moderate-Intensity Continuous Training, and Strength Training, in a randomized order. The group of patients was mostly (77%) female with an average age of 46.6 years.

Researchers had participants rate their symptoms before and after exercising, and 48 hours post-exercise. In addition to this, a series of tests were conducted including blood tests, heart ultrasound, spirometry for lung function, muscle strength tests, neurophysiological tests, and muscle biopsies within two days of the exercise tests.

Fatigue Levels in Long COVID Patients Post-Exercise

Interestingly, there were no differences in the self-ratings of fatigue between the control group and the PCC patients. However, patients with PCC experienced increased muscle pain after the HIIT session.

As per Andrea Tryfonos, PhD and first author of the study, “Post-COVID patients do just as well as the controls, even though they had more symptoms to begin with. They did not worsen their symptoms or negatively affect their body during the 48 hours we observed them“.

Physical Performance of Long COVID Patients

When it came to physical testing, those with Long COVID had a 21% lower peak volume of oxygen consumption at baseline and less isometric knee-extension strength than the healthy controls.

The authors suggested that the lower aerobic capacity and lack of muscle strength may have been due to inactivity or the initial infection. Alarmingly, 62% of Long COVID patients in the study showed evidence of myopathy, suggesting an issue with muscle tissue capacity.

“This percentage is far too high to be explained by reduced activity alone. Therefore, we are currently analyzing the biopsies to see if we can explain the reason behind these muscle changes,” added Tryfonos.

Implications for Long COVID Treatment

UK-based researchers Peter Ladlow, PhD; Alexander Bennett, PhD; and Oliver O’Sullivan, MBChB, commented on the study in a separate commentary. They affirmed that these findings are reassuring and can aid clinicians in guiding their post-COVID patients.

They concluded, “The ability of individuals with PCC to tolerate various exercise activities, particularly hard-intensity activities … without major escalation of symptoms, fatigue, or exercise capacity is important for advancing rehabilitation.”