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Covid-19: Post Viral Fatigue Syndrome and Myalgic Encephalomyelitis

This 30 minute recording from June 2020 gives an overview of Post Viral Fatigue Syndrome, its link to ME and management priorities. 

The longer term effects of Covid 19 are still emerging, but our initial concerns around a cohort of patients developing Post Viral Fatigue Syndrome (PVFS) and potentially ME appear to have been confirmed with the emergence of Long Covid. 

The National Institute for Health Research have published their second themed review on Long Covid in March 2021, which is a detailed overview of the current knowledge base. 


From our understanding, Long Covid is a term that covers several groups of symptoms;

  • Continuing Covid-19 symptoms

  • Post Intensive-Care syndrome

  • Organ damage to heart and lungs

  • Post viral-fatigue syndrome

It is very likely people with Long Covid will fit across more than one of these subsets.


Our area of focus is the post viral fatigue syndrome elements of Long Covid 

Who is developing Long Covid?

Data continues to be collected but currently over 80% of those with Long Covid were not admitted to hospital with their Covid symptoms, the majority (63%) are between
30-49 years old and most (68%) were moderately to very physically active before contracting Covid 19.

Symptoms of PVFS / Long Covid

Symptoms are described as fluctuating in nature. The top three symptoms are:

  • Shortness of breath

  • Tightness in chest

  • Fatigue

Top symptoms Covid 19.jpg


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While not every patient recovering from Covid 19 will develop these problems, it is vital for physiotherapists to identify those with post viral complications, because the management of these patients will differ from a typical rehabilitative approach.

In fact, typical graded exercise approaches may exacerbate symptoms and are not recommended by NICE

Be sure to expand your subjective assessment to look for key signs that your patient has / is developing Post Viral Fatigue Syndrome as part of Long Covid, particularly looking for signs of Post Exertional Malaise

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