Ok, this is really concerning:
When Natalie Hollabaugh tested positive for Covid-19 in March 2020, her recovery felt extremely slow. Eighteen months later, she was still suffering from a litany of symptoms, including fatigue, shortness of breath, headaches and joint pain. She saw a cardiologist and a pulmonologist, who both ruled out other health problems, she said. And they advised her to start exercising, suggesting that some of her symptoms may have been a result of being out of shape. So Ms. Hollabaugh dutifully began using an exercise bike, speed walking on a treadmill and walking her dogs several miles a day.
But instead of helping, her new exercise regimen only exacerbated her symptoms. “I had never felt worse,” said Ms. Hollabaugh, 31, a lawyer who lives in Portland, Ore. She found she had to start taking daily naps, that her heart rate would skyrocket even when she was at rest and that she was so tired she couldn’t concentrate.
As one of the many Americans suffering from long Covid, a condition characterized by new or lingering symptoms that can be felt for months after a coronavirus infection, Ms. Hollabaugh is not alone in experiencing setbacks with exercise. Natalie Lambert, a biostatistician and health data scientist at the Indiana University School of Medicine, has collected self-reported data from more than a million long Covid patients through a collaboration with Survivor Corps, a Facebook support group for Covid survivors. Patients frequently report that their doctors have advised them to exercise, she said — but many say that when they do, they feel worse afterward.
“The research that I’ve done has shown that inability to exercise is one of the most common long-term symptoms,” Dr. Lambert said. Some people are simply too tired to exercise, she said, while others experience debilitating symptom relapses like increases in fatigue, brain fog or muscle pain. This worsening of symptoms after engaging in even just a little bit of physical activity — what is sometimes called “post-exertional malaise” — seems to be common among long Covid patients. When researchers performed an online survey of 3,762 people with long Covid, as part of a study published in August, they found that 89 percent reported post-exertional malaise.
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In one small study published in January, for example, Dr. Systrom and his colleagues compared 10 long Covid patients who had trouble exercising with 10 people who had never tested positive for Covid-19, but who had unexplained shortness of breath after exercise. The researchers found that nobody in the study had abnormal chest CT scans, anemia or problems with lung or heart function, suggesting that organ injury wasn’t to blame for their symptoms. Yet when the long Covid patients exercised on a stationary bicycle, Dr. Systrom found that some veins and arteries were not working properly, preventing oxygen from being delivered efficiently to their muscles.
Nobody knows why these blood vessel problems occur, Dr. Systrom said, but another one of his recent studies suggested that long Covid patients experience damage to a certain kind of nerve fiber involved in how organs and blood vessel function.
Other research on exercise intolerance implicates problems with how the heart rate responds to exercise. In one study published in November, researchers from Indiana studied 29 women who had tested positive for Covid-19 about three months earlier. When these women underwent a six-minute-long walking test, their heart rates didn’t accelerate as much — or recover as quickly — as the heart rates of 16 similar women who had not been infected with Covid-19.
“Clearly, there’s something going on that’s interfering with that normal response,” said Stephen J. Carter, an author of the study and an exercise physiologist at the Indiana University Bloomington School of Public Health.
These heart problems associated with long COVID are bad news. (This study from the other day is downright scary.) I think I’ll keep my masks handy for a while.
It looks like we are going to be dealing with some serious long term health challenges for quite a while. Let’s hope this is something that goes away over time.