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Chronic fatigue syndrome, the post Covid-19 disease

Sleeping person

What symptoms do people with Covid-19 have in common? The feeling of fatigue is one of the most common symptoms and the one that lasts the longest in the long term. We talk about chronic fatigue associated with COVID-19.

The chronic fatigue is a disease surrounded by unknowns. Its origin is unknown and can be related to factors such as age, genetics, stress or environmental factors. It can also be related to previous illnesses such as a type of herpes. Covid-19 could now be added to this set of causes.

People who suffer from chronic fatigue have a a persistent feeling of weakness that prevents them from even getting out of bed. Fatigue can be made worse by any kind of activity, physical or mental, but it never improves with rest.

Such an intense feeling of a lack of energy can be accompanied by sleep disturbances, loss of memory or concentration difficulties or a depressed or discouraged state as emotional symptoms.

Chronic fatigue is a disease but is also a symptom of other diseases, especially in terms of extreme tiredness. Therefore, although there are no definitive tests for its diagnosis, it can be detected by ruling out other diseases that may have, among their symptoms, that of chronic fatigue. This is the case with covid-19.

Fatigue is manifesting itself as the most frequent and long-lasting symptom of people suffering from covid-19. This is a normal symptom after an infectious disease and even during convalescence, but why can it manifest itself even months after the disease has passed?

Viral infections can lead to the onset of chronic fatigue and the development of chronic fatigue. diagnosis can occur when six weeks have passed since the covid-19 was passed and the tiredness and feeling of weakness persists.

Chronic fatigue affects around two million people in the European Union. With 2.5 million cases of coronavirus confirmed since March 2019, the population suffering from this syndrome in a few months' time could increase exponentially as the number of people suffering from chronic fatigue increases. half of the people who have recovered from covid have experienced chronic fatigue.

Specialists in environmental medicine, moreover, explain that Chronic Fatigue Syndrome is correlated with chemicals and point out that excess contaminants we are using in the disinfections with which we prevent covid-19.

From a positive perspective, there are those who see covid-19 and its consequences as a opportunity to destigmatise people suffering from chronic fatigue. This is a misunderstood disease and the Open Medicine Foundation believes that the number of people who "will not be able to recover from covid-19" will make the condition of those suffering from this syndrome more visible and understandable.

Further afield, Dr Liam Townsed of St Jame's Hospital has authored a study of 130 patients ten weeks after recovery from SARS-CoV-2 in which he quantifies that just over half of this group have chronic fatigue, irrespective of the severity of the illness or the care they required during treatment. Furthermore, they point out that chronic fatigue is not related to inflammatory markers or pro-inflammatory molecules.

This study does draw one important conclusion, women who had covid and a history of depression or anxiety had more symptoms of chronic fatigue.

How can we overcome chronic fatigue syndrome post COVID-19?

Chronic fatigue syndrome is a disease that is considered incurable. However, there are guidelines that can help us to maintain quality of life. Treatment is approached as a strategy that acts on symptomsby lowering its level of intensity.

Physical Exercise

While sport and exercise or activity are common recommendations for recovery from many illnesses, in cases of chronic fatigue this recommendation is made with caution as any activity can increase the feeling of tiredness.

Exercise is necessary as therapy and preventive: moderate-intensity cardiovascular activity, such as walking for half an hour, improves mood, helps control weight, and reduces anxiety, depression and sleep problems.

It should also be borne in mind that a person with chronic fatigue has a more sedentary lifestyle and this can lead to other problems such as cardiovascular problems.

Stretching or specific exercises to strengthen the muscles can help reduce the sensation of pain.

As for the recovery of work and sporting activity after a convalescence in which there is a strong presence of fatigue, such as that of SARS-CovV-2, it is recommended that this be done progressively.

Sleep habits

Rest time is a challenge for people with chronic fatigue syndrome because every morning they wake up feeling that their sleep has not been restful.

It is essential to create a calm and restful atmosphere, to take light and noise into account and to regulate or mitigate them until they provide a certain level of comfort.

Moreover, the transition between day-to-day activity and bedtime should be progressive. In the hour before bedtime, the patient can relax his or her activity before going to bed by relaxing, reading, etc. This will prevent him or her from being in a vigilant state at bedtime.

Routines, bedtime and wake-up times, as well as strict sleep schedules, are very beneficial in reducing sleep disorders.

Daytime naps can interfere with night-time sleep; the patient should gradually regulate daytime sleep hours to ensure that they are not "stealing" minutes of rest during the night.

Nutrition as part of a biological medicine treatment for chronic fatigue

A correct diet not only helps us to control sleep disorders but will also help us to maintain an adequate weight, which is essential to prevent pain or muscle overload.

Alcohol and coffee should be eliminated from the diet as they not only interfere with the quality of sleep of chronic fatigue patients but can also alter their mood.

On the other hand, it is recommended to eat well-washed fresh food in order to ingest as little as possible of herbicides or insecticides, which can aggravate our symptoms, especially among patients with chemical sensitivities. Prepared foods, processed foods and beverages containing additives should be avoided.

It is also important to follow a personalised diet, as not all people assimilate food in the same way, nor are they affected in the same way by "sensitising" foods, such as processed foods.

The treatment of Chronic Fatigue Syndrome at Biosalud Day Hospital

Mariano Bueno

Dr. Mariano Bueno and his team

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