Long-Haul Covid-19? Rehab Options
covid 19

The outbreak of the Covid-19 pandemic has stressed and challenged healthcare systems worldwide. This highlighted the need to improve our capacity to adequately address the needs of frail patients following prolonged hospitalizations [1]. For many who have had Covid-19, symptoms persist long after they are “infection-free”.


Especially for patients who undergo pro-longed hospitalization and/or including ventilation, long-term effects may include: weakness, fatigue, cardiopulmonary limitations, neuromuscular limitations, prolonged pain, depression, and other psychosocial affects [2]. In fact, some research suggests that these patients will experience physical function & fitness deficits for up to 2 years following infection [3]. That means they’ll likely need some sort of treatment or rehabilitation services to manage their recover following their return home.


Understanding this information makes clear the need for long-term approaches to rehabilitation for these patients in order to maximize their functional independence, safety, and mobility following inpatient treatment for Covid-19.


Recommendations from Research


Now that we’ve covered the importance of therapy and rehab following Covid-19 infection. Let’s take a look at what the research suggests are the most effective approaches to approach this long-term recovery.


What types of rehabilitation interventions are recommended following prolonged hospitalization for Covid-19?


There’s no shortage of rehab options for anyone recovering from a long-term disease or hospitalization. Treatments such as aquatic therapy, home safety assessment, or even exercise programs may be beneficial. However the research points to the importance of building endurance and strength as part of the recovery process.


For example, some research shows that patients with SARS-CoV infections have reduced levels of physical fitness post-infection compared to non-infected controls. These patients demonstrate incomplete physical function, with some lingering impairments, for 1-2 years post infection. Evidence shows that that a combined aerobic and resistance training intervention significantly improved physical function and fitness post-infection [3]. So, it’ll be important to participate in some exercise-based program to build endurance, strength, and what we call “functional capacity”.


What about addressing the many other factors associated with long-term Covid-19 recovery?


As we’ve mentioned previously, motion and movement plays a very important role in recovery from many diseases and diagnoses. The same holds true for combating the negative effects of Covid-19.


In fact, evidence suggests that people with restricted mobility should receive exercise programs to reduce the risk of frailty, sarcopenia, cognitive decline and depression [1]. This is also true for people who may not have had covid-19, but who are relatively inactive in their day to day routine. Movement, particularly exercise, helps improve endurance and strength, and can even prevent depression and memory problems.


But what sort of exercises should be included? Well, research shows that, multicomponent exercise programs should include aerobic, resistance, balance, coordination and mobility training exercises. Some research also recommends integrating the concept of cognitive training during the exercise training session [2]. So, exercises that challenge both the body and mind can be very beneficial for patients recovering from long-term diagnoses like Covid-19.




Hopefully, this article sheds some light on the treatment options and recommendations from the research for recovering from covid-19. It can be a long road to recovery, but the important thing to remember is to continue moving, exercising, and trying to do more and more every day.



[1] Ceravolo MG, de Sire A, Andrenelli E, Negrini F, Negrini S. Systematic rapid “living” review on rehabilitation needs due to COVID-19: update to March 31st, 2020. Eur J Phys Rehabil Med. 2020 Jun;56(3):347-353. doi: 10.23736/S1973- 9087.20.06329-7. Epub 2020 Apr 22. Update in: Eur J Phys Rehabil Med. 2020 Jun;56(3):354-360. Update in: Eur J Phys Rehabil Med. 2020 Aug;56(4):508-514. PMID: 32316718.

[2] Jiménez-Pavón, D., Carbonell-Baeza, A., & Lavie, C. J. (2020). Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Progress in cardiovascular diseases, 63(3), 386–388. https://doi.org/10.1016/j.pcad.2020.03.009

[3]Rooney S, Webster A, Paul L. Systematic Review of Changes and Recovery in Physical Function and Fitness After Severe Acute Respiratory Syndrome-Related Coronavirus Infection: Implications for COVID-19 Rehabilitation. Phys Ther. 2020 Sep 28;100(10):1717-1729. doi: 10.1093/ptj/pzaa129. PMID: 32737507; PMCID: PMC7454932.

Are you dealing with pain?

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Rafi Salazar OT

Rafael E. Salazar II, MHS, OTR/L (Rafi) is the CEO & President of Proactive Rehabilitation & Wellness, as well as the Principal Owner of Rehab U Practice Solutions and the host of The Better Outcomes Show. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center, where he worked on projects to improve patient & employee engagement and experience throughout the organization. He has experience as a faculty member at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT. Rafi also authored the book Better Outcomes: A Guide to Humanizing Healthcare