Starting your COVID Recovery

Aaron S. Weinberg MD, MPhil
October 21, 2020
7 min

Most COVID-19 cases are considered mild and symptoms resolve between 7-14 days, but every case is unique, and the symptoms of each — their timing, location, and severity — can differ greatly.

A Useful Guide: Recovering from COVID-19

Symptoms you’ll likely experience while recovering from COVID-19

  • Severe fatigue
  • Ongoing breathlessness
  • Lingering cough
  • Muscle weakness
  • Confusion and difficulty with memory
  • Anxiety and depression

If you are recovering from a severe case of COVID and you’ve just been released from the ICU, you’ll likely need robust recovery care with everything from physical therapy to anxiety management. This guide should serve only as a reference point, but we recommend Carbon Health’s comprehensive COVID Positive Care program to actively assist and support you at every point along your unique journey.

Some areas of your health to focus on while recovering from COVID-19

  • Physical activity
  • Focused breathing
  • Nutrition
  • Mental health check-ins
  • General wellness through preventive care
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Physical Activity

Recommended steps to return to your usual physical activity

We know it may take a long time to recover after being diagnosed with COVID. Patients report difficulty climbing stairs and exercising, and some even have a tough time walking their dogs around the block. You’re out of breath and everything just feels more difficult.

There’s solid evidence to show a physically active approach to recovery can help you recover far more quickly (and thoroughly) than resting all day, even if that feels counterintuitive. Rest remains important, but now that you’re in recovery, we want you to gently challenge yourself with physical activity.

Important: If your oxygen saturation levels have been low, be sure to check with your provider before initiating activities. Our providers at Carbon Health can help you assess your oxygen saturation levels, and provide patients who qualify with pulse oximeters.

How to return to physical movement at the beginning of your recovery

  • Participate in gentle movement in multiple brief sessions throughout your day.
  • Practice standing from sitting a few times each day, attempting to stand more and more during your sit-to-stand session.
  • Climb the stairs using a guardrail to keep you steady. Take steps one at a time. This may feel extremely challenging, and that’s ok. We repeat: one step at a time.
  • Take slow walks, beginning around the house, then progressing to up and down the street. Aim to walk a little further each time.

Tip: Keep track of your progress using a journal or notepad. It can be easy to lose motivation when you’re making slow progress, but we’re here to encourage you. Slow and steady progress is big progress!

Progress your physical exercise with strength training

You’ve likely lost some muscle mass and strength due to your illness, but you can get it back and we highly recommend you do! Muscles aid in stability and strength for navigating your daily life. The WHO offers a great guide to specific arm and leg exercises using bodyweight and dumbbells when you’ve been approved for strength training by your physician.

Focused Breathing

Manage ongoing breathlessness

Breathlessness is a terribly uncomfortable feeling, and it’s one of the consistently persistent challenges in day-to-day recovery. We recommend staying in cool, well-ventilated spaces. Try these positions when you can’t get comfortable, and above all else, stay calm.

Positions to help reduce breathlessness

  • When lying down — Lay on your side propped up generously with pillows to keep your head and neck supported. Bend your knees slightly into your body.
  • When sitting — Lean forward so you can rest your arms on your lap or on the arm rests.
  • When standing — Lean forward and rest your hands on a stable surface such as a sturdy table or window sill or lean with your back against a wall, hands at your sides, feet about shoulder width apart and a foot or so out from the wall.

Try controlled breathing or belly breathing. Recommended by the World Health Organization (WHO), this breathing technique aids in relaxation.

How to control your breath

1. Sit in a comfortable and supported position.

2. Put one hand on your chest and the other on your stomach.

3. Only if it helps you to relax, close your eyes (otherwise leave them open) and focus on your breathing.

4. Slowly breathe in through your nose (or mouth if you are unable to do this) and then out through your mouth.

5. As you breathe, you will feel the hand on your stomach rise more than the hand on your chest.

6. Try to use as little effort as possible and make your breaths slow, relaxed, and smooth.

Nutrition

How nutrition can fuel your COVID recovery

Known symptoms of the coronavirus are loss of taste and smell. And that may mean your palate has changed as you deal with recovery. Nevertheless, it’s crucial for recovery to eat well and stay hydrated. In fact, as your body first fights the virus and then struggles to recover, you really need even more nutrition and additional hydration to get going again.

The nutritional building blocks to recovery

  • Protein-rich foods — Think beans, nuts, fish, and eggs (try to avoid red or processed meat).
  • Fruits and veggies — Go for the rainbow! Different colors mean different vitamins and minerals.
  • Water — Hydration prevents a host of complications that we don’t want you dealing with on top of a potentially difficult recovery. Daily fluid intake is different for everyone, depending on age, size, and activity level, but we generally recommend patients should drink around eight eight-ounce glasses of water per day (that’s 64 ounces total). Remember, your body is made up of 60% water so hydration is important.
  • Complex carbohydrates — If you need to address weight loss (with healthy weight gain), consider adding to your meals with foods such as whole grains, brown rice, quinoa, and sweet potatoes.

Mental Health Check-ins

Be open about your mental health

The recovery period from this virus can really drag out. When it takes longer than usual to feel like yourself again, it’s not just your physical health that suffers. Ongoing COVID-related complications, the experience of new symptoms long after initial recovery, and the physical isolation of quarantine — you name it. This virus presents a serious mental health challenge. So what can you do?

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Tactics that can help with mental health issues related to COVID-19

Take care of your basic needs.

Sleep. Try to get quality sleep on a regular schedule. Go to bed and wake up at the same time every day. Minimize nicotine and alcohol. Check out relaxation apps to help your mind wind down before bedtime.

Exercise. Physical activity reduces stress, releases endorphins, and can help with quality sleep.

Eat. Remember, your body needs nutrients during this stressful time. If you can, eat protein, vitamin, and mineral-rich meals to fuel your muscles and mind.

Take part in relaxing activities of self-care.

Breath slowly. Try out those controlled breathing exercises mentioned above.

Listen to music or read. It can help reduce stress.

Connect with your spirituality. Whether you’re spiritual or religious, tap into the rituals that provide comfort and familiarity.

Stay connected.

Talk to friends and family about your needs and let them know if you’re feeling down, so they know to reach out.

With COVID Positive Care, our team of providers will offer clinical support every step of the way on your road to recovery.

General Wellness Through Preventive Care

Focus on preventative care for a holistic recovery

Factors that can inhibit your recovery are the same factors that put you at risk for health issues in general. Historically, when we address these factors we consider it preventative care. During this pandemic, it’s both preventative and potentially vital to your prognosis. Being overweight, for instance, has been shown to greatly impact the body’s ability to recover and even increases a person’s risk of a more severe covid-19 clinical course and even death. And for the most part, obesity is a risk factor completely within your control. Addressing weight issues will also help reduce the risk of chronic medical conditions such as diabetes and heart disease and protect you from an increased risk of poor outcomes from future infections.

So whether or not you were fit and healthy before, now is the time to thoroughly consider your lifestyle and how you can improve certain aspects.

Ways to improve your overall health

Improve your diet. Where can you get more lean protein? Where can you cut out sugar?

Exercise. Even moderate, routine physical activity helps keep off excess weight, improves mental health, and aids in consistent sleep cycles. At the beginning of your recovery, walking regularly is a great place to start.

Get 7 to 9 hours of sleep. Quality sleep may be difficult to achieve when dealing with prolonged breathlessness. Stack up pillows to elevate and support your head and neck, and sleep on your side in that elevated position with knees slightly bent.

Reduce alcohol and nicotine consumption. And stay away from secondhand smoke.

We’ll leave you with this you-can-do-it tip.

Start with small changes and stick to your new habits in order to progress your recovery, get back to life as usual, and, ultimately, sustain a healthy lifestyle. The road to recovery is not a straight path, nor is it easy, but knowing you have the support and care you need out there can help alleviate some of the stresses that come with the unknown.

Your long-term wellness is our top priority at Carbon Health. Our COVID Positive Care providers offer ongoing support as you rebuild your health and can help triage any long-term complications that may arise post COVID-19. It was designed to ensure every patient has what they need to understand their condition, manage infection, and start the road to recovery.

Aaron S. Weinberg MD, MPhil

Aaron S. Weinberg, MD, MPhil, is Director of Program Development at Carbon Health and triple board-certified in Pulmonary, Critical Care, and Internal Medicine.


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