Understanding COVID-19 Fatigue: Causes, Symptoms, and Treatment

Fatigue Is a Sign of the Body Healing Itself

After this kind of stress response to COVID-19, the body needs to go into rest-and-recovery mode, experienced as fatigue. “It’s similar to what happens after you overexert yourself with vigorous exercise or a marathon,” says Tania Mucci-Elliott, MD, infectious disease doctor at NYU Langone in New York City.

Dr. Gupta agrees that fatigue is a sign that the body is healing itself. “When you have a sense of tiredness, you should be concerned, but keep in mind that this is the natural state. It’s your body mounting an immune response and telling you to rest,” says Gupta.

She adds: “Fatigue can be like an internal alarm system saying, ‘Hey, you need to sit down and take a break.’”

Is COVID Fatigue Different Than Fatigue Caused by Other Viruses?

Even a relatively mild case of COVID-19 can wipe you out. “A lot of people who have had COVID-19 describe the fatigue they feel as worse than they have experienced at any time in their lives,” says McClelland. “It’s certainly a unique feature of the illness.”

Chopra agrees, saying, “It’s not just feeling tired — it’s an extraordinary sense of weariness and a lack of energy that is not only physical but also cognitive, emotional, and mental.”

Again, it may go back to the extent and type of inflammation triggered by the viral infection. “COVID-19 is a systemic illness; it affects many parts of the body, such as the whole respiratory mucosa, the kidneys, fat cells, parts of the brain. The illness causes a remarkable amount of inflammation — and that, as it is resolving, is likely to leave people feeling fatigued,” says McClelland.

How Long Does COVID-19 Fatigue Last?

The severity and duration of COVID-19 fatigue is often correlated with the severity and duration of the illness itself. “Typically, the worse the illness, the longer the fatigue is likely to last. For people who had to be admitted to intensive care for COVID-19, it might be a few months before they get back to where they were before they got sick,” says McClelland.

For people who feel bad but are able to ride out COVID-19 at home, it might take just a week or two for the fatigue to abate, says McClelland.

Rest, Healthy Foods, and Medication Are All Part of COVID-19 Fatigue Treatment

When you are battling COVID-19, rest is critical. “I can’t emphasize it enough — make sure you get enough rest and sleep when you are acutely ill and during the week or two following,” says Chopra.

Even if you don’t have much of an appetite, focus your diet on nourishing foods and drinks and avoid alcohol during this time, she adds.

The Centers for Disease Control and Prevention also recommends treating symptoms with over-the-counter medications such as acetaminophen or ibuprofen — or, if you are at high risk of serious complications, with antiviral medications such as nirmatrelvir and ritonavir (Paxlovid).

Fatigue That Lingers or Gets Worse Is a Top Symptom of Long COVID

When people continue to have symptoms for weeks or months after their initial bout of COVID-19, they are considered to have long COVID.

Fatigue is one of the most reported symptoms of long COVID, says Chopra. “There are studies that suggest that a large number of people may continue to struggle with fatigue three to 12 months after infection,” she says, referencing research published in Brain, Behavior & Immunity-Health in 2022.

With long COVID, fatigue is also an aspect of post-exertional malaise, described as a kind of “energy crash” following an activity that involves any level of effort. For some people with long COVID, even a 10-minute walk can result in debilitating exhaustion that lasts for days, according to Yale Medicine.

If you still have bothersome COVID symptoms, including fatigue, at the three-month mark, McClelland recommends checking in with your healthcare provider (if you haven’t already).

“It’s important to note that most people don’t end up with long COVID, and even among the people who do, about 85 percent are better by the end of 12 months,” says McClelland. “I think psychologically it’s good to know that the fatigue is something that will go away,” he adds.

Practice the Three P’s to Manage Long COVID Fatigue

McClelland recommends practicing three principles — the “three P’s” — if you are experiencing persistent, ongoing fatigue that interferes with daily life:

Pace. Pace yourself and don’t push yourself to exhaustion. “If you overdo it, it can make recovery harder and set you back in your progress. Make sure you build rest into your activities, even for small things like walking up the stairs,” McClelland says.

Plan. Map out your activities for the day and the week. If you find that your energy or ability to concentrate dips at certain times, strategize accordingly, suggests the Royal College of Occupational Therapists.

Prioritize. Figure out which items on your to-do list are essential and which can wait. “When you’re fatigued, dump the stuff that doesn’t have to get done, or ask someone to help you,” says McClelland.