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  • Ann-Sophie Briest, MD

'Long COVID' - updates, thoughts and strategies

You’ve probably heard of ‘long COVID’, haven’t you? Either in the news, reading about it or knowing someone directly. Or maybe you yourself have experienced it?

‘Long COVID’ is the term to describe long-lasting, possibly chronic symptoms of a COVID-19 infection. At this point there have been more than 200 Million reported Covid cases worldwide out of which a fifth experiences longterm symptoms - which makes the treatment of ‘long covid’ a global health priority.


But what are some of the commonly experienced symptoms?

Let’s have a closer look. All of the listed below may last for months and may range from mild to severe/incapacitating.Probably the most reported symptom is a persistent, overall fatigue together with a cognitive dysfunction (‘brain fog’). Other symptoms affect:

  • Pulmonary: including shortness of breath and coughing/wheezing

  • Cardiovascular: including palpitations and chest pain

  • Endocrine: including dizziness, weight loss/gain and irregular menstrual cycle

  • Autoimmune: including fevers, rashes, joint/muscle pains and decreased vision

  • Mood disorders: including irritability, anxiety and depression

  • Sleep disorders: including poor, non refreshing sleep, nightmares and morning headaches

  • And many more…

If you are interested to read more about the medical assessment, please find an interesting link here:


Research is only starting

As the West seems to slowly come out of the acute phase of this pandemic more and more research programs are focussing on the effects and possible ways to cope with ‘long COVID’. While I’m writing this blog - October 2021 - there is still very little scientific evidence. However, this shall change very soon: hundreds of millions Euros are invested to support large-scale studies on the long-term effects of COVID-19.


Can Yoga Therapy help? And if so, how?

My immediate answer to that question is always ‘YES!’ ;-) A well-trained yoga therapist can help a great deal in individualising gentle practises or suggesting dietary and lifestyle changes which support autonomic balance and the self-healing mechanisms of the body. If you are curious to read more about how yoga therapy can boost your immune system make sure to read our blog on the subject here!

Let’s take the common symptom of fatigue for example. A recommended medical strategy in dealing with fatigue (mild, moderate or severe) is energy conservation and is called the ‘Four Ps’: Pacing, Prioritising, Positioning and Planning. All of these four can be easily included in a holistic strategy.

1. Pacing

Aiming for avoiding the ‘push and crash cycle’. Activity should be very gentle with plenty of breaks avoiding any overexertion or rush.

In yoga therapy following the ‘langhana principle’ is recommended. In yogic breathing techniques it refers to the exhalation. In yoga posture practice it refers to those which are more gentle and relaxing (balancing the nervous system, slowing the heart rate, calming the mind etc.)


2. Prioritising

Aiming for differentiating which activities are necessary on a specific day and which ones can be postponed or skipped altogether.

In yoga therapy discussing and encouraging a healthy day structure is one of the components of lifestyle recommendations. It can greatly help to avoid overexertion and crashing.


3. Positioning

Aiming for adaptations which make daily activities more accessible and easier to perform.

In yoga therapy individualising postures and movement routines is one of the key elements. This is true in an asana practise but can be easily applied to other daily life activities. Recommending ergonomic working equipment or the usage of a chair while cooking, showering etc. can be of great support.


4. Planning

Aiming for a structured day or week helps to avoid overexertion while benefiting from periods of increased energy (‘energy windows’).

In yoga therapy bringing awareness to those energy fluctuations and developing a daily structure is a crucial component - using moments of increased energy to complete tasks and optimise therapy and other activities while also planning generous times for rest and recovery. Mindfulness of one's own body helps to stay more connected and identify moments of decreased as well as increased energy. Writing a diary of bad and good moments may be very supportive as well. In general, gentle routines and rituals are of great help.


Yoga therapy is multi-dimensional

As you can see, these are only a few ideas about how a holistic strategy in case of ‘long covid’ could look like. What are your thoughts on this?

Strategy is always the first step in developing a treatment plan. Only once I am clear about the strategy I start choosing specific techniques for that unique person in front of me - understanding their strengths and resources as well as their challenges and restrictions.

Each technique is then individualised to respect any restriction and adapted to current life circumstances. Important: Regular follow-ups and check-ins as well as interdisciplinary collaboration are absolutely crucial to ensure full recovery!


I believe that yoga therapy can be of immense help in attending holistically to the many of us who experience ‘long covid’. There is still so much to study, understand and implement - what a time to be alive!


I wish you and your loved ones all the best! Please let me know if you have any comments or questions. I’m excited to discuss the subject further.


Namaste, Ann-Sophie



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