Don’t try to 'tough out' long COVID-19 symptoms

Clinicians help UW Medicine patients recognize and manage triggers that can exacerbate their condition. 

Dr. Janna Friedly has this advice for patients dealing with long COVID: If you’re experiencing symptoms and are tempted to tough it out, don’t.

“I tell patients to really not try to push through COVID,” she said. “Pushing through and trying to recover very quickly oftentimes doesn't work, so people have to take the time to rest and recover after COVID.”

Friedly speaks from experience, having recovered from a mild case of COVID-19 in 2020 whose symptoms persisted. She is also executive director of the UW Medicine’s Post-COVID Rehabilitation and Recovery Clinic at Harborview Medical Center.

Triggers that made her symptoms worse included stress, insufficient sleep, overexertion and eating poorly, Friedly said. Focusing on what she could control helped to reduce her symptoms. It is possible to recover completely, she added. 

“Absolutely, so we've had many, many patients fully recover from long COVID, so I think that's the biggest message I have for patients and for the public. New studies have shown that some patients' symptoms improve after getting the vaccine and Friedly has found this to be true among her patients. The clinic employs a variety of treatment strategies to support the immune system, to reduce inflammation, and to help regulate the nervous system – all of which seem to be involved in longer-term post-COVID symptoms.  

“It doesn't mean that you're going to have symptoms for the rest of your life, but it does take a regimented and comprehensive approach to manage your symptoms and get you on the right track,” she said.

The number of patients at her clinic has boomed – from 15-20 new patients per month, early in the pandemic, to 150.

One study published this summer suggested that almost 25% of COVID patients will develop at least one persistent symptom. Another study published in October estimated that almost half of COVID-19 cases worldwide may include lingering effects.

“People who have the longer-term symptoms of COVID tend to have a variety of symptoms, and on average patients experience nine to 10 different symptoms. It affects different organ systems and affects people physically, cognitively and emotionally,” Friedly said. “It takes a holistic approach to help care for these patients.” 

Harborview’s post-COVID clinic has about 10 physicians, representing areas of physical medicine and rehabilitation, general internal medicine and family medicine.

In her experience, Friedly's ability to pinpoint triggers led to reduced symptoms.

“Once I was able to identify some of the most common triggers, like not having enough sleep, being stressed, and not eating well, I learned to avoid them. And that really helped to reduce my stress about the symptoms and whether the symptoms would ever go away,” she said.

One of her primary symptoms was overwhelming fatigue. She thought exercise would help, but it made things worse. So she focused on getting good quality sleep, and then started a restorative exercise program.

“People (with long COVID) are anxious because they don't understand it,” she said. “A lot of what we do is education and helping people to develop strategies that work for them in their lives.”

Reach the Post-COVID Rehabilitation and Recovery Clinic at 206-744-5862

– Barbara Clements, 253-740-5043,

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