COVID-19 can have a significant effect on quality of life and it can take a long time to recover from it. This is a new condition, and globally we are continuing to learn more about how best to treat and manage it daily. The majority of patients will recover from their respiratory illness, fatigue and pain without specialist care however about 5% have been reported to become severely unwell. But we can help you with our bespoke, COVID Rehab programmes!

Data analytics have shown that older people, men and Black and Asian ethnic minority populations have shown poorer outcomes. According to the REACT-2 study led by Imperial College persistent symptoms (post COVID-19 syndrome and Long COVID) were more prevalant in women, people who smoked, were overweight or obese, lived in deprived areas, or had been admitted to hospital.

Some Definitions

Acute COVID-19

Signs and symptoms of COVID-19 for up to 4 weeks.

Ongoing symptomatic COVID-19

Signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.

Post-COVID-19 syndrome 

Signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis. It usually presents with clusters of symptoms


In addition to the clinical case definitions, the term ‘long COVID’ is commonly used to describe signs and symptoms that continue or develop after acute COVID-19. It includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and post-COVID-19 syndrome (12 weeks or more).

COVID-19 and post-COVID-19 syndrome

Symptoms after acute COVID-19 are highly variable and wide-ranging. The most commonly reported symptoms include (but are not limited to) the following.

Most common symptoms associated with post-COVID-19 and long COVID

Respiratory symptoms

  • Breathlessness
  • Cough
  • Decreased exercise tolerance

Cardiovascular symptoms

  • Chest tightness
  • Chest pain
  • Palpitations

Generalised symptoms

  • Fatigue
  • Fever
  • Pain

Neurological and Speech and Language symptoms

  • Cognitive impairment (‘brain fog’, loss of concentration or memory issues)
  • Problems with word-finding
  • Headache
  • Sleep disturbance
  • Peripheral neuropathy symptoms (pins and needles and numbness)
  • Dizziness
  • Delirium (in older populations)

Gastrointestinal symptoms

  • Abdominal pain
  • Nausea
  • Diarrhoea
  • Anorexia and reduced appetite

Musculoskeletal symptoms

  • Joint pain
  • Muscle pain

Psychological/psychiatric symptoms

  • Symptoms of depression
  • Symptoms of anxiety

Ear, nose and throat symptoms

  • Tinnitus
  • Earache
  • Sore throat
  • Dizziness
  • Loss of taste and/or smell


  • Skin rashes

What to expect from a COVID-19 Physiotherapy assessment

1. Screening for serious illness that requires further investigation

Our respiratory trained Physiotherapists are able to decide whether any of your symptoms require further investigations or blood tests. Typically, this could be related to your respiratory and heart function.

2. Your case history and current functional challenges

Your Physiotherapist will take a full history and talk to you to fully understand all the challenges that you are facing. This will help signpost the interventions they will use to treat you as well as help set your goals and treatment outcomes.

3. Your examination:


We will listen to your chest (auscultation) using a stethoscope to listen for breath sounds, abnormal breath sounds (such as wheezes) and vocal resonance (found in specific lung conditions).

Your Physio will also percuss (tap) over your lungs to listen for any abnormal sounds associated with some lung illnesses.

We will also measure your chest expansion, respiratory rate, oxygen saturation and blood pressure.

If you have any current chest X-rays, we are also able to read and interpret them.

We may then proceed to looking at how well you can tolerate exercises, this can vary from doing some simple activities such as standing up from a chair to cycling on a bike or running on a treadmill.


This involves looking at the affected areas of you body where you may have pain or dysfunction.

Your Physiotherapist will choose appropriate tests to measure the strength, range of motion and quality of movement. They will where appropriate, assess nerve function if they expect a problem with this.

4. Physiotherapy Treatment

We use a holisitic management plan with you at the centre of care at Vitality Physiotherapy. Based on your specific goals and objectives as well as using the functional markers that we find in our examination, we design you a custom made treatment plan. This may include techniques to tackle breathlessness, improving your lung capacity, pacing of activities, fatigue management, improving your exercise tolerance or rehabilitation of muscle and joint dysfunction.

5. Onward Referrals

We use both telephone triage to strictly screen for any suspicious symptoms. If we suspect anything in either your triage call or our examination that requires further investigation, we have a large network of specialist clinicians to refer you to, including Specialist Medical Physicians, Respiratory consultants, GPs, Psychiatrists, Sports and Exercise Medicine Consultants.

Should we establish that you would benefit from a Sports Doctor, GP, Dietician, Speech and Language Therapy, Occupational Therapy, Psychotherapist or any other allied health professionals, we have a network of specialised professionals to refer you to.

At the core of our value system, we want to understand our patient’s concerns, experiences, and help manage their symptoms and comorbidities, referring patients as needed. Our objective is to help solve every problem in the complex puzzle that Long COVID can be, with a multidisciplinary patient-centric approach.