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Long COVID-19; the lasting impact.

Updated: Sep 14, 2020

Post Viral Fatigue - Long COVID. Can Perrin Technique help?

It’s been in the news a lot with examples of previously fit and healthy marathon runners, busy nurses and generally well and active people having COVID-19 but then never really shaking the symptoms of fatigue and general malaise. In some cases, those symptoms appear to worsen and remain for many months after the original infection.

This is not a phenomenon unique to COVID-19, these fatigue symptoms can occur after any serious infections.

What’s important to remember is that after any illness your body will naturally be fatigued, and this is entirely normal; it has just fought a huge battle against an infection and used its’ resources for a prolonged period of time. It now needs to recover. Normally after a cold or minor infection you can expect to feel a bit groggy and not quite right for a couple of weeks. During this time, it’s important for you to be kind to your body; feed it well, increase activity and exercise slowly (physical and mental), and give it the rest and relaxation it needs.

Following simple advice such as that given by the NHS on this website will be enough for most people to get back to health within that ‘normal’ recovery time.

However, for a few, those persistent symptoms just do not go away. The Zoe study, an ongoing project run by Professor Tim Spector, Professor of Genetic Epidemiology at King’s College London, estimated on June 8th, that although most people recover within two weeks, 1 in 10 people still have symptoms after three weeks. It would be interesting to see what the data says now three months later. A recent small study of 143 participants in Italy found 53% of those participants were still experiencing fatigue symptoms 60 days post discharge from hospital. (Carfi et al 2020).

Historically researchers have found the following persistent fatigue symptoms in other serious infections:

  • SARS in 2011, Moldofsky found 40.3% experiencing fatigue in a 4 year follow up.

  • A(H1N1) Spanish Flu in 1918, reports suggest 2 in 10 did not fully recover and fatigue was one of the longest reported symptoms.

  • Ebola in 2016, Wilson et al found that 28% of survivors presented with persistent fatigue.

  • Infectious Mononucleosis in adolescents, Katz et al found fatigue in 13% at 6 months and 4% at 24 months follow up.

So, why we think you have become ill and what we think we can do to help.

As Perrin Practitioners, we are already treating people with Chronic Fatigue. Not everyone who suffers an illness gets post viral fatigue, and not everyone with post viral fatigue will go on to experience chronic fatigue (CFS) / myalgic encephalomyelitis (ME), but it is expected that some will according to the research already quoted.

We are hopeful that the techniques we use to treat CFS/ME can also be used to prevent the post viral fatigue from progressing into chronic fatigue. We are already seeing some promising results.

Our treatment is a combination of lymphatic massage, thoracic mobilisation and cranial osteopathy and is based around the idea that the illness is caused by a build-up of toxins in the fluid surrounding the brain and the spinal cord. We aim to aid lymph drainage, improve spinal mechanics, reduce spinal inflammation and improve the function of the autonomic nervous system. In the case of post viral fatigue, the toxin build-up is a result of the infective stress that has been placed on the body.

Stressors that bombard the body come from different sources: physical trauma, emotional/psychological trauma (such as stress, depression, PTSD) environmental issues (mould, pollution, heavy metals) and other infective events (viral, parasitic, bacterial); and although bodies are designed to process and eliminate these toxic elements, it is usually a combination of more than one of these events that create an overload that the body cannot always cope with effectively.

The build-up of toxicity results in an overload in the lymphatic system, the system responsible for breaking down and processing larger molecules; the system slows down and fails to keep up with demand. This then impacts the central nervous system, and this is when we start to see the sorts of dysautonomia, brain fog and fatigue symptoms synonymous with CFS/ME in our patients.

If you would like to find out more about the treatment or would like to book in with us at Harper Road Osteopaths; both Victoria and Lorna are Perrin Practitioners and Registered Osteopaths experienced in this area.

I’ll leave you with this final observation made in the Lam et al. research paper on SARS in 2009:

” Because new infectious diseases are emerging at an unprecedented rate and pose a global threat for pandemics, there should be better preparation in public health strategies for dealing with both the acute phase of a disease and the long-term complications related to the disastrous outbreaks of new infectious pathogens”

This insightful comment is more relevant than ever. The world of Post Viral and Chronic Fatigue must surely now have the spotlight shone upon it enough to invite the funding it deserves for research that will truly uncover the physiological processes at play and to develop better management and treatment options.

Victoria Diamond (Sept 12th 2020)


Angelo Carfì, Roberto Bernabei, Francesco Landi, et al, (2020) Persistent Symptoms in Patients After Acute COVID-19, JAMA. 2020;324(6):603-605. doi:10.1001/jama.2020.12603

Himiede W. Wilson, Maame Amo-Addae, Ernest Kenu, Olayinka Stephen Ilesanmi, Donne K. Ameme, and Samuel O. Sackey (2018), Post-Ebola Syndrome among Ebola Virus Disease Survivors in Montserrado County, Liberia 2016, BioMed Research International Volume 2018, Article ID 1909410

Leonard A. Jason, Ben Z. Katz, Yukiko Shiraishi, Cynthia J. Mears, Young Im, and Renee R. Taylor (2014), Predictors of post-infectious chronic fatigue syndrome in adolescents Health Psychol Behav Med. 2014 Jan 1; 2(1): 41–51.

Marco Ho-Bun Lam, Yun-Kwok Wing, Mandy Wai-Man Yu et al, (2009) Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors Long-term Follow-up Arch Intern Med. 2009;169(22):2142-2147.

Moldofsky H., Patcai J. (2011) Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol. 2011; 11:1–7. [PMC free article] [PubMed]

Perrin, Raymond (2010). EPA and the Perrin Technique: a combined approach to treating myalgic encephalomyelitis. Annals of General Psychiatry. 9. 10.1186/1744-859X-9-S1-S25.

Ray Perrin, Lisa Riste, and Mark Hann (2020), Into the looking glass: Post-viral syndrome post COVID-19, Med Hypotheses. 2020 Nov; 144: 110055. Available online:


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