In this blog I am going to discuss the link between hyperventilation (over breathing or disordered breathing) and long COVID. Early in the COVID-19 pandemic a lot of attention was focused on spread of the virus and on helping the surge of hospitalised patients with serious illness.

Long COVID

More recently in the pandemic, focus has been on care of the survivors of COVID-19 who have “long COVID”. Many people have persisting symptoms several months after the onset of the infection including exercise intolerance, fatigue and breathlessness. Previous outbreaks of coronaviruses have also caused persistent breathlessness, muscle weakness, fatigue and reduced quality of life.

Two types of symptoms after COVID-19

However, there seem to be two different types of symptoms. The first can be directly related to the organ damage from the initial infection or to the complications of treatment of the hospitalised patients. But the second type of persisting symptoms can  be seen in people who only had MILD initial disease, without evidence of organ damage. The NICE guideline scope published on 30 October 2020 defines post-COVID syndrome as “signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis”.  In the UK 2 million people may be affected, a third of them with severe disease.

Causes of long COVID

Although not enough is known about what causes long COVID,  recent findings suggest that hyperventilation may be a major factor.  The reduced levels of carbon dioxide or CO2 (hypocapnia) related to hyperventilation can reduce available oxygen and cause multiple symptoms including: breathlessness; fatigue; dizziness; anxiety; brain fog; palpitations; poor circulation and cold hands; tingling and many other symptoms. Symptoms overlap with those of ME/CFS and with long COVID.  So this lack of oxygen could certainly contribute to exercise intolerance by reducing available oxygen.

Here, for example, is an article documenting a BBC journalist’s slow return to health. She states “Many people with long Covid have breathing pattern disorder or hyperventilation syndrome”.  Long Covid: Will I ever get better? – BBC News

I know it seems counter intuitive that over breathing can cause lack of oxygen; but you do need a certain amount of CO2 to use oxygen efficiently. Th balance of blood gasses is crucial, CO2 helps to get oxygen from the bloodstream and into the cells that need it. When people feel breathless they tend to want to breathe more, but in fact in these situations they need to learn to breathe less.

Stress and hyperventilation

So chronic stress can cause chronic hyperventilation; Dr Buteyko said that anything that makes you breathe more than you need is a stress on the body. The virus infection itself can be a stress on the body. Additionally so can fear of the virus sweeping across the globe, media reports, lockdown, isolation, financial insecurity and all that came with the handling of the pandemic. All could contribute to the anxiety, stress and hyperventilation. This can result in symptoms increasing, you feel worse, breathe more, get more anxious, breathe more- a vicious cycle.

Free Breathing Assessments

Do you have long COVID? Hyperventilation/over breathing/disordered breathing are exactly the conditions that the Buteyko method was designed to treat. Some respiratory physiotherapists can also help. I am still offering a number of free breathing assessments for people with long COVID (the cost is normally £70). Please contact me if you are interested before the end of 2021, I would like to help.

(Thanks Shane @theyshane for the Unsplash photo)