Breathlessness and Long COVID

What is breathlessness?

Breathlessness is a very common symptom in people with long COVID. Your lungs can become inflamed with your initial infection and the effort of breathing can increase.

You may be breathing more quickly and shallower than normal, however, it is important to try and stay calm.

As your lungs recover and time passes into the 12 week mark following infection, there can be other reasons for your breathlessness to continue. These can be due to being deconditioned and anxiety.

Anxiety can also increase your heart rate and make your breathing rate increase further. We encourage breathing control to help manage your breathlessness. Practice at rest to begin with then use during activity.

What is cough?

You may be experiencing a persistent dry cough. Coughing is one of the most common symptoms of COVID-19 and Long-COVID, and whilst it is typically in the form of a dry cough, coughs with phlegm can also be caused.

Coughs can be irritating, exhausting and can lead to inflammation in your upper airways. The more you cough, the more irritated your upper airways become, and the more you feel the need to cough.

Breathing control


Try this method for controlling breathlessness by following the below steps:

First try at rest, then try doing it during activities. 

  1. Get in a comfortable position
  2. Close your eyes and bring your attention to your breathing
  3. Breathe in and out through your nose (or mouth if you are unable to do this – but work towards trying to breathe through your nose in time).
  4. Put a hand on your stomach and recognise how it rises and falls when you breathe in and out
  5. Try to breathe in for the count of one, PAUSE and then out for the count of two, working towards a longer breath out than in. This will slow your breathing rate down.
  6. Notice areas of tension in your body and try to release this with each breath out.
  7. Gradually try to make your breaths slower and deeper.

This is useful during activities that make you breathless e.g. lifting an object (can be used with pursed lip breathing)

  1. Breathe in before you make the effort.
  2. Breathe out whilst making the effort (e.g. as you lift the object).
  3. Always breathe out on the hardest part of the actions

Techniques for managing breathlessness

This section will show you some positions of ease to help you in times of breathlessness.

  • Lie on your side.
  • Use multiple pillows under your head and shoulders.
  • Bend your knees a little.

  • Sitting upright, lean forward on to a table.
  • Add as many pillows as required.

  • Sit leaning forward.
  • Rest your forearms on your knees.
  • Relax you shoulders and chest.

  • Stand leaning forward and use a chair, bench or wall for support
  • Relax your chest and shoulders.

Suppressing the urge to cough

This section will give you tips and exercises to help you with coughing and coughing fits. 

  1. Breathing in and out of your nose instead of your mouth.
  2. Sucking on boiled sweets or lollipops.
  3. Having regular drinks breaks / sips of fluids.

As soon as you feel the urge to cough, close your mouth and cover it with your hand (SMOTHER the cough). At the same time, make yourself SWALLOW. STOP breathing – take a pause. When you start to breathe again, breathe in and out through your nose SOFTLY.

“Smother – Swallow – Stop – Soft” is a good way to remember this exercise.

If you need to cough, try to cough into a tissue or the crease of your elbow and over 2 metres away from other people. Always wash your hands for 20 seconds after you cough.

If you cough at night, try lying in a different position and / or use pillows to prop yourself up.

Types of cough

Coughing is one of the most common symptoms of COVID-19 and Long-COVID, and whilst it is typically in the form of a dry cough, coughs with phlegm can also be caused. 

A dry cough is one of the most common coronavirus symptoms and can continue into Long-COVID for many individuals.

If you have a dry cough, try to:

  • Stay hydrated. Take small sips of a soft drink, one after the other. Try not to take large sips..

  • Inhale steam. Pour hot water into a bowl, then put your head over the bowl. If comfortable, cover your head and bowl with a towel.

  • Drink a warm drink, such as honey and lemon, as this can soothe your throat.

  • Swallow repeatedly if you don’t have a drink near you. This can work in a similar way to sipping water

A dry cough is one of the most common coronavirus symptoms and can continue into Long-COVID for many individuals.

If you have a dry cough, try to:

  • Stay hydrated. Take small sips of a soft drink, one after the other. Try not to take large sips..

  • Inhale steam. Pour hot water into a bowl, then put your head over the bowl. If comfortable, cover your head and bowl with a towel.

  • Drink a warm drink, such as honey and lemon, as this can soothe your throat.

  • Swallow repeatedly if you don’t have a drink near you. This can work in a similar way to sipping water

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