Can ‘Pacing’ Reduce Long COVID Symptom Exacerbation

A recent international qualitative study explored the experiences of adults with Long COVID using pacing as a strategy to manage symptoms, particularly post-exertional symptom exacerbation (PESE) and post-exertional malaise (PEM). Led by Kiera McDuff and corresponding author Kelley K. O’Brien both from the University of Toronto and others involving researchers and collaborators from institutions in Canada, Ireland, the UK, and the U.S., the study engaged 40 adults living with Long COVID through community-based interviews. Participants, mostly women with a median age of 39, described pacing as a challenging, yet crucial method to balance rest and activity, mitigating symptom exacerbation. They conceptualized pacing through relatable analogies like Spoon Theory and energy budgeting, revealing that the strategy, though helpful, is a “moving target” requiring constant adjustment.

In the context of this study, pacing refers to a self-management strategy used by individuals with Long COVID to balance activity and rest in order to mitigate symptoms such as post-exertional symptom exacerbation (PESE) and post-exertional malaise (PEM). It involves carefully regulating physical, cognitive, social, and emotional exertion to avoid overexertion that could worsen symptoms or lead to debilitating "crashes."