The American Heart Association has endorsed the controversial stance that a tailored exercise programme should be prescribed to long covid patients.
Summary
- An Australian publication, The Medical Republic, have written an article about the American Health Association's (AHA) views that exercise therapy should be used in the treatment of Long Covid.
- The MEA firmly disagrees with this, citing the NICE Guideline recommendations, and instead recommends pacing as the best form of activity management for people with Long Covid.
On the 14th July, 2025, The Medical Republic, an online Australian publication, published the article, ‘Exercise recommended for long covid,' based upon the American Heart Association's (AHA) recent endorsement of exercise therapy for people with Long Covid.
Dr Charles Shepherd, MEA Hon. Medical Adviser, comments as follows:
Once again, exercise therapy is being promoted to people with Long Covid on the basis of new guidance from American Heart Association.
However, as the MEA keeps pointing out:
- Long Covid covers a very wide spectrum of clinical presentations and illness severities.
- Most people with Long Covid have one or more symptoms – activity induced fatigue, PEM, cognitive dysfunction, unrefreshing sleep, orthostatic intolerance – that occur in ME/CFS. And a significant proportion of people with Long Covid also meet diagnostic criteria for ME/CFS.
- Whilst there will be be some people with Long Covid who may benefit from a more active approach to activity and energy management, those who have ME/CFS type fatigue and/or PEM are highly likely to be made worse by an inappropriate exercise programme.
- There are now a number of research studies from very reputable research groups which show how inappropriate exercise can have an adverse effect on mitochondrial and muscle function in Long Covid: Nature – Reply: Muscle abnormalities in Long COVID
- NICE does not recommend the use of graded exercise therapy for Long Covid: Blog: NICE cautions against using graded exercise therapy for patients recovering from COVID-19
- The MEA therefore recommends that pacing, as it applies to people with ME/CFS, is the best form of activity management for most people with Long Covid.
- Following the principles of informed consent, and ‘first do no harm', doctors who prescribe exercise therapy for Long Covid should let patients know that other doctors do not believe that exercise programmes should be prescribed in our current state of knowledge.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
The ME Association has previously written about the AHA recommendations on exercise therapy for long covid. You can view our previous reply here: