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Post-COVID syndrome is an emerging population health problem that has become an urgent concern. Since the start of the COVID-19 pandemic, CDC has reported more than 41 million confirmed cases of infection in the United States. An estimated 10% of COVID-19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms. CDC (2021) listed symptoms that people commonly report, such as shortness of breath, fatigue, loss of taste or smell, persistent cough, and many others. Among all signs, fatigue remains the most prevalent, affecting 58% of all long COVID cases.

Although both sexes are affected by COVID infection, most studies report that women develop post-COVID fatigue at higher rates than men. There is also an association between previous anxiety/depression and a higher level of fatigue. Most of the studies report mixed findings of an association between severity of the COVID, age, previous comorbidities, and risk of developing post-COVID symptoms.

Patients report post-COVID symptoms right after infection and, in some cases, longer than 90 days after the initial infection. Most patients report remitting/relapsing symptoms with changes in the nature and duration and unknown outcomes. National Institute for Health and Care Excellence (2020) recommends using diagnoses post-COVID syndrome for patients who experience ongoing symptoms longer than 12 weeks after initial infection.

The prevalence of the post-COVID symptoms highlights the significance of the problem. Every one of seven infected with COVID-19 virus patients may have long COVID symptoms. Many people cannot return to work even three months after the initial infection. Currently, there is no treatment for the post-COVID syndrome. Due to the significant burden to our society, the U.S. Congress has approved the COVID-19 Long Haulers Act (H.R. 2754), authorizing and funding research benefiting patients with long COVID.

The healthcare community has recognized the urgency of the post-COVID symptom, and some medical centers started to create post-COVID rehabilitation programs and recovery clinics. For example, in New Jersey, there are fifteen post-COVID rehabilitation centers listed on the Survivors Corps website, a non-profit dataset and research tool dedicated to ending the pandemic. Every Post COVID care facility offers different services and access to specialists. For example, Multidisciplinary Long-Term Recovery offers comprehensive programs with multiple treatment options; Rehabilitation & Therapy focuses on rehabilitation; Acute COVID-19 Recovery focuses on improved function after severe illness or hospitalization, often in-patient services. Due to the new and emergent nature of these programs, there is no research available to analyze their effectiveness in relieving post-COVID symptoms.

Unfortunately, the traditional medical community has difficulties addressing complex, ambiguous complaints. That is why the holistic nursing approach to treatments may be beneficial and justified. Holistic Prime Care can help COVID survivors to overcome post-COVID symptoms by including nontraditional approaches in the treatment plan. Mindfulness-Based rehabilitation program (MBRP) can reduce the duration and severity of post-COVID symptoms.

The program includes Mindful Breathing, Present Moment Awareness Exercises, Mindful Smelling and Testing, and Mindful Motion.

Mindful Breathing

Since COVID infection targets the lungs in many cases, the patients often experience cough and shortness of breath after the acute phase of the disease. The nurses have recognized the role of deep breathing exercises for pneumonia prevention for many years. Some pulmonologists started implementing diaphragmatic breathing training for COVID patients during the current pandemic. For example, Dr. Lein has posted a breathing exercises video guide on the John Hopkins Medicine website for Coronavirus recovery. Research confirms that a single session of 20-minute mindful breathing effectively reduces dyspnea rapidly for patients with lung cancer, chronic obstructive pulmonary disease, and asthma. Therefore, the mindful breathing session can help post-COVID patients to relieve respiratory symptoms.

Present Moment Awareness

One of the basic concepts in mindfulness is increased awareness of the present moment. Many medical professionals recognized the value of mindfulness for stress reduction during the COVID pandemic. For instance, Dr. Behan commented that mindfulness-based stress reduction (MBSR) is an evidence-based practice that the medical community can use in times of stress, such as the current pandemic. The techniques of present moment awareness will be introduced through exercises aimed toward awareness of the object, surroundings, and outside in nature.

Mindful Smelling and Testing

Many COVID patients report losing a sense of smell and taste. For some of them, these senses do not return for months. Dr. Mastrangelo said that smell and taste disorders probably result from a loss of function of olfactory sensory neurons and taste buds, mainly caused by infection, inflammation, and subsequent supporting dysfunction of non-neuronal cells in the mucosa. Currently, many news channels report that smell and taste training is recommended to regain senses. Recent research by medical professionals confirmed these recommendations. For example, Dr. Hopkins reported that an expert panel summarized the evidence and recommended olfactory training for all patients with persistent loss of sense of smell of more than two weeks duration. Therefore, mindful smelling and tasting exercises may be helpful with post-COVID symptoms.

Mindful Motion

Mindful motion means connecting mindful breathing with movement. The exercise will teach patients to breathe in rhythm while walking, moving arms, legs, and body. Depending on the progress, the lesson can end with simple yoga poses such as child pose, cat-and-caw, or tree pose. Mindful motion, including yoga, is beneficial for many stress-related health problems. Professionals agree that yoga is a therapeutic option for depression and positively affects people with anxiety disorders, particularly panic disorder. Yoga was found to impact physical and mental health conditions positively and was linked to positive health behaviors. Consequently, simple yoga or movements connected to breathing and awareness can benefit the participants of the program.

The COVID pandemic created an environment where increased stress and fear tagged the general public's human recourses. It also revealed chronic deficiencies in healthcare. However, this crisis also generated opportunities for population to develop innovative solutions to promote positive social change. The mindfulness program can positively affect the future, reduce stress, and increase patients’ well-being.