Simona Kopp is an athletic person: the 30-year-old logs almost 4,500 kilometers on her bike every year. When she fell ill with Covid in March 2020, her symptoms were relatively mild. “I never really felt that bad,” says Kopp. She was also not concerned that two weeks later she was still weak and found it unusually difficult to take a walk or make her way up a few flights of stairs. After all, as a physical therapist Simona Kopp understands that after growing weak due to an infection or accident, physical fitness has to be rebuilt little by little.
“I found myself wondering more and more, what’s going on with my lungs.”
Things didn’t seem to get any better. Twenty minutes of jogging were enough to make Simona Kopp feel for several hours that she could not get enough air into her lungs. “The doctors just told me that I had to be patient, but when, after three months, I still saw no improvement, I found myself wondering more and more: ‘What’s going on with my lungs?’”, says Kopp. Even her partner noticed that during their bike tours together, her performance was noticeably impaired.
Decision to take a stress test
Simona Kopp decided to undergo stress testing known as a cardiopulmonary exercise test (CPET or Spiroergometry) (find out more inin this blog post). A decision like this should be made with a specialist in the case of someone suffering from Long COVID: in some patients, overexertion can lead to a crash (Post Exertional Malaise or PEM)which can set them back for days. This is especially true if they are already familiar with this type of exertion intolerance from everyday life.
Yet, this was not the case for Simona Kopp: her shortness of breath would dissipate 2 or 3 hours after exertion, without wiping her out for days afterwards. She could still manage her full 90% workload. If there is no indication of PEM, then a stress test can be useful and provides meaningful diagnostic data (see the related blog post).
“I was happy to hear that as far as they could tell, everything was normal and that I could exercise.”
Simona Kopp thus underwent a cardiopulmonary exercise testing (CPET): under a predefined stress protocol, she had to steadily increase her level of exertion to the maximum on a cycle ergometer. Her lactate levels showed that her muscles were running out of oxygen far too quickly. “I had to stop the test much earlier than I would have expected, based on my experience,” says Simona Kopp. She was not alarmed that she felt shortness of breath for a few hours afterward. “At this point, I knew it was just temporary.”
Healthy organs
Kopp was able to discuss her results with a doctor. Her heart and lungs showed no abnormalities. “His opinion was that I could carry on training. I was happy to hear that I wasn’t putting myself at risk.” The exercise test was therefore a way to benchmark her health, which gave her a feeling of security. Simona Kopp began with light interval training. To make significant progress, however, she needed a different method.
Because she worked in the physiotherapy department of the Balgrist University Hospital, Simona Kopp knew that training devices for respiratory muscles existed. She would train multiple times per week with increased resistance. Sometimes she followed her breathing training with interval training on a bike (with short high-intensity intervals).
“I was happy I’d found a training method that allowed me to make progress. Just waiting and hoping it will eventually get better is really hard,” says Kopp.
It was a success: three months later she felt relatively fit again. She had another cardiopulmonary exercise test, and there was a marked improvement in her results. She was even able to participate in the Nationalpark Bike Marathon and was happy with her performance: “My lungs had regained 90% of their capacity.”
After around eight months, Simona Kopp felt like she was in shape again. So, was it all back to normal? Not really: almost two years after infection, her sense of smell still hasn’t really gone back to normal. “I’m at around 80% now,” Kopp estimates. At first, she had no sense of smell at all. It then quickly improved, followed by no more progress. Now, some smells return suddenly – like freshly mowed grass.
Not like before
Other smells have changed. “A banana doesn’t taste like it used to. Instead, it tastes like something new, something I can’t describe exactly.” Kopp had to change her shower gel and body lotion, as their scents made her nauseous. Raw onions are out of the question, and she now only eats dark chocolate – everything else is much too sweet. “Now my partner tastes things when we’re cooking,” she says.
Even though she feels healthy again, the long-term effects of her Covid infection are still with her. “No one can tell me if my sense of smell or taste will ever come back completely. So, I accept these changes, for the moment.”
