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‘Long COVID’ is Real: Here’s What You Need to Know

Published May 18th, 2021

Many COVID-19 patients are still battling symptoms long after the virus is no longer detected. While there is currently no consensus definition for this condition, patients suffering from “post-COVID-19 syndrome” can be separated into two cohorts: “post-acute COVID-19 syndrome” (PACS) and “Long COVID” (chronic COVID-19 syndrome; CCS)”. PACS is characterized by clinical symptoms extending three weeks beyond the onset of first symptoms and this becomes CCS if these symptoms persist for more than 12 weeks.

Incidence

​Recent studies have shown that approximately 10% of all people who test positive for COVID-19 experience prolonged symptoms up to three months later and a smaller portion continue to suffer chronic symptoms a year later. Evidence indicates that COVID-19 can spread to many different organs, including the heart, blood vessels, kidneys, gut, and brain. Not surprisingly, Long COVID symptoms can be systemic, which necessitates a multidisciplinary approach for evaluation and successful treatment.

Symptoms​

Patients with Long COVID experience a wide range of clinical symptoms, reflecting the truly systemic nature of this condition. Fatigue and brain fog (confusion) are the most commonly reported symptoms. However, patients may also experience diverse symptoms including shortness of breath, chest pain and tightness, cough, muscle and joint pain, headaches, diarrhea, sore throat, and a loss of taste or smell. Considering the wide range of symptoms, a comprehensive health team of specialists is needed to effectively evaluate a patient and implement the proper care.​

Cause

There is also evidence to support the continued presence of COVID-19 virus long after the resolution of the primary infection. Angiotensin-converting enzyme 2 (ACE2), the receptor used by COVID-19 to facilitate viral entry (i.e., infection), is present on many cells and tissues including those in the respiratory, gastrointestinal, and central nervous systems. Specifically, the virus can linger in these organ systems after the initial infection for an unknown amount of time. This could play a key role in contributing to Long COVID because a lingering infection can lead to a constant state of chronic inflammation, which can then manifest as symptoms of Long COVID.

Having symptoms long after a viral infection is not new. In fact, almost any viral infection can lead to a condition called post-viral syndrome. Post-viral syndrome can take many forms, including disorders like chronic fatigue syndrome or fibromyalgia, and even severe autoimmune conditions such as Guillain-Barre Syndrome, where the immune system turns against the nervous system.

Treatment

There are a number of clinics across the US and in Europe that are developing focused therapeutic programs to combat the effects of Long COVID. A tailored, multipronged approach to treating the long-lasting impacts of a COVID-19 infection should include a thorough diagnostic assessment of cardiac, pulmonary, vascular, metabolic, and digestive functions to plan a recovery program. A holistic approach will include a regimen of treating inflammation (steroids, antihistamines, allergy medicines), rebalancing gut health (prebiotics/probiotics), and engaging in sports medicine/rehabilitation services. Based on the clinical assessment, treatment may include autoimmunity potentiators (e.g., arthritis drugs) and antiviral treatments (e.g., remdesivir, ivermectin) to clear residual virus. Monoclonal antibody therapies authorized for COVID-19 infections, such as those developed by Eli Lilly and Regeneron, are also being explored to help eliminate lingering infections.

Relief of Symptoms with Vaccination

Recently, anecdotal accounts of COVID-19 vaccination alleviating the symptoms of Long COVID have been reported in the news, and a study was recently published on this topic. Patients hospitalized with COVID-19 who subsequently presented with Long COVID (at 3 months and 8 months) were compared 1 month after COVID-19 vaccination with Pfizer-BioNTech or AstraZeneca vaccines. Improvement in Long COVID symptoms was observed after vaccination as indicated by a decrease in worsening symptoms and an increase in symptom resolution. No differences between the vaccines were observed, indicating that the responses were independent of the vaccine type. If Long COVID is indeed caused by a chronic SARS-CoV-2 infection, the vaccines can serve as a booster to stimulate an immune response to eliminate lingering virus.

While this is an active area of investigation, the current data suggests that the COVID-19 vaccines are both safe in Long COVID patients and can alleviate symptoms in some cases. Therefore, Private Health recommends that anyone (including Long COVID patients) receive a COVID-19 vaccination if not otherwise contraindicated.

Private Health Management Can Help

While there are clinics across the country for PACS and CCS patients, the waitlists are often long. Private Health Management has years of experience helping patients with complex health conditions navigate the complicated health care system, connect with leading experts, and develop a personalized treatment plan. We are pleased to be helping clients experiencing the challenges of Long COVID. Please contact our team if we can be of support.

* Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

About the Author

Nicholas Young, Ph.D.

Director, Research

Dr. Young, Ph.D.is focused on designing treatment strategies for clients through a precision medicine approach that leverages the latest advances in science and therapeutic development.