Symptoms of Long COVIDIn a May 2021 review article in Infectious Diseases, author Shin J. Yong summarized the published literature to date on the symptomatology, pathophysiology, risk factors, and treatments for people experiencing persistent or unusual symptoms after being sick with COVID-19.
“While the precise definition of long COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnea [shortness of breath] that last for months after acute COVID-19,” Yong said. Other less typical symptoms include problems with thinking and processing information, psychiatric symptoms, headache, muscle aches and pains, chest and joint pains, abnormalities of smell and taste, cough, hair loss, trouble sleeping, wheezing, runny nose, coughing up mucus from lungs, heart problems, and digestive issues.
Interestingly, COVID-19 isn't the first coronavirus to result in long-term symptoms. Survivors of the viruses MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome) also reported experiencing symptoms of fatigue, muscle pain, and psychiatric impairments for several years.
Pathophysiology of Long-Haul COVIDLong-haul COVID may result from direct tissue damage, persistent inflammation from spike protein particles, immune system dysregulation, or the development of autoimmunity.
Yong also describes how gut microbiome disruption (i.e. gut dysbiosis) seen in patients with COVID-19 has been shown to persist after infection. Abnormalities in the microbiome in the intestines have been implicated in numerous diseases related to chronic inflammation. The influence of gut bacteria on brain chemistry may account for some of long-haul COVID’s neurological symptoms.
- Immune cells in the lungs called macrophages may remain active, fighting the enemy that is no longer there. This could account for the problems patients have with breathing, ongoing cough, inability to exercise due to feeling short of breath.
- Other immune cells called monocytes and microglia may also remain in fight mode activation due to the persistence of pieces of dead virus or debris such as the spike protein inside these cells that keeps the flames of inflammation burning. This could account for the overall feeling of fatigue, achiness, brain fog, and joint pains.
- Damage to both large and small blood vessels with the formation of blood clots and/or autoimmune attack by the immune system against brain proteins could cause the neurological symptoms that seem to be common in severe COVID-19 disease.
- Mast cells, which are present all over the body, including the brain, may get activated and result in mast cell activation syndrome (MCAS). The brain fog, cognitive impairment, and general fatigue reported in long-haul COVID may be due to mast cell-related inflammation of the brain and its blood vessels.
The article makes it clear that the S1 protein found in these patients appeared to be debris left over from initial infection with the virus and was not the result of ongoing, persistent viral growth and replication. Therefore, it is unlikely that long-haul COVID patients are infectious to others. Rather, the scientific evidence indicates that these patients’ immune systems are stuck on overdrive, pouring out inflammatory molecules in response to the persistence of the S1 spike protein fragment.
Diagnosis of Chronic COVID-19 SyndromeYong’s review article described how patients with post-COVID-19 syndrome had elevated levels of pro-inflammatory markers in the blood such as C-reactive protein; interleukin-6; ferritin; D-dimer as well as lowered levels of the white blood cells known as lymphocytes.
TreatmentThe overall goal of treatment should be to block the spike protein or its fragment from interacting with cells throughout the body, to reduce systemic inflammation and lower the thermostat (to turn down the heat so to speak), to balance the formation and degradation of clotting and remove excess fibrin or sludge-like debris in the blood vessels, and to eliminate symptoms.
Treating physicians may prescribe non-steroidal anti-inflammatory drugs or try pharmaceutical drugs (NSAIDS) repurposed from the treatment of chronic inflammatory response syndrome (CIRS), chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS). Most agree that personalized graded light aerobic exercises, physical rehabilitation programs, and breathing exercises can help post-COVID-19 patients recover.
In my own medical practice, I have been successful in treating long-haul COVID patients with a combination of enzymes that break up blood clots and debris, nutritional and herbal anti-inflammatories, herbal antibiotics, nutritional supplements, and pharmaceutical medications. These are the same modalities that I use to treat my chronically ill patients suffering from problems with tick-borne diseases, mold-induced illness, environmental toxicities, microscopic blood clotting or hypercoagulability, and genetic detoxification problems.