Latest Update for Long-COVID Treatment, Experts Share

Latest Update for Long-COVID Treatment, Experts Share
George Citroner

Long COVID, also called post-COVID condition (PCC), is defined as the continuation or development of new symptoms three months after initial COVID infection, with those symptoms lasting at least two months with no other cause found.

Long COVID can affect a person of any age infected with any severity of the disease.

A Mix of Many Different Conditions

It’s important to understand that long COVID is a mix of many different conditions, Dr. Jacob Teitelbaum, a board-certified internist and nationally known expert in the fields of chronic fatigue syndrome, fibromyalgia, sleep, and pain, told The Epoch Times.

“If somebody had a stroke, heart attack, loss of smell, or post-viral chronic fatigue syndrome after COVID,” he explained, “these are all being lumped together under the long-COVID diagnosis.”

The range of long-COVID symptoms is enormous, and more than 200 symptoms have been reported that impact how affected people live their lives.

“But it is critical to realize that these are all distinct diagnoses that each have their own required treatments,” Teitelbaum said.

Exactly how many people are living with long COVID worldwide is currently unknown, with no systematic data on post-COVID-19 conditions being reported by any country.

The most recent study, a global systematic analysis of long-COVID incidence, found that in 2020 and 2021, roughly 145 million people experienced any of three “symptom clusters”—fatigue, respiratory difficulties, and cognitive issues.

Fatigue occurred in 51 percent of cases, respiratory difficulties in nearly 61 percent, and cognitive issues in about 35 percent. Researchers observed that these symptoms occurred in nearly four percent of all COVID infections.

Overall, findings indicated that 15 percent of those affected continued to experience long COVID at 12 months, and disease severity was associated with the duration of COVID symptoms.

Those with milder COVID-19 cases recovered from symptoms faster than those admitted with severe infection.

Treatment of Long COVID Is Progressing

Dr. Richard Becker of the Division of Cardiovascular Health and Disease at the University of Cincinnati College of Medicine, who also runs the UCHealth Post-COVID Clinic, said progress in the field of post-COVID conditions has been made in five specific areas:
  • Acknowledgment that the condition does indeed occur in up to 20–30 percent of people with COVID-19
  • Recognition that long COVID can occur following either a mild or a severe case of COVID-19
  • Definition of specific symptom profiles or groupings in patients with long COVID
  • Appreciation that many patients have cyclic symptoms—improvement followed by recurrence of symptoms
  • The impact of physical, mental, or psycho-social stressors on these symptom cycles can occur every few weeks and last for several days at a time
Becker noted that patients with long COVID often improve with time and supportive measures from family, friends, employers, and health care providers.

Excluding underlying or worsening health conditions that pre-dated COVID-19 infection is “very important,” he emphasized, as treatments for these pre-existing conditions may be readily available.

Recently published research finds that preinfection psychological distress was strongly associated with an increased risk of long COVID and daily life impairment. The American Diabetes Association (ADA) reported that people with diabetes are up to four times more likely to develop long COVID.

Treating preexisting conditions like these may offer significant relief for people experiencing post-COVID symptoms.

However, Becker pointed out that specific treatments for the broad category of post-COVID conditions are still not available.

Clinical trials supported by the NIH, medical societies, and pharma are ongoing. “Answers, prevention, and treatments will emerge from these large-scale initiatives,” said Becker.

One such trial is currently looking at an HIV drug called leronlimab to treat prolonged symptoms of COVID-19, while another trial is analyzing whether Paxlovid can treat long COVID.

Post-viral fatigue, cognitive dysfunction, and pain are what most people are referring to when they talk about long COVID, observed Teitelbaum, who said the majority of people with the post-viral chronic-fatigue-syndrome component of long COVID have fatigue, "brain fog," and widespread pain.

Other symptoms can include shortness of breath, numbness and tingling in the fingers called paresthesias, palpitations, irritable bowel syndrome, and nasal congestion, which Teitelbaum said are all benign.

Shortness of breath after COVID is also common, causing some people to be afraid that they have lung or heart damage.

“But this is usually not the case,” said Teitelbaum, who added that long COVID responds very well to treatment.

A COVID-19 treatment that was much maligned at the height of the pandemic may offer relief for those experiencing chronic fatigue syndrome after infection.

A recent systematic review of 52 studies found that the prevalence of chronic fatigue syndrome four weeks after the onset of COVID-19 symptoms was over 45 percent.

"What differentiates these post-COVID patients from other causes of chronic fatigue syndrome and fibromyalgia is that many improve considerably with the medication ivermectin," said Teitelbaum.

A small study looked at 33 adult patients with persistent or post-acute symptoms of COVID-19 who were treated with ivermectin. Findings show that 94 percent of that group experienced partial or total clinical improvement after only two doses of the drug.

Ivermectin also helped patients with the chronic pain and tenderness of fibromyalgia, which some experience after COVID vaccination.

“Very surprisingly, I’ve also seen several people with post-COVID vaccine fibromyalgia, and for reasons that I cannot explain, this group responds very well to treatment with ivermectin,” said Teitelbaum. “I have not seen secondary CFS or fibromyalgia occur from other vaccines, except in cases where longer than the usual course of hepatitis B vaccine was given.”

A recently published study (pdf) co-authored by Teitelbaum of 188 people showed that people with post-viral fibromyalgia also improved considerably with a unique, highly potent form of ginseng called Korean red ginseng.
“We have not seen the same benefits from other forms of ginseng,” he noted.

Recovery From PCCs Is a Long Journey for Some

According to Becker, many of his patients who have improved acknowledge that the journey was longer and more challenging than they expected.

“They have also commented that adapting to mitigate symptoms is very important, specifically periods of rest—mental, physical, and emotional,” he said.

Becker acknowledged the challenges inherent in understanding the information being released regarding PCCs.

“A vast majority of our patients recognize the importance of sound information coming from the medical and scientific communities, as well as the potential harm of misinformation and untested therapies that come with a high cost and misleading promises of rapid cures,” he said.

Becker pointed out that his patients have also been highly supportive of research undertakings that have the potential to help others carrying the burden of long COVID.

George Citroner reports on health and medicine, covering topics that include cancer, infectious diseases, and neurodegenerative conditions. He was awarded the Media Orthopaedic Reporting Excellence (MORE) award in 2020 for a story on osteoporosis risk in men.