Why the name change you ask? Because words have power! And Long Hauler's COVID has a negative connotation that could, and will for many people, create fear, worry, stress, etc. Dr. Jennifer Possick from Yale School of Medicine agrees. Here is her quote, “On the one hand, ‘long-hauler’ acknowledges the fact that this is not just a cold or the flu and that people really do have protracted symptoms that have been life-altering,” she says. “On the other hand, the term seems to imply that these symptoms are here to stay, and I don’t like the hopelessness that conveys. We spend a lot of time with people talking about their experience and framing expectations and maintaining a sense of hope that things can improve. This isn’t the end. This is hopefully the middle of their journey back to health.” [1]
What Is Post COVID Conditions
According to the CDC, Post COVID conditions are a wide range of new, returning or ongoing health problems people can experience four or more weeks after first being infected with the Virus that causes COVID-19. [2] A study performed in the US found that one third of the people with COVID-19 report persistent symptoms up to 9 months after the initial illness. [3] A European study has shown that 87% of patients who are hospitalized due to COVID-19 had persistence of at least 1 symptom after 60 days. [4] BUT it is not just happening to people who were hospitalized! Most of the patients at Yale's Long COVID clinic were never hospitalized. [1]
Well, what are these persistent symptoms? Here's Figure 2 from the European study mentioned earlier that shows the pathophysiology of COVID in its different stages.
There was also a US study that found that 1/3 of people with COVID-19 report persistent symptoms up to 9 months after the initial illness. [5] It should be noted that there are some reports of people who were infected during the first wave/spike that were still having symptoms at 18 months. This is not meant to scare anyone, but to illustrate how important it is to take your recovery seriously and slowly!!! Here's a table from that study that show how long the symptoms persisted and some of the different symptom presentations.
Here is a list of symptoms that will be a little bit easier to read.
Symptoms of long COVID may include:
Fatigue
Headache
Shortness of breath
Chest pain or discomfort
Cough
Persistent loss of smell and/or taste
Joint pain; muscle aches and pain/weakness
Sore throat
Memory loss
Brain fog (difficulty concentrating, sense of confusion or disorientation)
Dizziness
Low-grade, intermittent fever
Rapid or irregular heartbeat (palpitations)
Anxiety
Depression
Post-traumatic stress disorder (PTSD)
Insomnia
Earache, hearing loss, and/or ringing in ears (tinnitus)
Rashes
Diarrhea, nausea, and/or abdominal pain
Diminished appetite
Hair loss [3]
I would also like to add to that Postural Orthostatic Tachycardia Syndrome, Mast Cell Activation Syndrome and Dysautonomia. According to Yale, it was thought that the normal recovery time after COVID infection is 2 weeks. However, most of the people in their program have had symptoms for 4-5 months and have multiple symptoms. [1]
What Can We Do For Post COVID Condition
I believe that I have mentioned in previous articles, and know I have in some video posts, that COVID can affect any and all body systems. This is why the symptomatology is so diverse! Here's some treatment ideas from Yale Medicine.
How is long COVID treated?
For patients who have multiple symptoms, treatment may involve specialists in cardiology, pulmonology, neurology, psychiatry, rehabilitation, and/or other relevant fields of medicine. Below, by symptom, are treatments and therapies that may help people with long COVID:
Fatigue. Patients may be taught strategies for “Pacing, Planning, Prioritizing, and Positioning” activities, sometimes known as the “4 Ps.” They may also be advised to undertake a physical exercise program that involves stretching, strengthening, and aerobic activities. If exercise worsens symptoms, the patient should stop or reduce the intensity and/or duration of the activity.
Respiratory symptoms. Treatment may involve breathing exercises, use of supplemental oxygen, and pulmonary rehabilitation, a medically guided program in which patients perform exercises and learn breathing techniques. Patients may need to use a pulse oximeter to monitor blood oxygen saturation levels. (If blood oxygen saturation levels fall below 92%, they should seek medical attention.) If respiratory symptoms do not improve, patients may be referred to a pulmonologist.
Cardiac symptoms. Patients with cardiac symptoms may be referred to a cardiovascular specialist for cardiac symptoms, such as rapid heart rate or chest pain. Treatment may involve cardiac rehabilitation. Medications may also be used to control specific symptoms.
Neurological symptoms. If patients have cognitive symptoms such as memory loss and/or brain fog, doctors may recommend exercise and to remain physically active. For patients with memory impairment, treatment might involve memory exercises and the use of memory aids such as calendars and planners. Patients may be referred to a neurologist.
Psychological symptoms. Treatment commonly involves counseling, support groups, and medications to manage depression, anxiety, or other conditions.
Smell and taste symptoms. Patients who have reduced or lost sense of smell and/or taste, doctors may prescribe topical (drops or sprays) corticosteroids to reduce inflammation in the nose. They may also perform olfactory training, a therapy in which patients regularly sniff various odors for a set period (usually several weeks) with the aim of restoring sense of smell. If symptoms do not resolve, patients may be referred to an ear, nose, and throat (ENT) specialist. [3]
Patients who have symptoms related to kidney, liver, or endocrine function—as well as those related to dermatology and gastrointestinal issues, treatment are usually referred to the appropriate specialist. [3]
Well, I think that covers the Conventional Medical side of things thoroughly, but what else can you do? You could work with a Functional Medicine or Integrative Medicine Practitioner. I would be honored to work with you and help you throughout this process. I am working with Dr. Jessica Drummond for this help during my recovery. There's a saying, "The athlete that coaches himself has a fool for a coach!" I think that applies to patients treating themselves too (it can be done, but it's often better to get help so our own biases don't get in the way of our recovery), and that is why I am working with Dr. Drummond. I can't recommend her highly enough! (And Dr. Kornweiss could cover your Conventional Medical needs. I can't recommend him highly enough too!) Here's a short list of what Dr. Drummond did during her own recovery from COVID and Post COVID Conditions (she worked with other practitioners too to recover. Great minds think alike!)
Very limited physical activity
Sleep as much as possible
Meditation and Breath Work a minimum of 2x/day
Anti-inflammatory diet and supplements
Lots of water with and without electrolytes
Probiotics, etc for gut health
Mitochondrial Support supplements [6]
You really need to work with someone to figure out exactly what you need to do in regards to physical activity, diet, anti-inflammatory supplements, mitochondrial support supplements, gut health, etc. I CAN"T EMPHASIZE THIS ENOUGH! (not yelling at you, I promise, the caps are just for emphasis) Please don't hesitate to reach out to a qualified Functional Medicine/Integrative Medicine Practitioner.
That's All Folks
Well, that's it for Post COVID Conditions. Hopefully, you have a better understanding of what it is and how prevalent it is too! I also hope you feel empowered and have some tools to help you recover from either an acute infection or Post COVID Conditions.
https://www.healthydesignfxmed.com/work-with-heth-1
About Heth
My name is Heth and I’m a husband, father of three children, Physical Therapist with 20 years of experience and Certified Functional Medicine Practitioner. I have witnessed the effects that chronic pain, chronic gut issues, chronic stress, etc. has had on my clients and on my loved ones, especially my wife. I have also seen how the conventional medical route is unable to adequately address these problems and provide answers. I have seen the disappointment and sense of helplessness that this can cause. I am sure that you have experienced this too.
However, I always felt there was hope…a different way to address these problems. After all, I learned that the key to treating clients in Physical Therapy is to get to the root cause of the problem, then the symptoms will take care of themselves. This is the same premise in Functional Medicine. I have seen the life transforming effect this can have on quality of life firsthand in my clients and in my wife!
During my career, I have treated athletes looking to return to sport, clients that are trying to recover from neurological insults like a stroke, clients that are attempting to return to their prior level of function following surgery and many other conditions. I have also focused heavily on the Nervous System and the treatment of chronic pain. This led to an interest in staying up to date on research regarding the role of the Immune System and Central Nervous System in pain. It also pointed out the important role that the Autonomic Nervous System and chronic systemic inflammation play in chronic illness.
REFERENCES/RESOURCES
MacMillan, C. (2020, September 4). When COVID-19 Symptoms Won't Go Away: The Long Road To Recovery. https://www.yalemedicine.org/news/covid-19-symptoms-wont-go-away
CDC (updated 2021, September 16). Post COVID Conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
Yale Medicine. Long COVID (Post-Acute Sequelae of SARS CoV-2 infection, PASC) https://www.yalemedicine.org/conditions/long-covid-post-acute-sequelae-of-sars-cov-2-infection-pasc
Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes & Metabolic Syndrome. 2021 May-Jun;15(3):869-875. DOI: 10.1016/j.dsx.2021.04.007. PMID: 33892403; PMCID: PMC8056514.
Logue JK, Franko NM, McCulloch DJ, et al. Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Netw Open. 2021;4(2):e210830. doi:10.1001/jamanetworkopen.2021.0830
Drummond, J. (2021, March 14). My Long Covid Recovery: Perspectives From A Nutritionist and Physical Therapist .https://integrativewomenshealthinstitute.com/my-long-covid-recovery-perspectives-from-a-nutritionist-and-physical-therapist/
https://www.youtube.com/c/RUNDMC1/videos (Lots of great videos and Q&As)
Disclaimer:
This article is for educational use only. Nothing contained in this article should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This article does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. Always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay in obtaining medical advice from your doctor or other qualified health care provider because of something you have read in this article. If you have or suspect that you have a medical problem or condition, you should contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, you should dial 911 or call for emergency medical help on the nearest telephone.
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