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Natural Awakenings Jacksonville-St. Augustine

Post-Acute COVID-19 Sequelae: In It for the Long Haul

Apr 30, 2021 09:31AM ● By Megan R. Weigel
COVID-19 is an infectious disease caused by a novel coronavirus, SARS-CoV-2. While coronaviruses are not new to humans (you may remember SARS and MERS), this particular one is. As we are now more than a year into the COVID-19 pandemic, you are likely aware that the constellation of symptoms caused by this virus is quite large, but the most common and severe ones tend to be respiratory-related.

Unfortunately for many, the effects of COVID-19 are not necessarily over after resolution of acute infection. People with continued symptoms have been referred to as “long-haulers” or to have Long COVID Syndrome. More recently, the term Post-Acute Sequelae of SARS-CoV-2 (PASC) has been used to describe this syndrome. Some symptoms are similar to those of acute COVID-19 infection, such as persistent loss of senses of taste or smell. Other symptoms, like cognitive dysfunction and dizziness, may not have been present during acute infection. Many healthcare providers are comparing PASC to myalgic encephalitis/chronic fatigue syndrome (ME/CFS). PASC is estimated to affect one in 20 people that have had COVID-19 in some studies, and 50 to 80 percent in others. It stands to significantly affect the health of society.

Based on results of a study in the UK, U.S. and Sweden, an algorithm was developed to predict the likelihood of PASC. The positive predictive symptoms include older age, female gender, those that experienced five or more symptoms, and having asthma. However, even children are presenting with the syndrome. The National Institutes of Health recently announced the appropriation of $1.15 billion to study PASC. Large academic institutions such as Northwestern University, Mayo Clinic and Mt. Sinai Medical Center are also studying PASC. Mt. Sinai has a dedicated Center for Post-COVID Care, a multidisciplinary center that provides holistic care. 

Following are the most common symptoms of PASC: headaches; vertigo; neuropsychiatric changes (including cognition and mood); tremors; sound and light sensitivity; phantom smells; tinnitus; fatigue; bowel issues; autonomic dysfunction (heart rate issues, dizziness, inability to exercise); body aches; insomnia; pulmonary issues; weakness; kidney problems; and worsening of endocrine disorders. Most people with PASC have normal tests when they are evaluated for their symptoms, which can increase anxiety for fear of concerns not being validated. Anthony Komaroff, M.D., physician and editor-in-chief of the Harvard Health Letter, posits that, similar to ME/CFS, symptoms might be caused by low levels of brain inflammation, autoimmune or autonomic issues affecting the brain, and/or insufficient energy production for the brain and body.

The question remains: What can you do about PASC?

The best treatment is to avoid COVID-19 infection by practicing such measures as social distancing, wearing masks, avoiding large indoor gatherings, and vaccinating. The Facebook group Survivor Corps recently surveyed 400 COVID-19 survivors after vaccination, and 36 percent of them reported an improvement in their PASC symptoms after vaccination. This finding needs to be replicated in larger studies, but is an interesting supposition. Staying healthy also mitigates risk of infection and more severe COVID.  If you currently suffer from PASC, a comprehensive primary care evaluation is recommended, as well as evaluation by an integrative or functional medicine provider. The latter may help you uncover hidden issues such as gut dysbiosis, autoimmune conditions, or latent viruses that are contributing to your symptoms.

In general, treatment of PASC should include the following to support the general functions of the body, reduce inflammation, encourage cardiovascular/pulmonary/neurological health, and reduce the effects of stress:

~ A plant-based, whole foods diet that is high in omega-3 fatty acids, and potentially gluten- and dairy-free.

~ Exercise according to your ability, which may be at a lower level than prior to COVID-19 infection.

~ Adequate and restful sleep.

~ Breathwork, meditation and mindfulness.

~ Cognitive behavioral therapy or counseling if livelihood has been affected by the illness.

Work with your healthcare provider to develop an individualized plan, which may include supplement support, other dietary modifications, and energy work to restore you to optimal health.

Factual references are available below.

 Megan R. Weigel, DNP, is a nurse practitioner specializing in neurological care in Jacksonville Beach, where she brings a unique integrative medicine and holistic nursing perspective to her practice, First Coast Integrative Medicine, located at 14215 Spartina Ct., Ste. 200. She has been a multiple sclerosis certified nurse since 2005 and a nurse practitioner for more than 20 years. She is also a board-certified advanced practice holistic nurse. For more information or to make an appointment, visit FirstCoastIntegrativeMedicine.com.


References

Collins, F.  (2021, March 23).  Predicting ‘Long COVID Syndrome’ with Help of a Smartphone App.  NIH.  DirectorsBlog.NiH.

Komaroff, A.  (2020, October 15).  The tragedy of long COVID.  Harvard Health Blog.  HealthHarvardBlog.

Menni, C., Valdes, A. M., Frieden, M. B., et al.  (2020).  Real-time tracking of self-reported symptoms to predict potential COVID-19.  Nature Medicine, 26(7), 1037-1040.  RealTimeTracking.

Mt. Sinai.  Center for Post-COVID Care.  Mt. Sinai.  PostCovidCare.

Nalbandian, A., Sehgal, K., Gupta, A., et al.  (2021).  Post-acute COVID-19 syndrome.  Nature Medicine, epub.  doi: Post-AcuteCovid.

National Institutes of Health.  (2021, February 23).  NIH launches new initiative to study “Long COVID.”  NIH.  NIH.gov.

Perrin, R., Riste, L., Hann, M., et al.  (2020).  Into the looking glass: Post-viral syndrome post COVID-19.  Medical Hypotheses, 144.  doi: PubMed.Ncbi.

Pezenik, S.  (2021, March 24).  Inside the ‘cyclone’ of brain fog many COVID-19 long-haulers are still experiencing.  ABC News.  BrainFogCovid-19.

Sudre, C. H., Murray, B., Varsavsky, T., et al. (2021).  Attributes and predictors of long COVID.  Nature Medicine, epub. doi: Predictors-Long-Haul.

Syrek, R.  (2021, March 12 ).  Trending clinical topic: PASC.  Medscape.  MedscapeArticle.