Long Covid

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For the past 3 years we have been dealing with Covid, most people who get Covid it lasts about two weeks. But in some cases, long-term effects of Covid can cause lingering health problems and wreak havoc for months.

Long coronavirus infection is when people continue to test positive weeks and months afterwards, or who continue to have symptoms for weeks and months afterwards. 

What is Long Covid?

The World Health Organization has developed a definition for post-Covid19 condition (the WHO’s term for long Covid) as coronavirus symptoms that persist or return three months after a person becomes ill from infection with SARS CoV-2, the coronavirus that causes COVID-19. 

Those symptoms can include:

  • Fatigue
  • Shortness of breath
  • Cognitive problems (thinking and memory)

The symptoms can come and go, but have an impact on the person’s everyday functioning, and cannot be explained by another health problem. 

What causes Long Covid syndrome?

While it’s clear that people with certain risk factors (including high blood pressure, smoking, diabetes, obesity and other conditions) are more likely to have serious Covid, there isn’t a clear link between these risk factors and long-term problems. In fact, long Covid can happen in people who have mild symptoms, although patients with more severe initial illness seem to be more likely to have long-term impairments.

What causes symptoms in Long Covid?

SARS-CoV-2 can attack the body in different ways, causing damage to the lungs, heart, nervous system, kidneys, liver and other organs. Mental health problems can arise from grief and loss, unresolved pain or fatigue, or from post-traumatic stress disorder (PTSD) after treatment in the intensive care unit (ICU).

Breathing Issues with Long Covid

A bad case of Covid can produce scarring and other permanent problems in the lungs, but even mild infections can cause persistent shortness of breath — getting winded easily after even light exertion.

Lung recovery after Covid is possible, but takes time. Breathing exercises and respiratory therapy can help.

Heart Problems in Long Covid 

SARS-CoV-2 infection can leave some people with heart problems, including inflammation of the heart muscle. In fact, one study showed that 60% of people who recovered from Covid had signs of ongoing heart inflammation, which could lead to the common symptoms of shortness of breath, palpitations and rapid heartbeat. This inflammation appeared even in those who had had a mild case of Covid and who had no medical issues before they got sick.

Kidney Damage from Long Covid

If the coronavirus infection caused kidney damage, this can raise the risk of long-term kidney disease and the need for dialysis.

Loss of Taste and Smell after Covid

The senses of smell and taste are related, and because the coronavirus can affect cells in the nose, having Covid can result in lost or distorted senses of smell (anosmia) or taste. Before and after people become ill with Covid, they might lose their sense of smell or taste entirely, or find that familiar things smell or taste bad, strange or different.

For about a quarter of people with Covid who have one or both of these symptoms, the problem resolves in a couple of weeks. But for most, these symptoms persist. Though not life-threatening, prolonged distortion of these senses can be devastating and can lead to lack of appetite, anxiety and depression. 

Neurologic Problems in Long Covid

Some individuals develop medium to long-term symptoms following Covid infection, including brain fog, fatigue, headaches and dizziness.  The cause of these symptoms is unclear but is an active area of investigation.

Cognitive Problems and Mental Health after Covid

Can Covid increase a person’s risk for anxiety, depression and cognitive issues? A study of COVID-19’s impact on mental and emotional well-being conducted by Johns Hopkins experts in psychiatry, cognition (thinking, reasoning and remembering) and mental health found that these problems were common among a diverse sample of COVID-19 survivors.

Cognitive impairment after acute coronavirus infection can have a severe impact on a person’s life. Long Covid patients may experience changes in the way they think, concentrate, speak and remember, and these symptoms can affect their ability to work or even maintain activities of daily living.

After recovering from the coronavirus, some people are left with lingering anxiety, depression and other post-COVID mental health issues

Post-Intensive Care Syndrome

Patients who were hospitalized for Covid treatment have a particularly challenging recovery. Experts note that post-intensive care syndrome, or PICS, puts Covid survivors and other people who have spent time in the ICU at a higher risk for problems with mental health, cognition and physical recovery.

The strange surroundings, multiple mind-altering medications, isolation and loss of control can leave patients with lasting and recurrent sensations of terror or dread, including post-traumatic stress disorder (PTSD).

Learn more about depression and anxiety associated with Covid.

POTS and Insomnia after Covid

Postural orthostatic tachycardia syndrome, or POTS, is a condition that affects blood circulation, and people who have survived Covid may be more vulnerable to it. POTS can leave survivors with other neurologic symptoms, including continuing headache, fatigue, brain fog, difficulties in thinking or concentrating, and insomnia.

Persistent Long Covid insomnia, or “Covid-somnia” is an increasingly common complaint among Covid survivors and can be a typical symptom of POTS.

Diabetes after Covid

The relationship between Covid and diabetes, especially type 2 diabetes, is complex. Type 2 diabetes is a risk factor for serious cases of Covid, and some survivors of the illness seem to be developing type 2 diabetes signs after they recover from Covid.

What we Know

Research on the long-term effects of SARS-CoV-2 continues to indicate that a substantial number of individuals experience lasting symptoms after the initial infection has been cleared, including psychiatric disorders and neurocognitive decline. Autopsies of patients confirm the presence of the coronaviruses in the central nervous system (CNS), especially in the brain. Follow-ups conducted in Germany and the United Kingdom found PASC neuropsychiatric symptoms in 20-70% of patients, including young adults. Multiple studies have shown that SARS-CoV-2 can directly or indirectly affect the CNS, and some patients experience a component of cognitive dysfunction, which includes psychological symptoms such as difficulty concentrating, forgetfulness, confusion, behavioral changes, depression, and fatigue. Relapse or recurrence of these symptoms may be triggered by exercise, physical or mental activity, and stress.

Scientists hypothesize that both direct and indirect mechanisms may contribute to the development of these symptoms, which are similar to those experienced by patients and are often linked to mitochondrial dysfunction. Some studies suggest that the neuropsychiatric manifestations may also lead to an increased additional long-term risk of neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease.

Mitochondrial Involvement in Covid

Long Covid causes a variety of symptoms, including extreme tiredness, sleep problems, and muscle pain. The cause is unknown; however, some scientists suspect that, in some individuals, these symptoms may be induced by a viral infection like Epstein-Barr or glandular fever, called postviral fatigue syndrome, which can develop as a result of a disruption to the mitochondrial metabolic pathway. 

A 2022 study on 50 patients provided the first evidence of mitochondrial dysfunction in Long Covid syndrome. During the test, the participants exercised to exhaustion (or near) on a bicycle. This retrospective study found normal exercise capacity overall (but reduced exercise capacity in a third of the patients), but more importantly, perhaps, it found increased lactate levels early in the exercise process and reduced fatty acid oxidation, indicating that mitochondrial dysfunction was present and “metabolic reprogramming” had occurred.

This is similar to the metabolic changes (cardiometabolic syndrome) seen in many of the chronic diseases caused by insulin resistance. Chronic diseases like diabetes, high blood pressure, dementia, depression, and many more.

Supplements and Lifestyle

The following nutritional supplements and lifestyle changes have also been recommended:

  • Antioxidant supplementation: Vitamins C and E, as well as selenium.
  • Plant-based diets: Diets high in plant defense compounds with pleiotropic actions that are known to modulate mitochondrial function and induce resolution of inflammation.
  • CoQ10 supplementation: Strategies to target mitochondrial energy production and antioxidant defense.
  • N-acetylcysteine (NAC) supplementation: NAC acts as an antioxidant through complex mechanisms that can improve situations of oxidative stress.
  • Acetyl-L-carnitine (ALC): ALC is key to mitochondrial function, promoting the expression of nerve growth factors and peripheral nerve regeneration and conduction.
  • Α-Lipoic acid (ALA): ALA, also known as thioctic acid or simply as lipoic acid, is a powerful antioxidant, acting as a coenzyme in mitochondrial reactions in which glucose is converted into energy.
  • Physical activity: Regular, moderate physical activity enhances immune function and mitochondrial fitness. Moderate intensity training (MIT) is usually performed at around 50-75% of the maximal capacity.

For treatment seek a functional Medicine Practitioner.

Lifestyle

A 40% increase in the consumption of vegetables created a 72% decrease in the likelihood that someone would have moderate or severe Covid. 

In treating long Covid is important to improve the gut microbiome and that can be done with diet, probiotics and prebiotics. One of the Gut’s functions is protection from viruses and bacteria that can make us ill.    There’s a whole host of prebiotic foods like asparagus, and artichokes, plantain, and Jerusalem artichokes. The gut microbiome also plays a roll in the body’s immune response once we get sick.

In Long Covid nutrition, exercise, stress reduction, and good sleep are very important. Those are ways to help your body. The bottom line is a 40% increase in the consumption of vegetables created a 72% decrease in the likelihood that someone would have moderate or severe Covid versus mild or minimal Covid. 

Everything that we recommend to reverse and treat cardiometabolic syndrome are the same things we recommend to treat Long Covid. One ounce of prevention is worth a lifetime of treatment. Preventing Covid infection is the best way to treat both covid and Long Covid.


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