Analysis by Marina Christov; Doctor of Chinese medicine and integrative health practitioner.
Covid-19, the worst viral outbreak in a century. Yet, when patients complain of serious symptoms that come after they have recovered from their initial infection, they are often dismissed, some even ridiculed and told “it is all in your head”.
Today, September 10, 2022, Australia’s case number amount to 10.1Milion COVID-19 infections, (*health.gov.au), 2320 are currently hospitalised and 57 in ICU.
Australia’s population is around 26 million and despite a rate of 63 M doses or 89% of the population vaccinated, the healthcare system faces a looming challenge for the remainder of 2022 and beyond, that I predict to be a move from hospital care to long COVID.
Post-COVID syndrome or Post-Acute Sequelae of SARS-CoV
Those who live with post-COVID syndrome are sometimes referred to as “long haulers.”
COVID long-haulers phenomenon — is receiving increasing attention outside of the doctor’s office, as the number of sufferers with lingering symptoms continue to rise worldwide.
Despite centuries of evidence that viral infections can later lead to debilitating conditions — the patient’s ordeal is often dismissed as unworthy of serious concern.
According to the vague estimates, up to 30% of those infected will not recover fully and suffer significant ongoing disability that lasts for months and longer. (In people with autoimmune disease, that number can be as high as 50%.)
That is at least 550,000 Australian long COVID sufferers in the year ahead, many of whom will significantly lose their quality of life.
If you have experienced COVID-19 yourself, you may have been familiar with the symptoms associated with inflammation. These include extreme body aches, nerve pains, fever, and encumbering fatigue.
Long covid is marked by an increase in secretion of pro-inflammatory cytokines, chemokines, tissue necrosis factors and other inflammatory proteins. The peripheral inflammatory responses which occur because of Covid-19 are bound to have long-term impacts even in those that have fully recovered. This surge in production and release of the mentioned inflammatory mediators, can cause severe impairment to the functioning of many organs.
The multi-organ effects experienced during the infection period include the: cardiovascular, neurologic, psychiatric, pulmonary, integumentary, and renal systems. The pro-inflammatory impacts of Covid-19 has led to multisystem inflammatory syndromes (MIS) as well as flare-ups of autoimmune conditions.
One of the most significantly impacted systems post-covid is the nervous system, with between 30-40% of people experiencing symptoms of: anxiety, depression, sleep disturbances, confusion, and cognitive impairment (brain fog).
Long COVID also has remarkable similarities to post-viral myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). As complementary medicine practitioners, we have been at the forefront of helping sufferers of ME/CFS for decades. This experience, I consider to be critical in the future healthcare and recovery of the long COVID patient.
The Centres for Disease Control and Prevention defines long Covid as having “a wide range of symptoms that can last more than four weeks or even months after infection.” The World Health Organization sets the line at three months and says symptoms must last “for at least two months and cannot be explained by an alternative diagnosis.” Both highlight fatigue, shortness of breath, cognitive dysfunction, brain fog, pain, digestive symptoms, depression, anxiety, cough, headache, and sleep disturbances. But as far as treatment strategies for these symptoms, they don’t offer much guidance.
The science of post viral conditions is complex and too little understood. It involves the: immune system, autoimmune conditions, neuropsychiatry, cardiovascular mechanisms, metabolic systems, and viruses themselves.
“There is not one biomarker that defines these post infection inflammatory syndromes’” explains Elizabeth Boham, MD, MS, RD, a functional-medicine physician and medical director at the Ultrawellness Centre in Massachusetts.
For many Western Medicine practitioners, the absence of a clear biomarker makes chronic conditions like these extremely challenging. For Eastern and integrative medicine practitioners, it is still a complex issue but using a multidisciplinary approach, we may provide hope. In the holistic, functional-medicine world, we as practitioners look at the distinct functions that go on in the body. When we look at a post-infectious state where someone is having persistent symptoms across multiple organs, we ask, ‘What’s the functional imbalance that is going on here? So, if the root cause of COVID-19 long-haulers’ symptoms is immune dysfunction and mitochondrial burn-out, we will consider the best approach to address it. We also look for any inherent weaknesses of the individual and try to strengthen those as a baseline approach.
“Increasing numbers of patients with chronic conditions, including growing numbers of COVID long-haulers, are looking for functional and integrative solutions, because there are no effective alternatives”, says Leo Galland, MD, a functional-medicine internist in New York City.
Now, let’s look at China.
China as the first country with the initial outbreak of the epidemic, has adopted of a series of effective preventive, multifaceted medical treatment measures. Chinese medicine plays an active and effective role in the prevention, treatment of symptoms and rehabilitation of COVID-19. Let us not forget that Traditional Chinese medicine, as a National treasure of Chinese civilisation has had a rich experience in the treatment of epidemics with many road-tested strategies going back more than 3000 years with records dated back from”Shi Ji 史记in 243 BC.
Australia will benefit from this knowledge and experience. I am convinced that Chinese medicine can be a major contributor towards any future outbreaks of global epidemic conditions through its practical TCM prevention and treatment strategies.
There should also be clinical trials, especially of antivirals because I suspect that a subset of long Covid might be caused by reservoirs of viruses that settle in the body.
COVID-19 infections are most likely to produce persistent, chronic symptoms in older people and those with a variety of co-morbidities. However, what is concerning is when even young, otherwise healthy individuals are experiencing symptoms for weeks to months after infection.
The following are typical symptoms that continue to exist over time:
- Fatigue (extreme tiredness)
- Symptoms that get worse after physical or mental effort
- GI Distress (Abdominal pain, Nausea, Diarrhoea, Weight Loss, Loss of appetite)
Respiratory and heart symptoms
- Difficulty breathing or shortness of breath
- Chest pain/ tightness
- Heart palpitations
- Cognitive Impairment (Brain fog, loss of Concentration & Memory)
- Sleep problems
- Dizziness when you stand up
- Pins-and-needles feelings
- Mobility Impairment
- Visual Disturbance
- Change in smell or taste
- Depression or anxiety
- Joint or muscle pain
- Hair loss
- Changes in menstrual cycles
- Sore throat
- Nasal Congestion
- Skin sensitivity