What is long COVID?

Long COVID is the commonly used term for what is officially called Post-acute Sequelae of SARS-CoV-2 infection (or PASC). It is a chronic condition that can occur after a mild or even asymptomatic initial infection, and it can be a prolonged and debilitating illness.

 

In some people symptoms are relapsing/remitting. In others they can take on a progressively worsening picture. Estimates of how commonly it occurs vary, with the range being between 10–30% of those infected. There is some evidence to suggest that the likelihood of long COVID increases the more infections a person has.

 

 

Illustration depicting the struggle against long COVID brain fog, with microscopic view of damaged cerebral vessels digital photography

 

 

Common symptoms of long COVID

  • Fatigue (often profound and disabling) and post-exertional malaise
  • Cognitive dysfunction ("brain fog")
  • Dyspnoea (breathing difficulties) and/or chest pain
  • Autonomic dysfunction – including POTS-like symptoms (racing heart and dizziness on standing)
  • Sleep disturbance
  • Muscle and joint pain/inflammation
  • Gastrointestinal issues (e.g., nausea, diarrhoea, IBS-like symptoms)
  • Mood disturbances – anxiety, depression, emotional lability

My approach to long COVID

From an ecological medicine perspective, whilst the COVID-19 infection has trigged your illness, there are usually preexisting vulnerabilities (ticking time bombs of sorts) that, when the virus is added on top, lead to this illness.

My work with long COVID starts by looking for these for root causes, so that we can start to address them. There are also often other "bombs" that have arrived as a result of COVID, and these may need addressing too.

The Human Brain A Network of Neural Connections

Many of the symptoms associated with long COVID likley result from an immune reaction that once switched on, does not switch off again (perhaps a "cytokine storm" of runaway immune messaging triggering ongoing inflammation). It is likely that that issues that were already affecting the immune system, such as gut dysbiosis or GI inflammation, high exposure to toxins such as mould, high levels of cortisol and stress hormones, meant that a number of people were close to their "physiological tipping point" before getting the virus. Then the SARS-CoV-2 infection was the straw that breaks the camel's back.

The issues I find most common in my long COVID patients are:

 

Red squirrel have a rest on the tree
  • Mould - most if not all of my long Covid patients have a mould/fungal issue as part of the clinical picture
  • Viral reactivation (e.g., Epstein-Barr virus)
  • Gut dysbiosis and sinus dysbiosis, especially fungal overgrowth
  • Autonomic/vagus nerve dysregulation
  • And other underlying inflammatory health issues, similar to those seen in ME/CFS

There is an overlap between long Covid, ME/CFS, MCAS, fibromyalgia and my approach for all these conditions is similar: I use supportive treatments where I can, to help with symptoms in the short term, while we explore and work through the root causes to bring about meaningful change in the long term.