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Post Covid-19, Long Haulers

Written by: Dr. Fred Harvey, MD

It is hard to believe, but we have entered year two of the coronavirus pandemic.

I hear stories regularly of people who are experiencing symptoms well beyond the usual course of a viral illness. We have seen this in other viral conditions such as the persistence of fatigue after Epstein-Barr virus infection, otherwise known as “mono”,

the weakened immune system after influenza resulting in secondary pneumonia, or the neuropathy after Herpes Zoster. People are experiencing a range of symptoms in recovery period after the acute infection phase of coronavirus has passed. These so-called “long haulers” experience a variety of symptoms. The top symptoms ranked by patient-led researchers from the most to least reported were mild shortness of breath, mild tightness of chest, moderate fatigue, mild fatigue, chills or sweats, mild body aches, dry cough, elevated temperature (98.8 -100), mild headache, brain fog/concentration challenges and dizziness. Neurologic symptoms are the most underreported in the media. Long hauler patients report that average recovery time is 27 days but if not recovered by day 50 the chance of recovery is less than 20 percent. Most are now sedentary, although they were physically active prior to the illness. 

These folks probably had one of the three reasons for severe response to SARS CoV-2, which are excess inflammation, compromised immunity, and organ system dysfunction. We can prepare the body ahead of infection by instituting lifestyle and nutritional programs. To support the immune system adequate sleep (at least 7 hours daily), exercise, water and food are needed. In addition, we can use vitamins, herbs, and minerals to enhance and protect our metabolic functions and organ reserves. Some help to reduce inflammation, support the immune system and can help repair organ dysfunction.

Once infected other supports can be useful. Increased doses of the preventive program like quercetin, astragalus, elderberry and Andrographis will help. Nettle’s extract, resveratrol and melatonin can promote better response. Of course, increased doses of vitamin C and D, Zinc and B vitamins are also supportive.

Recently there has been suggestion that Ivermectin may be of value. Conflicting reports in the literature have resulted in the National Institutes of Health (NIH) not recommending, but the Institute for Functional Medicine suggests it may be of value. I currently do not recommend it as dosing is very unclear. However, I have had one person respond well to Plaquenil (hydroxychloroquine) for chest pain and high cytokine levels. This is an evolving process. Stay tuned for more information.

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