Treating Long Covid-19

  • What is Long Covid-19 Syndrome? 
  • – Long Covid-19, aka Post Covid-19 Syndrome or Long-Haulers, refers to individuals who are experiencing persistence of symptoms at least 12 weeks after initial probable or confirmed Covid-19 infection.
  • – Much of the symptomatology and pathophysiology seen in long-haulers is similar to other post-infectious diseases including ME/CFS and chronic Lyme Disease. 
Proposed pathophysiology mechanisms contributing to Long Covid-19 symptoms. It exemplifies the complexity of this disease and the variety of symptoms that can present.
  • How many people are being affected?
  • – CDC estimates 10-30% of people who were infected experience long-term health problems. 54% of those who survived initial illness experienced at least one post-illness symptom at 6 months. 
  • Who is most at risk of having Long Covid-19?
  • – We propose a person’s risk is dependent on their toxin load (heavy metals, pesticides), infection load (EBV, Lyme Disease, Mold), immune system status (prior auto-immunity, dysregulation), and even inflammation levels prior to contracting acute Covid-19. How full was the person’s “cup” prior to infection and did contracting Covid-19 cause everything to overflow?
  • – Outside of our hypothesis, research studies have shown these are likely risk factors:
  • 1.) If you had more than 5 initial symptoms
  • 2.) Women are 1.4x more likely to have fatigue, muscle weakness and almost 3x more likely to have lung diffusion impairment at 12 months than men. 
  • 3.) Pt who had previously high levels of D-dimer or C-reactive protein; or low lymphocyte count.
  • 4.) Suspected but lacking clinical evidence: pre-existing comorbidity, prior psychiatric disorder, old age, high levels of IL-6, procalcitonin, troponin-1, blood urea nitrogen, and neutrophil count.
  • How long will Long Covid-19 symptoms last? 
  • – Our clinic suspects symptoms experienced by long-haulers may extend beyond just a few months to years if not properly treated. Historically research has shown other human corona virus infections can cause fatigue, myalgia, and psychiatric impairments for up to 4 years. Pulmonary and bone radiological complications were still evident amongst SARS survivors at 7-year and 15-year follow-ups. This underscores the importance of addressing the initial infection thoroughly early on and utilizing all known beneficial therapies to prevent persistent sequelae. 
  • What are the symptoms of Long Covid-19?
  • – Symptoms may persist from acute infection or may be new onset following initial recovery from acute infection. And symptoms may fluctuate or relapse over time.
  • – It is not viewed as a single illness, but instead a collection of numerous symptoms and diagnoses. Symptoms often occur in clusters, overlap with each other, and can involve all organ systems.
  • – Long-term symptoms are experienced by a significant number of patients irrespective of the severity of initial illness. 
  • – Common symptoms:
      • Constitutional: fatigue, brain fog, headache, weight loss/gain
      • Psychiatric: anxiety, depression, PTSD, social isolation 
      • Neurological: peripheral neuropathy, persistent loss of smell/taste, encephalopathy, stroke, dysautonomia, speech difficulties
      • Cardiovascular: chest pain, palpitations, tachycardia, myocarditis, pericarditis, heart failure, arrhythmias, peripheral limb ischemia, CHF from cardiomyopathy
      • Musculoskeletal: myalgia, joint pain, physical debility 
      • Dermatologic: erythematous or urticarial rash, alopecia, erythema multiforme-toes
      • Pulmonary: dyspnea, cough, chest pain, oxygen dependence, PFT abnormalities, interstitial lung disease 
      • Hematologic: venous thromboembolism 
      • Gastrointestinal: diarrhea, nausea/vomiting, abdominal pain, bloating, low appetite, nutritional insufficiency.
        Endocrine: diabetes mellitus, thyroid abnormalities,
        Gynecological: menstrual changes including amennorhea, dysmennorhea
      • Genitourinary: overactive bladder symptoms, kidney injury (Chronic kidney disease) 
  • What is the best treatment for Long Covid-19? 
  • – Nizhoni’s “(Re)verse Long Covid-19 Treatment Protocol” is a multifaceted approach aimed at addressing the root causes of your symptoms. It is individualized to address whichever bodily system(s) and disease mechanisms (see picture above) our doctors determine are contributing to your symptoms.  
  • Nizhoni’s (Re)verse Long Covid-19 Treatment Protocol has 4 STEPS:  
  • 1.) (RE) SEARCH the underlying pathophysiology contributing to your symptoms 
  • – Gather information about your physiology and biochemistry through an extensive patient intake, physical exam, and testing. 
  • – For lab testing, we frequently run: Standard labs (LabCorp, Sonora Quest) – CBC, CMP, Vitamin D25OH, D-Dimer, homocysteine, hsCRP/CRP, EBV Early Antigen, TSH/T3/T4, Thyroid Antibodies, Insulin, HgA1c, IR Score, Ferritin, TIBC/Iron, ANA w/ reflex. If we suspect a hx of CIRS, then we may also add tests like MSH, MMP9, CD57, and TGFB1.
  • – Specialized blood testing may include food sensitivity testing, mycotoxin testing, tickborne panels, environmental toxins, stool testing, genetic testing, and so forth.
  • – May also include referrals for imaging (chest x-ray, CT scan, MRI)

    2.) (RE) VERSE the underlying causes and tissue damage using the least amount of force possible 
  • – While we offer a “protocol” for managing Post Covid-19 Syndrome, every patient receives a completely different and individualized treatment plan. 
  • – Our clinic uses a variety of naturopathic, conventional, cutting-edge, and traditional therapies to help you feel better.

    3.) (RE) ESTABLISH foundations of health and stimulate the body’s healing mechanisms
  • – This step is done simultaneously while addressing the dysfunctional mechanisms contributing to your symptoms.
  • – We optimize detoxification, sleep, nutrition, exercise, and mental/emotional health, so you experience a deeper healing AND you’ll better tolerate the rest of your treatment plan. 

    4.) (RE) DEFINE what optimal health means to you.
  • – This is the phase of empowerment, growth, and transformation. Not only do you return to your prior work and social activities, but instead you thrive in a healthier and more resilient you. 
  • – We not only give you the tools to reverse your illness, but guide you on ways to further optimize your health and prevent reoccurrence. Our goal is to empower you with education and resources, so you live an even healthier life going forward.