Long COVID Now Looks like a Neurological Disease, Helping Doctors to Focus Treatments

[Nevilledog]

https://www.scientificamerican.com/article/long-covid-now-looks-like-a-neurological-disease-helping-doctors-to-focus-treatments/

Tara Ghormley has always been an overachiever. She finished at the top of her class in high school, graduated summa cum laude from college and earned top honors in veterinary school. She went on to complete a rigorous training program and build a successful career as a veterinary internal medicine specialist. But in March 2020 she got infected with the SARS-CoV-2 virus—just the 24th case in the small, coastal central California town she lived in at the time, near the site of an early outbreak in the COVID pandemic. “I could have done without being first at this,” she says.

Almost three years after apparently clearing the virus from her body, Ghormley is still suffering. She gets exhausted quickly, her heartbeat suddenly races, and she goes through periods where she can't concentrate or think clearly. Ghormley and her husband, who have relocated to a Los Angeles suburb, once spent their free time visiting their “happiest place on Earth”—Disneyland—but her health prevented that for more than a year. She still spends most of her days off resting in the dark or going to her many doctors' appointments. Her early infection and ongoing symptoms make her one of the first people in the country with “long COVID,” a condition where symptoms persist for at least three months after the infection and can last for years. The syndrome is known by medical professionals as postacute sequelae of COVID-19, or PASC.

People with long COVID have symptoms such as pain, extreme fatigue and “brain fog,” or difficulty concentrating or remembering things. As of February 2022, the syndrome was estimated to affect about 16 million adults in the U.S. and had forced between two million and four million Americans out of the workforce, many of whom have yet to return. Long COVID often arises in otherwise healthy young people, and it can follow even a mild initial infection. The risk appears at least slightly higher in people who were hospitalized for COVID and in older adults (who end up in the hospital more often). Women and those at socioeconomic disadvantage also face higher risk, as do people who smoke, are obese, or have any of an array of health conditions, particularly autoimmune disease. Vaccination appears to reduce the danger but does not entirely prevent long COVID.

The most common, persistent and disabling symptoms of long COVID are neurological. Some are easily recognized as brain- or nerve-related: many people experience cognitive dysfunction in the form of difficulty with memory, attention, sleep and mood. Others may seem rooted more in the body than the brain, such as pain and postexertional malaise (PEM), a kind of “energy crash” that people experience after even mild exercise. But those, too, result from nerve dysfunction, often in the autonomic nervous system, which directs our bodies to breathe and digest food and generally runs our organs on autopilot. This so-called dysautonomia can lead to dizziness, a racing heart, high or low blood pressure, and gut disturbances, sometimes leaving people unable to work or even function independently.

*snip*

[Bayard]

1. I've always tested negative for Covid

But reading these symptoms makes me wonder: "dysautonomia can lead to dizziness, a racing heart, high or low blood pressure, and gut disturbances." I've had a pulmonologist and a cardiologist trying to figure out why I have these symptoms for months.

Will do more research. Thanks for posting, Nevilledog!

[DET]

2. Dysautonomia, Orthostatic Hypotension, POTS, CFS, ...

Those are classic signs of POTS (postural orthostatic tachycardia syndrome), which has been implicated in long Covid. Symptoms are particularly pronounced when rising from a seated position. You can perform basic tests on yourself using a simple blood pressure monitor. More rigorous testing can be done in a medical setting using a ‘tilt table’ test. POTS is usually diagnosed by cardiologists; however, many doctors still dismiss POTS and CFS as psychosomatic illnesses of mostly ‘hysterical’ women (they don’t say it quite that directly anymore, but that’s what they’re thinking). If a doctor smirks or laughs when you mention long Covid or POTS or CFS, run. These are illnesses where you have to be proactive and persistent.

[mopinko]

4. post viral syndrome is a thing. not just covid.

i had west nile in ‘20, and been sick ever since. have autoimmune disease, and think this has also been implicated in long covid.
you might ask for an ana panel, and a crp. that’s the 1st step.

[Bayard]

6. They just did a slew of blood tests

At the hospital lab/outpatient. Said they were all normal.

[Ms. Toad]

7. It's much more prevalent with COVID

59% of a low risk population had damage to at least one organ at 1 year, and at last 20% of individuals with COVID have long COVID. That's similar to West Nile.

But it's far higher than we are used to with other similar post-viral syndromes with more common viruses like Guillan Barre following influenze, for example (17.2 per million influenza hospitalizations, as opposed to 1 in 5.).

[PuraVidaDreamin]

3. I'd try psilocybins

Have somehow avoided any Covid infections to date.

Psilocybins are showing promising results in several studies
coming out of Johns Hopkins. i.e. micro dosing

Therapeutic cannabis was instrumental in getting me off
gabapentin after a serious neck injury and fusion left me
with significant neuropathy. Both seem to have neuro
protective and neuro regenerative properties.

[area51]

5. Kick for the morning crew. n/t

[Ms. Toad]

8. It will be interesting to see if it is all neurological - or a collection of different syndromes.

8 months out, I've still got gut disturbance. It started with explosive GI disruptions, followed pretty quickly with pancreatitis. Now it's back to GI disturbance, which is less exposive than early after COVID, and decreasing frequency.

BUT - there's a strong gut-brain connection. So did I just get the gut version that didn't "bleed into" the brain, or is my version a different syndrome than the more common neurological one.