Long COVID - What To Look Out For - Making A Healthy Recovery
There is still a lot we don’t know about COVID however, there has been some good research that’s been published on long term issues patients are facing. As well as some of the options available to you for supporting recovery.
Awareness is key! Knowing what to look out for will help you to identify your need for further support.
You’ll see here that some of the common long term complaints may seem unrelated to the initial infection, creating some confusion as to where your health problems are stemming from.
This article is not here to provide you with medical advice, your health is important, if you have symptoms seek one on one support from your health practitioners.
At the tail end of this article I will briefly list some of the nutraceuticals that are being used clinically to support those with long haul COVID. It’s there for general purposes only. As always an individualised patient centric approach is key for best outcomes. No two cases are ever the same and so the approach should also be specific.
Let’s dive in…
Commonly reported Signs & Symptoms Of Long Haul COVID
Extreme persistent fatigue
Impaired cognitive functioning- Brain Fog
Dyspnea - Difficulty breathing or feeling short of breath
Poor or no exercise tolerance
Headaches
Joint Pain
Issues sleeping
Lightheadedness
Distorted or loss of taste and smell
Gut disturbances- Including loss of appetite, abdominal pain, diarrhoea, nausea and vomiting,
Anxiety
Depression
Worsening of existing chronic health conditions including auto-immune issues.
While there are other symptoms that could be added to this list these are some of the more common ones.
To be considered long term COVID these symptoms are present 4 weeks post infection and in some cases have been reported to last more than 12 months after the initial infection.
Are we clear on the mechanisms and reasoning for these long term issues? At this stage we have a limited amount of research, some of it pointing to several key areas of concern including, the gut and immune system.
Why is long haul COVID a concern?
Knowing what to keep an eye out for and what you can do to reduce your chances of having a long term issue should you be infected.
So why is it that this infection can have such a lingering impact? Shouldn’t it be just like a common flu that we manage to overcome within a short time frame?
Looking a little closer at some of the proposed mechanisms by which this virus impacts our body…
Inflammation Starts High
We know with this virus that there is a significant increase in the amount of inflammation created in the body.
If you’re already in an inflamed state, due to chronic health conditions, gut problems, auto-immune conditions or poor diet it’s likely that this inflammation can change the biochemistry in your body, which may lead to a longer recovery.
Noteworthy here, having a high stress level and anxiety will increase both cortisol and inflammation in your body, so important to understand that inflammation underpins most health issues.
Interlukin 1 and 6 are triggered in both the immune system and in the brain. With neurotransmitters like serotonin and dopamine being directly impacted. This leads to changes in sleep and mood.
We know that severity and recovery is significantly impacted the more inflammation there was pre-infection in the body, a poor immune function pre COVID is also of high concern.
Cancer (especially in chemotherapy treated patients due to a decrease in immune response)
Presence of other viral/bacterial infections like Glandular fever, chronic fatigue, herpes etc.
Heart conditions, obesity (which itself causes a large amount of inflammation the body) Chronic lung and liver diseases, pregnancy, smoking all impacting both infection severity and long term outcomes.
So it could be concluded that the better your health is pre infection and the lower your inflammation the less likely you are to experience long haul COVID.
Poor Gut Function
Don’t skip over this one…
Even if you don’t have poor digestive function some preliminary research has found a strong link between the COVID virus and it’s ability to impact gut health. In one study researchers found that SARS CoV-2 lived on in the digestive track of patients who had contracted the infection. Its thought that one of the causes of long COVID may be the persistent viral infection that lives on in the gastrointestinal mucosa.
One study showing patients who had COVID but tested negative (nasal swab) at the end of their infected period went on to test positive for SARS CoV-2 in the digestive track with one study showing that 43% of patients had viral shedding in their stool that persisted for up to 70 days after the symptom onset.
There is a dysbiosis (imbalance of gut bacteria) that’s been found to continue beyond the actual infection period. Not only with an increase in certain inflammatory markers seen in the gut but alongside that a disruption of healthy gut microbes responsible for keeping your digestive system functioning at an optimum level. It is vital that you keep an eye out for any changes in your digestive function both during and long after the infection.
There is a subset of COVID patients who report only experiencing gut symptoms during their infection, which may further support this connection between the virus and gut health.
If you haven’t yet had a COVID infection…
Support your gut function now.
There is information being published that proposes the state of your microbiota (gut bug profile and health) is correlated with the severity of the disease itself and the cytokines (inflammatory markers) produced by the disease. It’s likely that if you have a healthy gut you will be helping to prevent some of the long term complications.
Remember the gut brain axis? There is a tonne of research on this topic supporting the link between the gut and brain and we know that inflammation in the gut will likely result in issues in brain function. Potentially helping to explain why some of the most common symptoms reported with long haul COVID are linked to mood and brain function.
Can we consider some of the down stream impacts of gut inflammation and dysbiosis? We know when the gut is inflamed or compromised there’s a decrease in the absorption of key vitamins and minerals needed for health. A reduction in the breakdown and absorption of amino acids (bodies building blocks) is also going to impact long term health and vitality.
Perhaps most concerning - we know that many neurotransmitters essential for healthy mood and brain function are made in the gut, with up to 95% of your serotonin (happiness- feel good chemical) being made in your digestive system.
Understanding and treating the body as a whole is key in long haul COVID. This is where naturopathic medicine really shines.
Poor Immune System Function
If you have an immune system that is dysregulated or not operating at an optimum level then this could significantly impact your ability to overcome the initial infection as well as increase your susceptibility for longer term issues.
Just like different highways on a map that lead to one place, your immune system has different paths it can take to fight the virus, but not all highways are created equal.
It’s suggested that the most optimum for dealing with COVID is a Th 1 response (stimulates your cellular immunity).
If your immune system is compromised it’s possible your body takes an immune pathway that is less efficient at fighting COVID.
We know that the Th 2 cytokines can actually inhibit the more desirable immune response we see in a Th 1 lead attack against COVID.
Who’s at potential risk of having a less than optimum immune response?
Those who struggle with; auto-immune conditions, allergic conditions including asthma and psoriasis, multiple sclerosis, diabetes, and rheumatoid arthritis.
Compromised or low immunity may lead to an increased incidence of longer term struggles with COVID.
Inability To Produce Energy
Inside every cell in your body you have these little powerhouses called mitochondria, these are important for producing ATP (energy used by your body) If these mitochondria are impaired or don’t function the consequences are extensive and your cells will struggle to perform their tasks.
Research has shown that the SARS- CoV2 virus hijacks the mitochondria of immune cells, it then goes onto replicate within these little powerhouses and leads to the death of the cells that are infected.
It’s known that Co Enzyme Q10 (CoQ10) is found in large amounts within the cell membrane of mitochondria and there has been some research supporting its application in ageing, chronic fatigue but most recently in long haul COVID.
Also important to note here is that the inflammatory storm created in your body from the infection leads to oxidative damage (this is a problem because it will cause more inflammation- like a negative feedback loop).
Oxidative damage we know also leads to mitochondrial damage, so it’s no wonder the number one reported complaint in long term COVID is the fatigue.
If you’ve read any of my other posts you’ll see CoQ10 features often for its benefit in chronic inflammation and reproductive health. Another common question I’ve received is will COVID have a negative impact on my fertility?
We know that poor gut function, chronic inflammation and poor immunity all have impacts on your reproductive health. The jury is still out on long term impacts of COVID on fertility (I’m waiting on more research) however the body is a complex interconnected system so it would be imprudent to think there is no impact on fertility.
What can you do for long term COVID?
There are several ways your naturopath or functional medical practitioner might support you with COVID.
Influencing the initial immune response and helping to manipulate cytokines.
Herbs to help drive a Th 1 immune response- Mushrooms (very useful) and Astragalus, Rhodiola, and many others, in an extract form is often best.
Herbs to help reduce the pro-inflammatory cytokines- Curcumin, Lemon Balm, Feverfew to name a few.
Herbs known to have a strong antibiotic action or help with immunity- Goldenseal, Echinacea, Garlic and many others.
Probiotics- I’m not going into specific strains here, but what we do know is that certain strains of bacteria actually have the ability to modulate some of the immunity in your gut. Including helping to drive that desired Th 1 immune response to potentially help clear COVID out of the gut. Lactobacillus and Bifidobacterium just to mention a few could be indicated.
Consider your own individual gut health and function and add in pre and postbiotics where needed and indicated.
If you have long term or chronic digestive issues I can’t stress enough how vital it is to start your journey to healing this part of your body. We know that so much of the immune system is located directly around and in your gut. I would go as far as to say that without addressing your gut as part of your COVID recovery you’re missing a vital piece of the puzzle.
It might interest you to know that mortality rates from COVID are higher in males than in females, however we need more data on the long term impacts as we know that auto immunity is more common in females generally due to our strong immune response. We also know that females have a stronger immune response to vaccines.
Stimulate Autophagy Through Intermittent Fasting
Autophagy is a cellular process that’s best described as a self digesting or recycling of worn or broken down cell parts. In recent publications it’s received a lot of attention for its role in slowing ageing and decreasing prevalence of certain chronic diseases such as cancer and diabetes.
It may also be useful for reducing viral load in the body, when you fast for a set amount of time your body moves into this autophagy clearing up and clearing out mode, and it can help to kill off viruses and reduce symptoms.
It’s important to note here that as you get the initial killing off you may feel a little worse before getting better, fasting is best done under the supervision and support of a health practitioner. There are specifics around minimum hours and risk factors that should be adhered to for safe and optimum results.
While you may be completely resistant to the idea of fasting know that there are some nutraceuticals which help trigger autophagy without the need to go long hours without food. Including things like Quercetin, Rutin, Vitamin C and vitamin E.
Individualised nutritional support & Health advice
The key thing to note is that long haul COVID will present differently in each individual and therapeutics should be assessed for each person.
Here are 3 key things you can start doing right away to improve outcomes:
Get support early- As soon as you know you’ve got the infection engage your health practitioners so that they can monitor your progress and support you with appropriate next steps. Early intervention may help you improve recovery times.
Decrease inflammation- Avoid inflammatory foods, alcohol, smoking, allergens, chemicals and stress. There’s actually a lot you can do to reduce the additional load on your body.
Take steps to support your digestive health and nutrition- Including eating mainly plants, omega 3 fatty acids (reduces inflammation) from flax, fish, nuts and seeds, and consume mainly easily digested cooked foods. Include helpful herbs in your meals like turmeric, ginger.
Can COVID lead to an autoimmune condition?
One of the hardest jobs your immune system has is to decipher between what’s safe or ‘self’ and what’s foreign or ‘not self’
Immunologists appreciate that there are several potential contributing factors when it comes to autoimmunity.
Genetics
Nutrition (You have control over this)
Infections (impacted by COVID)
Microbiota (impacted by COVID)
Chemicals (You have control over this)
Ultraviolet exposure
So in a nut shell yes there is the potential to see an auto-immune condition longer term. However engaging early and getting some immune support may have an impact on reducing your susceptibility. You can review more immune-deficiency here
If you have an existing auto immune condition please consider getting some support for that as it’s possible that the virus can cause a flare of any existing auto-immune conditions.
Immunologists looking at long COVID and viral mimicry (where parts of the virus is closely identifiable to certain molecules in your body and therefore your body mistakes your own tissue for being foreign) is showing particular links between mitochondria and insulin markers in the body. (we still need more research)
Long Term COVID And Your Brain
A final note, but one well worth mentioning here!
There has been a study published in JAMA on how COVID-19 effects the brain. You can view it here.
In the article they discuss the damage that’s seen in the small blood vessels of the brain due to the neuro-inflammation and the resulting coagulation and blood clots that form. The tissue damage seen in the brain is thought to explain the attention deficit, cognitive deficit, development of anxiety, seizures and increase in suicidal thoughts. This was one of the main reasons I’ve created this post.
Having this knowledge is helpful in engaging your health team early!
Concerning was that 20-70% of COVID patients (in UK and Germany) experienced some neuropsychiatric symptoms. This included both depression and anxiety, it’s proposed that the statistics support a form of neurotransmitter imbalance along side this inflammation all as a result of the infection.
It’s also been reported that a significant number of COVID patients experienced PTSD (post traumatic stress disorder.)
As we know there is a significant risk to mental health from the isolation associated with the lock-downs and uncertainty associated with the pandemic, this additional risk potentially posed by the virus itself should cause all of us to stay aware of the connection and reach out for help early.
A final note
I hope this post has served to both inform you on what to look out for and also to show you that there’s actually a fair amount you can do to improve your health and immune function.
Keep an eye out for some of the symptoms in yourself and in those you love and care about, they could easily be dismissed or misunderstood.
Helpful to keep in mind that the virus we’re seeing come through now is lower in its severity. There is less inflammation than with previous mutations. This should hopefully mean better long term outcomes as well.
Having battled with my own health issues, and spending the last 15 years supporting others on their health journey. I do know that the body has an amazing ability to heal itself. Sometimes it just needs a little help.
Make sure you continue to spend time outdoors with those you love be it at a distance. This is known to improve health and immune function, and improve longevity.
There is so much within your control. Be proactive with your health- Make it a priority. Start taking the small steps today to improve your outcomes and reduce the risks.
If you have any questions about any of the above feel free to book in a 15 minute complimentary call with me down below.
Look forward to chatting soon : )