Hope for COVID Long-Haulers

hi and welcome to another edition of your health with dr christie my name is dr christy reisinger and today we're going to talk about the coveted long haulers that portion of patients that have had an initial covid19 infection and either have persistent symptoms that never go away or develop new symptoms it's been called several things but recently there's been a push to formally call this condition post-acute sequela of sars kovi to infection or pasque i want to make the caveat that i'm giving this information from the perspective of an internal medicine physician in order to empower those of you out there that may be experiencing this issue and are not sure where to turn next i hope this talk will give you information to take to your physician to help coordinate the next steps in your care every person's case is different so it's important that you talk to your own personal doctor about treatment the most common symptoms of covid long haulers include respiratory symptoms fatigue sleeping difficulties depression and anxiety and neurological dysfunction such as headaches numbness and tingling or brain fog the symptoms must be present for more than four weeks after recovery from your acute covet infection to be considered a long hauler an online support group called survivor corps conducted an online study that's currently in pre-print of over 5 000 survivors of covet 19 reporting symptoms for more than 21 days after their covet 19 infection the most common symptoms reported by them were fatigue headache shortness of breath difficulty concentrating cough change sense of taste diarrhea and muscle or body aches but know that there have been more than 200 symptoms reported from long haulers a study published in the lancet looked at over 1700 patients after they were discharged from the hospital with covid19 this study found that 75 percent of patients hospitalized with covid had at least one ongoing symptom six months after their acute illness most commonly fatigue or muscle weakness that occurred in 63 percent of these patients the next most common symptoms that occurred in about 20 percent were sleeping issues and hair loss and what was surprising to me was that it really didn't matter how severe the initial covid19 infection was the rates of lingering symptoms between the mild moderate and severe cases were about the same this is backed up in other studies that found that 35 to 54 of patients with mild covid19 had persistent symptoms after two to four months and it doesn't just have to be persistent symptoms sometimes these patients develop new symptoms or symptoms that initially resolved and then reappeared studies have shown that this can occur 50 to 76 percent of the time well what can be done first i would recommend finding a community so that you don't feel alone survivorcore.com is a great resource or there are groups on facebook as well next find a primary care doctor that will empathize with you and help coordinate your care this may include a team of specialists including neurologists which are nerve and brain specialists pulmonologists which are lung specialists and cardiologists which are heart specialists if you live in a big city some academic medical centers are developing clinics to help coordinate this care all in one place to see if this is true of your state go to survivorcore.com and click on the post covet care button next i recommend adjusting your expectations think of your recovery as a marathon not a sprint in most cases patients slowly get better but it simply takes time which can be frustrating realize that there is so much that's not known about the syndrome right now getting lots and lots of lab work and x-rays and scans often is not that helpful for patients and only costs a lot of money without much benefit okay so are there treatments well yes and no your doctor will probably look at each symptom you're having and focus on those for example if you're having trouble sleeping melatonin might be a good option if you're having lots of burning and numbness in your fingers and toes something like gabapentin may be tried if you're suffering from brain fog your doctor may send you for a neuropsychological evaluation which is used to quantitatively measure your acquisition of knowledge manipulation of information and reasoning this assessment helps to determine how your brain works when performing tasks such as learning new information or solving problems it's also used to determine which mental functions might be impaired and to what degree a lot of time this report can provide reassurance to patients suffering from brain fog but is there a known cure well no but there is some promising data with a few medications and treatments some exciting subjective data meaning that this is just doctors hearing from their patients which has the risk of being very biased has shown that patients with post-covet syndrome that have gotten the covet vaccine have improved some have even said the response is up to 30 to 40 percent of long-haulers have improvement of their symptoms after the covet 19 vaccine and it doesn't matter which vaccine is received this result has been reported after each of the vaccines available including pfizer maderna and johnson and johnson and this reporting has been supported by a very small pre-print study from england of 44 long haulers this study reported a small but statistically significant improvement in symptoms after receiving either the pfizer or moderna vaccine and these results have also coincided with an online poll conducted by survivor corps on facebook that found that out of a total of 850 responses 40 percent reported relief of their symptoms while 45 said they saw no change in the symptoms since vaccination however it is notable that 15 said their symptoms had gotten worse after vaccination this data is in line with other online polls that have been conducted by a filmmaker out of the united kingdom and body politic a support group for covid's survivors well why in the world would the vaccine help with long-haul symptoms the real reasons are not known yet but some hypotheses think that long haulers have never really cleared their initial covid19 infection and that there possibly is still a reservoir of infection maybe in the gut or that there are circulating viral fragments that the vaccine will finally help to clear once and for all another theory is that long-haul or symptoms are caused by an inappropriate autoimmune response and the vaccine may help the immune system to reset itself well what about oral medications there are many theories and early studies taking place for various medications however one medication that has consistently gotten some buzz is ivermectin this is based on patient testimonials which once again have the tendency to be quite biased but it's also based on a very small study that has remained in pre-print since it was released in july 2020. in this study 33 peruvian patients with long-haul symptoms for four to twelve weeks were enrolled all were given at least two doses of ivermectin based on weight and the doses were repeated if the symptoms continued in the end they reported that 94 of the patients had complete resolution of their symptoms after taking some amount of ivermectin but the data was unavailable for review and there was no placebo control i'd love to see more trials using ivermectin for the treatment of long haulers also fluvoxamine has also been discussed on this channel for its promise in the early treatment of coven 19. but i also want to point out that the study published in the open forum infectious diseases in february 2021 also spotlighted that those patients that took fluvoxamine had no ongoing symptoms at day 14 compared with 60 of those patients that were simply observed and received no medication of course once again this was a very small study with only 113 patients enrolled and they did not follow these patients beyond 14 days but i still think the early data on fluvoxamine is encouraging i'd love to see more trials done with fluvoxamine in patients with long-haul covid19 and i've seen very early and very preliminary remarks about proposed medications that are being studied and repurposed for treatment of long haulers but we will have to wait for more data on these i'd also like to stress the importance of an adequate vitamin d level both before during and after any covet 19 infection please see my prior video touting the importance of vitamin d at the end of the day long haul covid is a poorly understood condition that's caused so much frustration for patients and physicians i'm hopeful that more and more data will be coming but in the meantime i encourage everyone to get the covet vaccine there's speculation that by receiving the covet vaccine to prevent getting a covet infection you will prevent yourself from the possibility of developing long-haul coveted symptoms thanks again for joining me

Channel: Christy Risinger, MD

Views: 119,399

Keywords: your health with dr christy, long haulers, covid long haulers, PASC, treatment of long haulers, covid 19, reisinger, dr risinger, christy risinger md, dr christy, risinger, post covid syndrome, vaccine and post covid, long hauler and vaccine

Id: acAi96zAYoY

Length: 9min 44sec (584 seconds)

Published: Thu Apr 08 2021