What Can Be Done About Long-Haul COVID-19 Issues?

Jonathan Vellinga, MD

The world has watched and waited for each new COVID-19 development over the past year. After a few months, reports of lingering symptoms from those who had contracted the disease months earlier began to emerge. Now, we have millions of cases and over a year’s worth of data to study. Trends have come to light: long-term effects are common, tricky to treat, and seem to have no real current cause - except for a previous COVID-19 diagnosis.

Even so, there is good news. These symptoms can be addressed through multi-disciplinary and holistic approaches, meaning that functional medicine may be the best option for some COVID-19 survivors.

What have studies shown about long-term COVID-19 symptoms?

A number of studies have been done across the world. One University of Washington study found that approximately 30% of patients reported at least one persistent symptom 3-9 months after initially contracting COVID-19 (1). This study is particularly interesting because a high percentage of those who were studied had a mild form of the disease during the initial infection. Another study done in the UK found that only 65% percent of people felt that they had returned to their previous level of health three weeks after a positive test. The other 35% of COVID-19 patients felt that they recovered slowly and found holistic support, rest, and symptomatic treatment to be the best course of recovery. A smaller Irish study found that one symptom, persistent fatigue, lasted over 10 weeks after initial symptoms in over half the patients (3). A large study conducted in Wuhan, China looked at over 1,700 patients. The median age was 57, and the study included people who had mild to very severe forms of the disease. In this study, even after 186 days post-diagnosis, 63% of patients still felt at least one symptom was negatively affecting their health (4).

When comparing these studies, a common picture does emerge. Over time, we will learn more about the specific percentage risks and perhaps causes of what can cause long term-COVID-19 syndrome (sometimes shortened simply to “long COVID”). But in the meantime, we can see that people who have long COVID will need support and specific medical care.

Common Symptoms

Similar to the initial COVID-19 infection, there are quite a wide variety of symptoms that can occur in long Covid. Fatigue is the most commonly reported symptom across all of the studies mentioned above (1, 3, 4). However, other recurring symptoms may also be a sign of long COVID, such as (4, 5):

• Shortness of breath

• Anxiety or depression

• Memory or concentration problems (also called “brain fog”)

• Joint pain

• Loss of smell or taste

• Cough

• Chest pain

• Muscle pain

• Headache

• Diarrhea

• Sleep problems

• Rash or hair loss

While people who are experiencing these issues may or may not show physical damage that is leading to their symptoms, some people may. Especially for those patients that experienced more severe forms of the illness or had underlying conditions, COVID-19 can cause long-term damage to the heart, lungs, brain, and blood vessels (5). However, even patients that had mild illnesses were at increased risk for heart failure and complications, scar tissue in lungs, blood clots, and strokes and seizures (5).

So, with all of these risks, symptoms, and potential issues laid out, what can be done?

Although there is much study yet to be done on why certain people experience long-term symptoms and others don’t, there is still help for those who are experiencing long COVID. As mentioned above, functional medicine is a great option for treatment that can help spur healing in ways that other disciplines of medicine may not be as adequately equipped for. In Italy, for example, one clinic recognized the full-body, multi-organ effect that COVID-19 was having on its patients (6). So, the physicians worked together to create a multidisciplinary care service for patients with long COVID that included “virtually all branches of internal medicine and geriatrics” (6).

Those in functional medicine, who are focused on taking a holistic approach, have found themselves uniquely primed to treat this type of disease. Because so many people with diverse symptoms (and sometimes nothing to indicate clear infection or disease) have turned to integrative medicine to find help, clinics like TCIM are a great resource to those who are suffering from syndromes like long-term COVID-19.

How Functional Medicine Can Help

Chronic fatigue is the most commonly reported symptom that those with long-term COVID face. Although non-COVID related chronic fatigue doesn’t have a root cause that has been identified yet, many integrative medicine doctors have found ways to work with patients to restore energy and vitality. Although this approach may vary from person to person, our doctors will focus on a few different aspects in order to treat chronic fatigue. Often, the first way that we partner with our patients is to establish healthy sleep patterns that are actually restorative (7). This may involve creating a schedule, adjusting lighting, or even taking a supplement such as melatonin in order to get good sleep. Since sleep is one of the five pillars of health, we really hone in on getting this aspect of health as good as it can be.

Another symptom is muscle weakness, or exercise intolerance. Both of these can also contribute to or exacerbate chronic fatigue. We can work with you in order to create realistic, achievable exercise plans in order to slowly build stamina over time. We will monitor progress together, and can also focus on diet in order to make sure that your body is being fueled correctly in order to support your health goals (9). We can also work together to determine which supplements are the best for you and can support building strength, stamina, and vitality.

Speaking of diet, another aspect of long-term COVID syndrome can be diarrhea or other gut issues. After working together to rule out any other root causes of gut issues, we can establish a diet plan that will help mitigate this unpleasant side effect.

Beyond just addressing fatigue, muscle weakness, and gut issues, diet can also be a way to treat the memory and brain clarity issues that many people face (commonly referred to as brain fog). Since our diets affect our brain function, they also affect our emotional regulation and ability to combat anxiety and depression - another symptom of long-term COVID. We can also work on brain health by addressing sleep quality, emotional health, stress levels, etc.

Another aspect of integrative medicine that is worth mentioning in relation to COVID-19 symptoms is regenerative therapy. Our therapies include stem cell therapy, pulsed electromagnetic field therapy, and platelet-rich plasma therapy. These therapies can address some of the other symptoms that commonly occur in those with long COVID symptoms, such as joint pain, heart problems, and inflammation, among others.

If you need help, please reach out!

If you or a loved one has been experiencing long-term COVID-19-related symptoms and have not been finding relief, please reach out to us to discuss what options you have for finding greater health and healing. Even if they aren’t COVID-19 related, if you have been experiencing any of the symptoms listed here, please call us! It is so important to us to partner with our patients to seek out root causes and address health from every angle possible. We would love to partner with you, too!

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Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.​

Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.

info@tcimedicine.com

951-383-4333

www.tcimedicine.com

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Sources:

1. Jennifer K. Logue, B. S. (2021, February 19). Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560.

2. Greenhalgh, T., Knight, M., A’Court, C., Buxton, M., & Husain, L. (2020, August 11). Management of post-acute covid-19 in primary care. The BMJ. https://www.bmj.com/content/370/bmj.m3026.

3. Townsend, L., Dyer, A. H., Jones, K., Dunne, J., Mooney, A., Gaffney, F., … Conlon, N. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0240784.

4. Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., … Cao, B. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet, 397(10270), 220–232. https://doi.org/10.1016/s0140-6736(20)32656-8

5. Mayo Foundation for Medical Education and Research. (2020, November 17). COVID-19 (coronavirus): Long-term effects. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351.

6. F. Landi, C. B., A. Pan, L. L., G. Kim, M. W., L. Lan, D. X., Ahmed, I., MC. Savastano, B. L., … E. Marzetti, R. C. (1970, January 1). Post-COVID-19 global health strategies: the need for an interdisciplinary approach. Aging Clinical and Experimental Research. https://link.springer.com/article/10.1007/s40520-020-01616-x.

7. Horwitz, R. (2020, December 30). Integrative Medicine and the Long Hauler Syndrome—We Meet Again. The American Journal of Medicine. https://www.amjmed.com/article/S0002-9343(20)31171-2/fulltext.