Many younger Coronavirus sufferers, who initially presented with mild symptoms (therefore not receiving ITU care) are now Covid-19 long haulers

This is not that unusual.

Patients diagnosed with SARS in Hong Kong in 2002 continued to have lung impairment two years after the symptoms began.  Italian patients, from 19 to 84 years old, are still experiencing symptoms related to COVID-19.  Physicians in one Paris hospital report seeing an average of 30 “long” Covid-19 patients every week.

We want to know what the “long Covid” symptoms are, the predisposing factors, how to predict cases, the most effective way to help them and how to prevent the condition in the first place.

These are previously healthy young adults who are still haven’t recovered from their first infection.  Statistics show that a quarter of these younger patients, aged 18 to 34, do not regain their health.

Symptoms include fatigue, shortness of breath, body aches, headaches, brain fog, joint pain, chest pain, fever, sweats and gut issues.

I have seen some patients who had mild to moderate infections, and most of them did not receive any hospital treatment.  But these patients continued to have severe fatigue, resulting in their needing to have prolonged rest following a mild to moderate effort that they had previously completed with no problem at all.

A recent survey in New York found that fatigue was the most common symptom experienced by more than 1,500 patients, followed by muscle or body aches, difficulty breathing, memory issues and lack of concentration.

Doctors find it hard to understand why some patients continue to have significant symptoms, while others recover.

Post-viral fatigue syndrome (PVFS) 

PVFS is when a Covid-19 patient is taking months, rather than weeks, to return to normal health.  The condition is serious and more likely to happen post-Covid-19 than after any other viral illness.

Patients present with lethargy, general malaise, muscle aches and pains due to the release of cytokines by the immune system to fight the infection. This is the normal immune response to defend the body and reinstate homeostasis.

What is not normal is when the immune system become over reactive and continue to fire causing severe lung damage and other complications. Resulting in what is known as a cytokine storm.

I think the overreactive immune system is the common factor between acute old patients who progress to develop severe lung disease and the later development of PVFS in young patients who started by having a mild covid-19 infection.

When a patient continues to have symptoms of fatigue for a longer period after the acute infection, this means the immune response had not settled down and continued to cause serious problem with energy production in the cell energy plants (mitochondria).

These patients fail to return to normal energy levels after any form of exertion. They develop activity-induced fatigue after normal physical activity at work or at home and they have to take prolonged rest.  They experience sleep disturbance, so they sleep longer at night, as well as needing periods of sleep during the day.  This is known as hypersomnia, a normal body response attempting to achieve natural recovery post viral infection.

However continuing symptoms of fatigue should not be interpreted as persistent viral infections as these patients are no longer infective (contagious) to others.

Good management of patients presenting with mild-to-moderate symptoms during the early stages of Covid-19 infection is essential in enhancing their natural recovery process to reduce their chances of turning into PVFS cases.

Who suffers with PVFS?

This 40-year-old lady presented with severe fatigue post Covid-19 in March, with the frequent need to clear her throat of tiny sputum, but no real cough.  She had a migraine at mid cycle with ovulation and just before her periods. The migraine resulted in neck muscle tightness and jaw tension. She had 10 silver dental fillings, 4 of them removed recently.

I diagnosed post Covid-19 virus fatigue syndrome (PVFS) with a background of migraine, oestrogen dominance from a history of PMS and ovarian cysts. Possibly high mercury load in view of the 10 dental silver fillings.

I found her immune system was struggling to cope with a low lymphocytic count at 1.04.  This could explain her history of having frequent yeast infection.

B12 was low at 192 despite that fact that she consumes a well-balanced diet, rich in animal and vegetable proteins and she was taking multiple vitamins that contained a good amount of vitamin B12.  This made me think her B12 deficiency must be due to malabsorption. I prescribed vitamin B12 injections and requested further tests for gluten sensitivity and for an inherited condition (pernicious anaemia) as possible causes of B12 malabsorption.  I advised her to eliminate gluten from her diet.

I also found her detoxification system slow to process oestrogen and mercury.  Both governed by a gene called COMT.  A COMT variant can result in high oestrogen and mercury.  Vitamin D was relatively low at 106 and is likely to contribute to her immune system over reactivity.

There was evidence to suggest leaky gut syndrome and autoimmunity as she had a patch of eczema and psoriasis on the back of the neck.I am sure you will agree with me here a patient with all these problems might not recover fully after a Covid-19 infection.

I am pleased to say that we are in the 21st century and we have got all the tools and technology that can help us to find these problems and to deal with them effectively to prevent over reactivity of the immune system in the future.

Covid-19 is a test of your health and fitness!

Not having an infection at all is a great sign, while having the infection or becoming a long hauler is a concern, indicating this person needs a full health MOT to find and correct any abnormality.

I remember that there was a high incidence of chronic fatigue syndrome among the army personnel returning from the first and second Gulf Wars.  We could not identify what makes some develop the condition while others stay in perfect health?  Maybe a high toxic exposure in those with an inadequate detoxification system was severe enough to damage their energy production system.

Unfortunately, we continued to consider ME/CFS as psychosomatic condition offering these patients antidepressant and psychiatric medications.

Maybe this is happening because we haven’t got enough tools to test the mitochondrial function or the technology is available but not currently applied in routine medical practice.

How to find high-risk patients?

The process should start at an early stage when the diagnosis is confirmed by a positive covid-19 test. We can expand the assessment to include the tests listed below in the high-risk group. I found low lymphocytic count; low vitamin D and high ferritin are sensitive enough to detect the high-risk status likely to deteriorate into PVFS.

Tests to detect high risk status

  • High CRP
  • High Lactic Dehydrogenase (LDH)
  • Low Albumin
  • High Ferritin
  • Low Lymphocytes
  • Presence of Interleukin IL-6: an indicator of a poor outcome
  • Vitamin D and Homocysteine

Increasing numbers of patients won’t recover

Increasing numbers of patients suffering with post viral fatigue or post viral fatigue syndrome following Covid-19 infection are reported by GPs, and research indicates that 10% of cases of these cases won’t recover fully.

Poor management of a post viral fatigue causes these patients to progress to ME/CFS.

Mitochondrial disease

In each cell in your body, there are energy plants.  These energy plants burn food like glucose and fat to make the energy required by the cell to run its daily activity.

The mitochondria require macro nutrients like sugar and fat to make energy.  The process also requires micro elements, such as vitamins and minerals (spark plugs!), to burn the fuel to generate the energy.  Normally there is no problem with the fuel, but there’s always some deficiency in the vitamins and minerals.

With severe infection, the mitochondria shift from energy production into defence mood, stopping producing energy, and the affected person ends up having severe fatigue.

What makes patients at risk of PVFS?

An immune system that is busy sorting out internal conflicts does not have the capacity to fight foreign invading organisms. The body internal conflicts vary from a simple sugar problem to inflammation, severe toxicities or deficiencies, examples included in the list below:

  • Permeable gut lining also known as leaky bowel syndrome.
  • Blood sugar problems.
  • Obesity and belly fat.
  • Nutritional deficiencies, such as Vitamin D.
  • Toxicity (oestrogen and heavy metals)
  • Faulty lifestyles (processed food, inadequate sleep, lack of physical activity, stress and poor relationships)

Chronic PVF syndromes have been associated with clinical conditions, such as gluten sensitivity, heavy metal toxicity and nutritional deficiencies such as vitamin D.

There are also genetic factors that interfere with the body ability to activate essential cellular elements (methylation) such as MTHFR gene. COMT, GSTT1, GSTP1, GSTM1 are important detox engines in the liver.

In addition, high levels of heavy metal like mercury in silver dental fillings, can impede the mitochondrial energy generation machine.

Mitochondria foods include alpha lipoic acid, CO-enzyme Q10 (COQ10), L-carnitine, D-Ribose and B vitamins may help some patients.

When there is inadequate energy supply, the body will start to prioritise the most important organs.  For example, the heart will go into palpitations, when there is inadequate energy.  The brain is a big energy consumer (25% of our daily energy) and if there is inadequate energy you start having brain fog and can progress rapidly to cognitive decline, with lack of concentration, poor memory and difficulty with the decision-making process.

How to help Covid-19 long haulers?

Remember covid-19 is a virus that cannot live or multiply independently. The virus has to move inside the cell to gain access to cellular energy resources to multiply.  Cells swollen with viruses can show up on the immune system Reeder to cause over reactivity. If you can lock the virus out, then the whole process can be aborted completely.

Scientists discover that the only way of stopping the virus from entering the body cells is to put zinc there. Zinc acts like (Tom) can stop the virus (Jerry) from entering the cell. Tom is very lazy needing a lift to get inside the cell. hydroxychloroquine, Quercetin and EGCG in green tea can offer the lift.

Zinc is a potent antiviral agent that Inhibits viral replication. Sources include meat, shellfish, legumes, chickpeas, lentils, beans, seeds (Hemp & Pumpkin), Nuts, dairy, eggs, wholegrain. Food rich in Quercetin include red apples, red grapes and red onions.

You can take a dose of 30mg to 50mg of Zinc daily during the epidemic. Taking too much Zinc is going to lower you copper level.

In a nutshell zinc, Quercetin and EGCG in green tea as food or supplements can support the immune System, enhance treatment and recovery from corona virus infection. 

Covid-19 is going to close the gap between conventional medicine and holistic functional medicine, since patients will benefit from both healthcare systems.

How to recover 

Patients are advised to have plenty of rest and relaxation, avoid stressful situations, do not return to work, school or domestic duties until they are feeling well again.  Practising yoga or meditation can help relaxation.  Do not to exceed what you are comfortable doing. keep a good balance between activity and rest.  Limit screen time, avoid using electronics, and increase your level of activity gradually.

The governments failed to issue Covid-19 health passports but can support the healthcare system to issue MOT certificates.  You can have your own MOT certificate by completing an online health assessment and doing hi-tech tests that do not require a blood draw.

 Please contact me now to register for YOUR health MOT and hopefully your Covid-19 clearance!