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COVID: What About Those Who Don’t Recover?

COVID: What About Those Who Don’t Recover?
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What causes ill health months after infection, and what can be done to prevent it. Action Alert!

One of the mysteries of the COVID-19 pandemic is why some people who become infected with the virus continue to have symptoms months after infection. Much is still unknown, including what causes “long-haul” COVID, particularly in those who had only a mild case of the virus. But the science is starting to give us some answers, including a possible link with previous autoimmunity. Natural medicine offers some hope, but only if we can pass reforms that allow us to learn about its benefits.

Here’s what we know so far.

How prevalent is long-haul COVID?

It’s estimated that 10 percent of people who have had COVID experience prolonged symptoms one, two, or three months after infection; other estimates put the number even higher at 33 percentAnother study found that only 65 percent of people returned to their previous level of health 14-21 days after a positive test. This amounts to millions of Americans with long-haul COVID; according to the CDC, there have been more than 30 million COVID cases in the US.

What characterizes long-haul COVID? 

The most common symptoms appear to be neurological, with 85 percent of long-haul patients reporting brain fog, fatigue, headache, loss of sense of smell or taste, and impaired cognitive function. Some have suggested that long-haul COVID likely is the same or very similar to chronic fatigue syndrome. Tinnitus, or a ringing of the ears, has also been reported: in a survey of 650 long-haulers, a third reported earaches and two thirds reported dizziness and vertigo. Other studies have suggested that men who have recovered from COVID may be at risk for developing low sperm counts.

Who is getting it?

Clinical experience suggests that most long-haulers tend to fall into the high-risk category—older individuals with existing chronic conditions—but long-haul COVID is affecting a growing percentage of people who were otherwise healthy before infection. According to the Cleveland Clinic, “it still seems random.” A quarter of 18–34-year old’s have reported they have not regained their health.

What is causing long-haul COVID?

We still don’t know. A review in Nature Medicine suggests that cell damage, an inflammatory immune response, and abnormal blood clotting may be the cause of the long-term symptoms. The picture seems clearer in patients who experienced severe COVID infection. In those cases, damage to multiple organs such as the heart, lungs, or kidneys could produce the longer-lasting symptoms. But this doesn’t explain why those with mild COVID cases experience persistent symptoms. 

Some speculate that chronic, low-grade neuroinflammation generated by the disease may cause chronic fatigue and some of the other neurological symptoms of long-haul COVID. Another possibility is previous autoimmunity. According to a new study, approximately 70 percent of long-haul patients are women and 16 percent had preexisting autoimmune disorders. This profile resembles the female to male ratio of autoimmune diseases such as multiple sclerosis and rheumatoid arthritis, suggesting an autoimmune contribution to long-haul COVID. 

Other evidence has shown that COVID infection itself can trigger autoimmunity that may be behind long-haul COVID. Research has shown that infection with COVID is driving the development of autoantibodies that mistakenly attack the patient’s own tissues instead of the virus. These antibodies can persist months after the infection has resolved. 

Note that autoimmunity after illness isn’t unique to COVID and can occur after other inflammatory infections like malaria and other respiratory viruses. Autoimmunity is relatively common, estimated at 10-15 percent of the population. One study found that 10 percent of severely ill COVID patients had existing autoantibodies that prevented their immune systems from responding to the COVID virus. 

Should long-haulers get the COVID vaccine?

We don’t know. There are anecdotal reports from a few long-haulers who found relief from their symptoms after the first dose of the vaccine. But there are concerns. There is evidence that vaccines can trigger autoimmune reactions. This happens when proteins on the pathogen introduced by the vaccine are similar to human proteins (called “molecular mimicry”), causing the immune system to attack human cells. The National Academy of Medicine reported in 1991 that there was a causal relationship between the rubella vaccine and acute and chronic arthritis (some types of arthritis are considered autoimmune conditions). Both the flu vaccine and vaccines containing tetanus (like DTaP) have been linked with Guillain-Barré syndrome (GBS), an autoimmune condition where the body’s immune system attacks the nerves. One study cited numerous reports of autoimmune disease following various vaccinations, suggesting that certain genetically predisposed individuals might be particularly at risk. There have been 70 reports of GBS in relation to COVID vaccines, along with 22 reports of rheumatoid arthritis and 32 reports of other autoimmune problems. Dozens of patients receiving the COVID vaccine are reported to have developed a rare autoimmune blood disorder. 

What can we do about long-haul COVID?

As our friends at ANH International point out, reducing the risk of long-haul COVID has to do with the body’s ability to deal with the pathogen and to resolve the resulting damage from our body’s fight with the virus (such as inflammation). Our ability to accomplish those tasks depends on a number of factors like genetic predispositions and state of health prior to infection, including levels of nutrients key to the immune system. We’ve reported on vitamin D’s role in the immune system and in COVID generally; we’re also seeing that severe COVID cases are in scurvy territory when it comes to vitamin C levels. Other immune-supportive nutrients include vitamin A, zinc, selenium, and iodine. Supporting brain function may help address COVID long-haul issues. Brain-supporting nutrients include omega-3 fats, choline, acetyl-l-carnitine, vitamin B12, coconut oil, and probiotics. Many long-haulers may be suffering from gut dysbiosis, allowing pro-inflammatory bacteria to thrive. Dietary interventions aimed at restoring gut health (plenty of phytonutrients, probiotic foods, eliminating sugar, etc.) could be of use to long-haulers.

Check out this week’s video for Dr. David Brownstein’s advice for managing long-haul COVID.

Natural medicine thus has an important role to play in supporting our health and reducing the risk of severe COVID infection and long-haul COVID. But, as we’ve been writing for some time, federal policies prevent us from fully harnessing the power of natural health by stifling the free flow of information about its benefits. Until reforms are passed, we will continue to fight the COVID pandemic, as well as the epidemic of chronic disease, with one arm tied behind our back.

Action Alert! Write to Congress in support of our legislation to allow the free flow of information about the benefits of natural medicine. Please send your message immediately.

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