https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785388
I have hesitated to write this blog. We are all sick of COVID (although based on the latest MN hospital census, COVID is not sick of us yet…), and the controversy surrounding the management of this never ending pandemic is putting everyone on edge, often leading to unproductive discussions. However, this latest JAMA study was a compelling enough confirmation of what I have observed at the office for the past three months that I thought I would still stick my neck out and share a little info for those interested in hearing it.
The latest study was interesting, and sobering, as it improves upon previously gathered data in several ways-
It uses a well established outcome measurement tool to assess and categorize cognitive impairment, rather than simply self reported symptoms.
It looks at a broader array of COVID patients, not just patients with severe illness and hospitalization.
This intersects quite well with my office observations of the past three months. Post COVID symptoms of continued widespread soft tissue pain, cognitive loss (“brain fog”), and aggravated autoimmune symptoms are common and persistent for several months. For some reason, I have seen that more in women than in men. I have also noticed a unique temporal pattern of those secondary symptoms suddenly appearing about 2-3 weeks after the resolution of the initial upper respiratory symptoms, about 5-6 weeks after the initial infection, often catching patients off guard who thought they had fully made the corner.
The research into prolonged COVID seem to suggest that the infection can lead to the development of a dysregulated immune system stuck in pro-inflammatory mode, based on blood markers like cytokines and interleukins, which would explain why women and folks prone to auto-immune illnesses tend to experience that more frequently. There is some question about the possibility of a persistent low grade, relapsing viral infection hiding in the body, very much like chronic Lyme disease. For some reason, COVID really likes central nervous system tissue like the brain.
Based on some recent inter-professional discussions among colleagues in integrative health, I have started to use nutritional protocols very similar to those we use for auto-immune and inflammatory conditions, with some encouraging results. It would be very premature to talk about it in more detail, but we are certainly here to sit down with individual patients and try to come up with some solutions for what is otherwise a very challenging situation with few definite answers as of now.