Is Covid the new persistent infection?
By late 2022, it is estimated that 60% of the world’s population has been infected with the virus that causes the Covid-19 infection. What was originally thought to be a devastating, acute, upper respiratory illness is now potentially emerging as a new persistent infection. The same co-morbidities that predispose patients to Lyme and latent EBV seem to increase the risks of latent covid. As a result, many integrative practitioners believe taking a root cause approach may be of benefit with their long haulers.
A September 2022 longitudinal cohort study evaluated 1864 hospitalized covid patients from Wuhan China. At the two-year follow up mark, nearly 20% still had symptoms (Xinyue Yang, Chao Hou, Ye Shen, & al, 2022). US Data provides similar results with 19% of patients who reported ever having Covid currently having symptoms of long covid (Post-COVID Conditions: Information for Healthcare Providers, 2022). The US CDC currently considers post-covid conditions to be present if symptoms have not resolved after the 4-week mark. This can include persistent symptoms, worsening of symptoms, or an evolution of symptoms over time. Dyspnea or shortness of breath is one of the most widespread symptoms reported among long haulers. Fatigue is prevalent, both in the form of general exhaustion and extreme exertion after normal activity. Neurological symptoms are also common, including brain fog, feelings of anxiousness or depression, as well as memory challenges (Post-COVID Conditions: Information for Healthcare Providers, 2022).
For integrative practitioners, a few key points have emerged. The first being that management of the initial infection matters. The Wuhan study established that patients admitted to intensive care are more likely to have persistent symptoms (Xinyue Yang, Chao Hou, Ye Shen, & al, 2022). Likewise, in an evaluation of 120 long covid patients, and 36 controls, researchers established that the immune inflammatory response during the acute phase of covid predicted the severity of fatigue, depression, and anxiety symptoms 3-4 months later (Al-Hakeim, 2022). Second, the list of linked co-morbidities goes far beyond those typically cited by conventional medicine. Providers should evaluate for diet, autoimmune activity, toxic load, mold exposure, other infections, and even emotional trauma. Lastly, once the symptoms have transitioned to the persistent phase, equal emphasis should be placed on balancing the immune system as managing the virus itself.
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Works Cited Al-Hakeim, H. A.-R.-H. (2022). Long-COVID post-viral chronic fatigue and affective symptoms are associated with oxidative damage, lowered antioxidant defenses and inflammation: a proof of concept and mechanism study. Mol Psychiatry. Post-COVID Conditions: Information for Healthcare Providers. (2022). Retrieved from https://www.cdc.gov: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html Xinyue Yang, B., Chao Hou, B., Ye Shen, M., & al, e. (2022). Two-Year Health Outcomes in Hospitalized COVID-19 Survivors in China. JAMA Netw Open.
