Understanding post-covid syndrome

Immune Health


Owen Wiseman
@AVogel_ca


03 May 2021

Imagine battling this potentially lethal virus and after coming off of the ventilator, you have a newfound sense of freedom. That feeling only lasts so long though as you begin to notice that you maybe haven't recovered as much as you previously thought.

We are also only just beginning to understand how long and how severe these lasting impacts could be. This article will explore the most current information as of the date of publication and will interchangeably use the terms post-covid syndrome, long haulers and long covid.

What are the symptoms of long COVID?

It is important to stress that symptoms vary based on the individual and a multitude of factors. A study was conducted by Boston's Dana-Farber Cancer Institute and looked at the frequency of symptoms in long-haulers. The team conducted a review of the available information with certain symptoms showing up more than others. These included:

  • Psychiatric concerns (56%), i.e. anxiety, depression, PTSD
  • Fatigue (53.1%)
  • Shortness of breath (43.4%)
  • Joint pain (27.3%)
  • Chest pain (21.7%)

What is important to recognize is that across these symptoms, multiple organ systems are impacted. This shows the ability of the novel coronavirus to move beyond the respiratory system, the main target of the virus. The psychiatric and psychological impacts are also critical to recognize and respond to as to overlook them is to put the full recovery of patients in jeopardy.

What are some of the other extrapulmonary symptoms?

Changes in liver enzymes, nausea and vomiting, changes in blood sugar, arrhythmias, rash and dizziness are just a handful of symptoms that fall outside the major respiratory manifestations like pneumonia.

How long do the symptoms last?

We are consistently learning more as those who battled COVID-19 at the start of the pandemic gradually get further from the initial infection. One study showed that almost 30% of those studied suffered at least one symptom, not limited to the list above.

Another study showed that almost 50% of those hospitalized experienced multiple symptoms two months after discharge.

Who is more prone to becoming a long hauler?

Data collected from the Covid Symptom Study app identified a few early factors that may increase one's risk of becoming a COVID long hauler. Specifically:

  • Women were 50% more likely to experience symptoms
  • Adults older than 70 were 22% more likely
  • Having asthma increased chances of lasting symptoms as did those considered overweight
  • Those experiencing more than five symptoms in their first week with COVID

What are some ways to support our general health in response*?

As we know, focusing on overall health is the key to protecting yourself not just against the novel coronavirus, but all pathogens. This is done through supporting the body and the foundations of health.

  1. Exercise. Sedentary behaviours are a known contributor to ill-gains in health including diabetes, metabolic disorders, cancer and early mortality. With that knowledge, one can only imagine how even the most basic of motions may help buffer the impacts of lethal viruses like COVID-19. Meeting the recommendations set by the Canadian Society for Exercise Physiology is the most evidence-based approach to supporting your fitness health. Chat with your primary care provider though if you have any concerns regarding mobility or modifications specific to your cardiovascular health.
  2. Nutrition. Supporting against any foreign pathogen requires a lot of resources and the fight between our white blood cells and the virus may create many free radicals. These pro-inflammatory agents can be better managed with the proper nutrients present in the body. A diverse and robust diet helps us meet the recommended daily allowance set by Health Canada. Should you require a bit of support, products like Bio-Strath can be added alongside a healthy diet to ensure you get the right amount of nutrients.
  3. Sleep. Missing out on sleep could put your entire self at greater risk of not only long COVID, but all manner of maladies. What is important to be aware of here is that COVID has also been implicated in causing changes to sleep patterns. If you begin to notice these shifts in yourself or loved ones, it is worth attending a nearby clinic for assessment. Researchers identify that it may cause hypersomnia where individuals could sleep for hours beyond their normal routine.
  4. Mind. Stress can induce a fight or flight response that will only exacerbate inflammation throughout the body. Practicing mind body techniques like yoga and diaphragmatic breathing can help reduce levels of cortisol circulating through the body. This is an important aspect to consider as cortisol levels and the experience of anxiety as per the Hospital Anxiety and Depression Scale were shown to be significantly higher in those battling COVID-19.

*Disclaimer: At A.Vogel, we recognize the ever-evolving situation of COVID-19 and continue to respect the guidance released by our local health authorities. We wish every Canadian continued health and a speedy recovery.

References:
https://journals.lww.com/neurotodayonline/fulltext/2020/07090/sleep_neurologists_call_it.1.aspx
https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1
https://www.nature.com/articles/s41591-020-0968-3
https://www.nature.com/articles/s41591-021-01292-y
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274952/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368100/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505377/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506115/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642637/
https://pubmed.ncbi.nlm.nih.gov/32563278
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2