Why Bother ?
Long Haul Covid is real. We know this with certainty. https://bravethewave.org/2022/03/07/long-haul-covid-a-problem-with-many-faces/
But why should we spend time looking into this if we believe we are possibly manifesting the symptoms of this post Covid conundrum?
Well, I have two hypotheses that should make us more aware of what is going on and should motivate us to try to come up with treatment regimens or therapies for this unusual phenomenon.
First of all, we aren’t surprised by all the confusion and all the different ideas that are being thrown around when it comes to Long Haul Covid. I can tell you from experience that Covid-19 manifests in so many different ways in so many different people that it can be described as multifaceted and multisystem when it comes down to where and how it attacks our bodies.
Some people think Long Haul Covid or Post Acute Covid syndome (PACS) is really just another manifestation of Mast Cell Activation Syndrome or MCAS. The bodies immune system is triggered at the level of specific cells in our bodies that release histamine.
Some people think long covid is just a problem with dysautonomia and people are having problems with Postural othostatic tachycardia syndrome or POTS.
Some people think long Covid is merely a manifestation of a long known and studied entity known as myeloencephalitis or Chronic Fatigue Syndrome.
Getting Older, Faster ?
There is now data to show that Post Covid long haulers who have continued symptoms have something called hyperoxidative stress.
Oxidative stress is an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage. Oxidative stress occurs naturally and plays a role in the aging process.
https://www.medicalnewstoday.com/articles/324863
Free radicals are the normal byproduct of energy production in the body. Some studies have shown that in Long Haulers, there is an overabundance of free radicals and a relative depletion of anti-oxidants such as glutathione in the body. This can lead to the manifestations of chronic fatigue. Also, if there is an overabundance of free radicals that lead to cell and tissue damage, could this lead to an increased incidence of cancer ? At this point in time, we don’t know.
So, in the first hypothesis, Long Covid could possibly lead to an acceleration of the aging process because we are well aware of a hyperoxidative state in Long Haul Covid. I have symptoms of Long Haul Covid, and I can tell you, I don’t feel younger.
https://www.frontiersin.org/articles/10.3389/fimmu.2021.799558/full
One of the most important results from this study is that people who had mild disease with regard to Covid had persistent hyperoxidative and hyperinflammatory responses.
Importantly, the sustained cellular stress and inflammatory status found in the COVID-19 patients post-recovery was not associated with initial disease severity, since this inflammatory profile was observed regardless of patient classification at the acute phase of the disease as inpatients or outpatients. These findings suggest that COVID-19-related stress and inflammatory responses persist after short-term recovery even in patients displaying mild symptoms at the acute phase of disease.
So just a little background on the idea of the hypothesis. A hypothesis is what scientists use to try to explain their observations about what is going on when it comes to a particular problem they want to solve or disease they want to treat. But in this case we have growing evidence for a hyperinflammatory process, a hyperoxidative state, and a vascular inflammation problem, which may be the most concerning.
There is some information about long haul covid or Post Acute Covid Syndrome (PACS) as the scientists are calling it, but in my personal opinion, very few are describing this phenomenon as a true medical emergency.
Accelerated Heart Disease and Stroke ?
I want to mention one thing here that is personal and one of the main motivators for me writing this blog post. I don’t have a history of heart disease in my family. My dad smoked for 40 years and had no sign of cardiac disease at all in his mid 70s. He died of emphysema. My aunt lived to the age of ninety-two and smoked cigarettes every day starting at the age of 15. If I got chest pain that seemed unusual, I never considered a heart attack as the cause.
I have lost two friends due to Covid. One was sick and went to the hospital and he was told to go home since his oxygen level was not low enough for admission, he died that night in his sleep. Another died of a massive heart attack. He too had no history of heart disease in his family and he habitually ran 10 miles a day. One of my physician colleagues just had a heart scan that showed significant calcium deposits (atherosclerosis) where there were none just 2 to 3 years ago. He has no history of heart disease in his family.
I have been dealing with joint pain, body aches, mental fog, post exercise malaise and persistent shortness of breath all of which represent some of the most common symptoms associated with Long Haul Covid, so this is personal for me. Also I feel compelled to share the information that I have learned from studying this disease entity.
So this brings me to the second hypothesis. This one involves the possibility that a Post Covid pervasive vascular inflammation could be occurring that might accelerate heart disease or stroke in patients with NO RISK FACTORS FOR EITHER OF THESE DISEASES. Why the caps? Because, think about accelerated heart disease in millions of Americans with no risk factors for that problem. Now think about the millions of people who do have risks for heart disease. What about them? Regardless, if this pervasive vascular inflammation is real, and the studies seem to indicate that it is, the impact on our nations health over the next 5 years could be substantial. Remember that the estimates are 11 million to 24 million people are suffering from PACS, post acute covid syndrome.
https://bravethewave.org/2022/03/07/long-haul-covid-a-problem-with-many-faces/
This next study is quite eye opening
Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.
What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes.
“It doesn’t matter if you are young or old, it doesn’t matter if you smoked, or you didn’t,” says study co-author Ziyad Al-Aly at Washington University in St. Louis, Missouri, and the chief of research and development for the Veterans Affairs (VA) St. Louis Health Care System. “The risk was there.”
Al-Aly and his colleagues based their research on an extensive health-record database curated by the United States Department of Veterans Affairs. The researchers compared more than 150,000 veterans who survived for at least 30 days after contracting COVID-19 with two groups of uninfected people: a group of more than five million people who used the VA medical system during the pandemic, and a similarly sized group that used the system in 2017, before SARS-CoV-2 was circulating.
https://www.nature.com/articles/d41586-022-00403-0
Ardehali and Al-Aly agree that health-care providers around the world should be prepared to address an increase in cardiovascular conditions. But with high COVID-19 case counts still straining medical resources, Al-Aly worries that health authorities will delay preparing for the pandemic’s aftermath for too long. “We collectively dropped the ball on COVID,” he said. “And I feel we’re about to drop the ball on long COVID.”
A Shared Responsibility
I want to respond to the critics who may say, “You are overreacting and creating fear. You are just causing alarmist behavior and exaggerating the risks.” Or, “This is irresponsible behavior as a physician, you shouldn’t be putting these ideas into people’s heads.” I believe we all have a responsibility to share what we have learned with others when it comes to truth. Especially if we are believers. I also believe we will be held accountable for that sharing.
There has already been so much tragedy and pain with mothers and fathers and family members dying at a young age from Covid infection. What I hope to do is warn people so that they can seek treatment and try to find out of they are dealing with PACS.
If you look at the above study from the VA hospital there are two numbers that should grab our attention. 150,000 and 5 million. This study involves big numbers and plenty of study subjects. That means power and proof.
Here is a small list out of the 200 most common symptoms associated with Long Haul Covid
- Difficulty breathing or shortness of breath
- Tiredness or fatigue
- Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
- Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
- Cough
- Chest or stomach pain
- Headache
- Fast-beating or pounding heart (also known as heart palpitations)
- Joint or muscle pain
- Pins-and-needles feeling
- Diarrhea
- Sleep problems
- Fever
- Dizziness on standing (lightheadedness)
- Rash
- Mood changes
- Change in smell or taste
- Changes in menstrual period cycles
If you know anyone who is suffering from Long Haul Covid please forward this post to them. This is important information you can share with family and friends. If you are having these types of symptoms, please seek medical care.
I have started one of the most studied regimens for Long Haul and hope to give an update soon.
Have a blessed day !!
Your Brother in Christ
Johnny Cavazos MD