CEO BLOG- Long Covid FAQ’s… From the Frying Pan into the Fire!

One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don’t do anything at all  

This could describe doctors during the Covid pandemic. We had no studies, concept of what to give, or what to treat with. In the final analysis, only Paxlovid was approved orally for treatment. 

For music buffs you will recall White Rabbit (the song above) was written in 1967 by Grace Slick, a true matriarch of American rock. 

Grace’s story is interesting. A major force in American rock ‘n roll for 20 years, she became disillusioned with her situation. As lead singer, songwriter, and spokesperson for the Jefferson Airplane/Starship, she became fed up with record company execs, fellow band members’ poor work ethic, and the overall commercialization of the American music scene.

So in 1988, she left–to be on her own.

And failed miserably.

Relegated to singing some backup vocals and finding no success with her music away from her old band, she retired from the music industry in 1990.

Hers is a good example of the saying “out of the frying pan into the fire.”

It is commonly used as a metaphor describing moving from a bad situation into one that is worse.

Which we can use now on a very frustrating medical issue facing us–Long Covid. 

It’s not bad enough you may have used masks, socially distanced, contracted Covid anyway, took the meds given, quarantined yourself for weeks, possibly spent time in the hospital, missed work—but now you find yourself with a strong possibility of fighting Long Covid.

In other words, going from the frying pan into the fire. 

In early 2020, we had no idea how to treat Covid, let alone that it can morph into a true monster even AFTER the antibodies did their job.

Even 3 1/2 years later, we can’t agree on a true definition of Long Covid. 

Most authorities use four weeks after recovery (some use 12 weeks) as the time the Long Covid symptoms start–they are sometimes unrelated to the symptoms of the Covid you started out with.
To make matters worse, the symptoms can appear and disappear during the course of Long Covid. So, you’re never really sure when you are out of the woods. 

So are you or a loved one affected?

Here are the major symptoms-

• Fatigue (the most common and frustrating one)
• Memory Loss
• Breathing issues
• Sleep issues
• Autonomic nervous system issues, especially with POTS -just think dizziness and unsteady gait

Minor symptoms (experts’ terms, not mine)

• Headaches
• Loss of taste /smell persisting
• Extremity weakness 
• Cognitive issues, especially anxiety/anger/depression

In addition, there are three criteria:

1. Documentation of prior Covid infection over four weeks from onset
2. Presence of any of the above symptoms
3. Alternate explanations are ruled out

Higher risk or more serious cases are linked to:

1. The unvaccinated
2. Women
3. Over age 50
4. Covid needing hospitalization, especially ICU care
 
If you had a mild case, you have a 20% chance of contracting Long Covid and it lasting over four months
If you had a serious case, it goes up to an 80% chance and it may have not yet cleared even three years later. The CDC estimates there are currently NINE MILLION cases of Long Covid in the US now.

Authorities now are calling Long Covid a “post-viral syndrome,” which usually implies an autoimmune basis, persistent inflammation, and continued Antigen resistance to the Antibodies produced. 

So—why bring up Covid again when it seems the pandemic is over and normalcy has returned?

Well don’t tell that to the nine million cases of Long Covid–not counting the millions who have not yet been diagnosed. They have truly gone from the frying pan into the fire-and until now did not have a good handle on what to order or use to treat.

The news came out a couple of weeks ago- Long Covid patients show a change in immunity and hormone function- per a study in the respected journal Nature.

Moreover, there are now specific biomarkers that can be tested to assist in diagnosing and possibly treating this resistive condition. 
 
The study also showed lower morning cortisol levels in Long Covid, something relatively easy to check.

Hopefully this is the tip of the iceberg and more studies will show biomarkers and other blood tests to assist in diagnosing and treating Long Covid.

What if you decide to be tested and all the evidence points to you having Long Covid?

Still no treatments are approved. Only anecdotal reports. 

Almost all authorities advise more Paxlovid which has shown some promise. Trying to boost the immune system through IV Hydration with Immune Boosting formulas has helped in small numbers.

Using antihistamines is under trial in the university settings–Benadryl and Famotidine specifically.
HIV drug Maraviroc and the cholesterol medication Pravastatin have been helpful in some clinical trials. 

Being able to better identify Long Covid victims will allow us to better find which of these–or yet unthought of -treatments may help. 
 
In summary:

1. If you had Covid and now have any of the major or minor symptoms, please consider you may be suffering from the post viral syndrome Long Covid. Consider contacting us for an evaluation for this not-rare condition.

2. Via an office visit (possibly virtual by Zoom) and blood work, a severity determination may be possible, new data confirms.

3.Treaments for Long Covid are being researched and may possibly achieve off label use.
Incidentally, some celebrities have gone public with the Long Covid to encourage more research–Colin Farrell and Alyssa Milano come to mind.

Having navigated over 8,000 patients through the gnarly rapids of Covid-19, we are well positioned to help you if you have Long Covid. The same team of Covid providers that followed and cared for you through Covid, is ready and willing to help you through Long Covid.

Remember, you won the war, however the battleground can take longer to heal.

What about our Rock Queen Grace Slick? She feels her frequent masking has prevented a Covid infection. In fact, she was prophetic about our lack of sanity and scale with the whole pandemic-as she ended the song White Rabbit with-
When logic and proportion
Have fallen sloppy dead
Remember what the dormouse said
Feed your head!
 
Gregg DeNicola MD
CEO
Caduceus Medical Group
PDQ Urgent Care & More
 
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