Long COVID

by adminJune 1, 2021

We are finally emerging from lockdown restrictions and the vaccine roll-out has given many people much more protection and confidence. However, one of the worst effects of fighting a severe respiratory disease is the ongoing poor health that can last for many months. This blog will help anyone suffering from Long COVID.

What is it?

Long Covid describes the symptoms that follow Covid-19 after the initial illness has passed.[1] According to the National Institute for Health and Care Excellence (NICE) symptoms that last for more than 12 weeks are indicative of Long Covid and these symptoms can last for months afterwards.

Long COVID includes a range of respiratory and systemic problems including coughs, breathlessness, fatigue, headaches, palpitations, increased heartbeat, pins and needles, numbness, ‘brain fog’ (not being able to think straight), joint or muscle pain.[2] Post-Covid fatigue can also be linked to exhaustion, anxiety and depression, which can also exacerbate respiratory symptoms and create a vicious cycle of ill-health.[3]

From my clinical experience I am also seeing IBS, insomnia, chest pains, low blood pressure, rhinitis and exhaustion post exercise. Different symptoms seem to appear in different months after COVID. Frustratingly, most people seem to have a relapse in their symptoms brought on by exercise, stress and the vaccine.

Most importantly, long COVID triggers a condition called ‘mast cell activation syndrome’ (MCAS).[4] MCAS is a chronic multisystem disorder with inflammatory and allergic themes, which causes cells to release histamine into the body resulting in allergic type symptoms such as hives/itching, swelling, low blood pressure, difficulty breathing and severe diarrhoea. You can find out more about MCAS in this diagram and at The Mast Cell Disease Society.

Some research that symptoms of Long Covid may be the result of injury to the lungs, heart, and brain.[5] Other research identifies inflammation as a key factor in affecting multiple organs and resulting in Long Covid symptoms.[6] Long COVID seems to affect five times more women than men. It is thought this is because women have different immune systems to mean.

One interesting health condition which has been linked to long Covid is postural orthostatic tachycardia syndrome (PoTS). This unusual condition is well known for causing dizziness and rapid drops in blood pressure when a person stands up, along with other symptoms such as feeling lightheaded, having palpitations and debilitating fatigue. PoTS is one of those obscure health conditions that can be controlled by diet and lifestyle choices, as you can see form the story of the founder of Deliciously Ella.[7]It is interesting to see the similarities in symptoms between long COVID and chronic fatigue syndrome.[8]

Another interesting health condition is loss of smell, or olfactory dysfunction, a common symptom of Covid-19.

What can we do?

First of all, there are many ways to reduce inflammation in the body with diet and lifestyle changes. We know that high levels of inflammation in the body have a direct effect on the immune system and respiratory illnesses such as Covid-19 have a very high inflammatory status. Research shows protein found in eggs, lean meat, fish, and dairy all contain essential amino acids that can exert an anti-inflammatory effect.[9] By consuming more of these foods, along with less highly processed carbohydrates, we can prevent mitochondrial overload and help reduce inflammation in the body.

A balanced diet, full of antioxidants can help to reduce inflammation. Antioxidants are mainly found in plant-based foods. I often suggest to my clients that the gold standard is to aim for 10-15 varieties of different vegetables per day, and 20-30 different polyphenols (plant-based foods) per week. I also share the BANT Wellbeing Guidelines with them. BANT Wellbeing Guidelines – BANT

Vitamin D has been shown to reduce inflammation and enable the immune system to activate defence cells which could destroy SARS-CoV-2. The best way to boost vitamin D is by getting safe solar sun exposure and eating enriched vitamin D foods such as liver and other offal. People with a limited ability to make vitamin D from sun exposure can take 2,000iu of vitamin D daily which is likely to be safe and may save many lives.

Antihistamines help to reduce MCAS. The best success I have seen with my long COVID clients is when they follow a Low Histamine Diet and take high doses of niacin (vitamin B3) which helps to stablise mast cells. Other nutrients such as vitamin C, quercetin, zinc and selenium are also helpful at regulating histamine. A general B-Complex helps the body clear histamine. Saccharomyces Boulardii can help relieve COVID induced diarrhoea.

Finally, if you are suffering from loss of smell, you might like to try ‘smell training’! According to the British Medical Journal, research has shown that sniffing the same four scents every day for several months helps recover your sense of smell. According to the smell loss charity Fifth Sense, Fifth Sense – The charity for people affected by smell and taste disorders. try to use scents from the four smell categories (flowery, fruity, spicy and resinous). You can try coffee, pepper, fresh herbs or fresh fruit that you already have at home!

Tips for coping with symptoms of Long Covid such as fatigue, breathlessness and joint pain:

Stay active – remember to keep your body moving but only do as much as you can manage. Think about what you enjoy doing such as walking in the countryside appreciating the beautiful flower and the sound of the birds!
Pace yourself and find a routine that works well for you. You will find you have more energy at different times in the day, so try to adjust your activity around that. Please be kind to yourself and remember than your healing journey is normally two steps forward, one step back.
Connect with friends and family for support. There are so wonderful support groups you can now join to link you with people going through a similar experience so you do not feel so alone.
The Chrysalis Effect and the Lightning Process are places you may get some additional psychological support
Supplements to consider for Long-COVID include an broad-spectrum antioxidant, vitamin D,[10] vitamin C,[11] niacin, zinc, quercetin, selenium and a B-Complex, the most important being niacin and quercetin. For further information on the exact quantities to take, please book in for a consultation with me.

Every blessing,

Emma

Emma Maitland-Carew – Registered Nutritional Therapist

Dip.ION, mBANT, CHNC Registered Practitioner,

Metabolic Balance® Coach, HeartMath Coach.

[1] Halpin S, O’Connor R, Sivan M. Long COVID and chronic COVID syndromes. Journal of Medicine and Virology. 2020 Oct 30: 10.1002/jmv.26587.

[2] Carfi A, Bernabei R, Landi F, ‘Persistent symptoms in patients after acute COVID-19.’JAMA. 2020; 324: 603-605.

[3] Dani M et al. Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies. Clinical Medicine. 2021 Jan;21 Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies (nih.gov)

[4] Afrin LB et al. ‘Covid 19 hyperinflammation and post Covid 19 illness may be rooted in mast cell activation syndrome. International Journal of Infectious Diseases. 2020 Nov; 100: 327 332. Published online 2020 Sep 10. Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome (nih.gov)

[5] Michael Marshall, (2020) ‘The lasting misery of coronavirus long-haulers’, Nature, https://www.nature.com/articles/d41586-020-02598-6

[6] Zabetakis I., Lordan R., Norton C., Tsoupras A. COVID-19: The inflammation link and the role of nutrition in potential mitigation. Nutrients. 2020:12:1466.

[7] You can read a summary of her story on her Instagram posts such as this one Deliciously Ella on Instagram: “There were lots of questions on my last post about my illness and what helped me so I thought I’d share more here. I was diagnosed with…”

[8] DoykovI et al. ‘The long tail of Covid-19’ -The detection of a prolonged inflammatory response after a SARS-CoV-2 infection in asymptomatic and mildly affected patients. F1000Res. 2020 Nov 19;9:1349. doi: 10.12688/f1000research.27287.2. eCollection2020.

[9] Carlson J.L., Erickson J.M., Lloyd B.B., Slavin J.L. Health effects and sources of prebiotic dietary fiber. Food Science and Nutrition. 2018:2.

[10] Abraham J et al. Can Optimum Solar Radiation Exposure or Supplemented Vitamin D Intake Reduce the Severity of COVID 19 Symptoms? International Journal of Environmental Research and Public Health. 2021 Jan; 18(2): 740. Published online 2021 Jan 16. A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency (nih.gov)

[11] Thomas S et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection. The COVID A to Z Randomized Clinical Trial. February 12, 2021. JAMA NetwOpen. 2021;4(2). Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial | Complementary and Alternative Medicine | JAMA Network Open | JAMA Network