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Show 1273: Finding Ways to Manage Long COVID

Some people who were infected with SARS-CoV-2 continue to suffer symptoms for months afterwards. How can they manage long COVID?
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Finding Ways to Manage Long COVID

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When the COVID pandemic began, doctors thought that patients either recovered fairly quickly or they died. Before long, though, some patients identified themselves as “long haulers” because they were suffering debilitating symptoms for months after their diagnoses, neither dying nor recovering. There are people who become short of breath just walking up a few steps, while others experience dizziness, fatigue, insomnia or brain fog that makes it difficult or impossible to concentrate. What can they do to manage long COVID symptoms? The first step is to recognize that long COVID is real, not psychosomatic.

How to Manage Long COVID:

Dr. Kristin Englund is an infectious disease specialist who runs the reCOVer clinic for people with long COVID at the Cleveland Clinic. To manage long COVID symptoms, her health care providers do a thorough evaluation of each patient’s symptoms. As a result, they are able to connect the patient with the most appropriate specialists throughout the Cleveland Clinic.

Addressing the Cause Could Help Manage Long COVID Symptoms:

Some scientists are trying to figure out why some individuals develop long COVID while others recover promptly from the infection. One research group has found differences in certain white blood cells in people with lingering symptoms. These monocytes carry some of the virus protein (not its RNA) and attach themselves to the walls of blood vessels. The immune system reacts to these protein fragments as if it were fighting off the virus itself. Consequently, the body responds as if it were infected, with symptoms such as fatigue, brain fog, difficulty breathing, loss of the sense of smell and so on.

While this research is preliminary, it offers an intriguing hypothesis about how to manage long COVID. The investigators have tried an anti-HIV drug, maraviroc, in combination with a statin, pravastatin. The maraviroc (Selzentry) affects the monocytes, at least in theory, while the statin calms the inflammation of the blood vessels. If further research supports this approach, it could be a big step forward in the search to manage long COVID symptoms better. Dr. Patterson suggests it may even help people with quite different problems, such as chronic Lyme disease. Presumably monocytes are misbehaving in similar ways in such conditions.

This Week’s Guests:

Kristin Englund, MD, an infectious disease specialist, leads the Cleveland Clinic’s reCOVer clinic for long COVID patients with lingering symptoms. Dr. Englund is board certified in internal medicine with a subspecialty certification in infectious diseases by the American Board of Internal Medicine. She supplied the photograph.

Bruce K. Patterson, MD, is the CEO & Founder of IncellDx, Inc., a single cell diagnostic company committed to advancing Precision Medicine by offering transformative diagnostic and prognostic clinical patient information based on an innovative technology platform that enables simultaneous cell classification and single cell analysis of proteomic and genomic biomarkers. This research offers clues to medications that can be used to manage long COVID. Previously, Dr. Patterson was the Medical Director of Diagnostic Virology at Stanford University Hospitals and Clinics. https://incelldx.com/who-we-are/

You can read Dr. Patterson’s research papers here, here and here. The link he offered our listeners is here: https://covidlonghaulers.com

Listen to the Podcast:

The podcast of this program will be available Monday, Sept. 27, 2021, after broadcast on September 25. You can stream the show from this site and download the podcast for free.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Agresti N et al, "Disruption of CCR5 signaling to treat COVID-19-associated cytokine storm: Case series of four critically ill patients treated with leronlimab." Journal of Translational Autoimmunity, Jan. 6, 2021. DOI: 10.1016/j.jtauto.2021.100083
  • Patterson BK et al, "Disruption of the CCL5/RANTES-CCR5 pathway restores immune homeostasis and reduces plasma viral load in critical COVID-19." MedRxiv, May 5, 2020. DOI: 10.1101/2020.05.02.20084673
  • Patterson BK et al, "Immune-Based Prediction of COVID-19 Severity and Chronicity Decoded Using Machine Learning." Frontiers in Immunology, June 28, 2021. DOI: 10.3389/fimmu.2021.700782
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