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?
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.
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 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.
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. Previously, Dr. Patterson was the Medical Director of Diagnostic Virology at Stanford University Hospitals and Clinics. https://incelldx.com/who-we-are/