Long COVID: Prevention and Treatment

This is an attempt at a summary of the document linked below because 52 pages. Functional medicine approach to COVID. Haven’t reviewed the evidence. Haven’t delved into the plausibility and evidence of the underlying biochemical theories. Grain of salt stuff.

But any approach to long COVID that attempts to work from the bottom up with simple lifestyle modifications that people can do themselves seems useful.

Would suggest erring on the side of following the simple advice and avoiding expensive and complicated supplement regimens.

Don’t just read the document, buy every expensive supplement from Amazon and take them all simultaneously expecting a cure.

COVID

  • COVID-19 attaches to ACE2 in cells.

  • ACE2 acts as a spike protein but also an enzyme.

  • ACE2 plays a role in tissue repair and immune regulation.

  • ACE2 deficiency linked to complications in COVID-19

  • ? Affects mitochondrial function

Long COVID

  • COVID is a disease of blood vessels, inflammation, and clotting

  • Long COVID can occur after COVID infection, or sometimes later after another viral infection

Web of Long COVID

Endothelitis

  • Inflammation of cells lining blood vessels called endothelium

  • Restricts blood flow

Microthrombosis

  • Capillaries

  • Worsening endothelitis

Mast cells activated

  • Sentinels where internal and external environments meet

  • Produce and secrete 200 mediators

  • Release histamine, chemokines, and cytokines

  • Change in blood vessel diameter, often makes them leaky to allow cells through

Monocytes

  • White blood cells, complex life cycle

  • Attack, repair, patrol

  • Can turn into macrophages, ongoing inflammation

  • ACE2 helps regulate this

Auto-antibodies

  • Produced under the direction of B-lymphocytes

T-cells

  • Coordinate immune response

  • Different types

  • T-effector memory cells keep latent infections at bay e.g. EBV

Viral Persistence

  • Persistence of COVID fragments

  • ? Persistence of actual virus for months ? e.g. in gut bacteria

Microbiome

  • Link with COVID and gut microbiome

  • Changes to gut bacteria identified after COVID

  • Loss of important SCAF like Butyrate which is known to help with regulating the immune system in the gut

Treatment of long COVID

Lifestyle

Sleep

  • Incredibly important

  • Sort it out, probably first priority

Water

  • Hydration is always important, more so in people with orthostatic intolerance along with adequate salt

Exercise

  • Essential for recovery

  • Go slow, build it up over time

  • Especially in those

    • Who are deconditioned

    • With autonomic dysfunction like POTS

    • With chronic fatigue

    • With post-exertional malaise and muscle aches

Nutrition

Diet

  • Plant-focused diets likely help

  • Herbs and Spices

    • Rosmarinic acid in Rosemary, Lemon Balm, Basil, Sage, Thyme, Oregano, and Spearmint

    • Curcumin - Tumeric

Supplements for improving ACE2

  • Vitamin D

  • Curcumin

  • Omega-3 Fatty acids

  • ? CBD

  • ? Resveratrol

  • ? Alpha lipoic acid

  • ? NAC

  • ? Oestrogen

  • ? Cortisol

Supplements for supporting mitochondria

  • CoQ10

  • B-Vitamins

  • L-Carnitine

More

The rest of the document gets a bit squirrelly. Read it if you wish.

To summarise the simple, cheap overlying principles without getting into weird, expensive supplements

  • Support your gut microbiome

    • Increase fibre

    • Vitamin D

    • Probiotics

    • Increase SCFA like Butyrate

    • Zinc

  • Thrombosis

    • Gingko

    • Natto beans

Appendix B

There is some useful info here for specific conditions

  • POTS

  • MCAS