I received this question from a lady
friend in England a few days ago. It reads:
Uncle Lim… whats ur opinion about
Long Covid symptoms
What are the complications and
symptoms?
Any cure?
-----------------------------
Thank you for your question, Shan.
I wish I know the answer.
It is not quite clear to me why only
a small percentage of people who were infected with Covid 19 experienced the aftereffects
of the infection? There are also cases of small population of people who never
got infected with Covid confirmed through PCR or other blood and saliva tests,
and yet came down with Long Covid-like signs and symptoms of the disease,
confirmed through lab investigations?
Others who have been infected with the virus but were asymptomatic. Then later experienced
long Covid? We scientists and clinicians
ourselves we cannot explain this phenomenon. This is not characteristics of any
disease that we know of, except perhaps from varicella-zoster virus in chickenpox
into herpes shingles that was presented differently years and years later.
Sometimes we call this as Long Covid as Post-COVID Conditions (PCC), long haul
Covid, post Covid syndrome that only emerged months after the Covid infection. Actually,
Long COVID can include a wide range of ongoing health problems, not necessarily
it must be the same as the signs and symptoms of Covid infection.
This gives me the impression that
they may already have other comorbidities that did not show up previously till
Covid-19 greatly weakened their immunity. As a result, their previous
asymptomatic Covid and other unrelated conditions such as a common cold, an underlying
chronic infection that did not show up earlier, now showed up after been
accentuated by this coronavirus.
In other words, the so called long
Covid has nothing directly to do with their already existing pathology. This
may explain why there were many people who never got Covid previously symptom
wise or found to be negative through throat swap or Covid virus load test in
their saliva, but strangely later seems to be infected with "Long Covid
symptoms".
In other words, they actually already
have an existing underlying morbidity that has nothing to do with the SARS-CoV-2
(Covid-19) virus, but their underlying hidden morbidities have now presented differently.
This is the only explanation I can at the moment offer as to why the signs and symptoms
of the so-called “Long Covid” were different from individual to individual?
In medicine our diagnosis is guided
by the signs and symptoms a patient was presented. In textbook knowledge each
disease has characteristics signs and symptoms, although in practice this is
not necessary so. A disease can be presented in many ways outside textbook
description, especially if only one or two signs or symptoms appears making
diagnosis uncertain clinically without lab support to confirm unless they are a
collection or group of signs and symptoms called ‘syndromes’ characteristics of
a specific disorder. But unfortunately, this is not the case with ‘Long Covid’
that differs even with a collection of signs and symptoms from individual-to-individual
This is what I gathered from reports I have read. This gives me a suspicion
that this so-called ‘Long Covid’ may have nothing to do with the Covid-19 per
sec.
It may be a manifestation of some previous
multiple underlying chronic condition now showing up in different ways because
their immunity has been compromised by this SARS-CoV-2 virus. that is my strong
suspicion. Furthermore, their varied conditions last for months and months in
different ways. Why should a specific disorder present itself in different ways
for months for different individuals? I have never come across such odd events
in my entire 65 years of knowledge in medicine as well as in medical research. It must be something else unrelated to Covid-19
infection?
This is my personal hypothesis. If I were to do my PhD in medicine once again, I
would forward this hypothesis to work on
it. This study may be very difficult to conduct because I would need large
populations with and without being infected with this coronavirus, plus
screening both populations with hidden (asymptomatic) diseases then comparing
matching populations with or without Long Covid cross-sectionally as well as
using cohort groups followed up longitudinally. This is going to be a very tough and challenging
piece of research and very time consuming as a PhD degree is limited to just 3 –
5 years to work on.
.
Long COVID occurs more often in people who had severe COVID-19 illness, but
anyone who has been infected with the virus that causes COVID-19 can experience
it. It was also claimed that only those who are not vaccinated against COVID-19
and become infected may have a higher risk of developing Long COVID compared to
people who have been vaccinated. Unfortunately, they have no evidence to back
this claim, not that I know of.
It was also claimed that people can
be reinfected with SARS-CoV-2 virus multiple times. Each time a person is
infected or reinfected with SARS-CoV-2, they have a risk of developing Long
COVID? Unfortunately, again such a claim has never been published in the
literature, not that I know.
While most people with Long COVID
have evidence of infection or COVID-19 illness, in some cases, a person with
Long COVID may not have tested positive for the virus or known they were
infected.
CDC and partners are working to understand more about who experiences Long
COVID and why, including whether groups disproportionately impacted by COVID-19
are at higher risk.
Whatever it is, or was claimed,
scientists are still uncertain if Long Covid has anything to do with this
pandemic outbreak?
As far as your question on any ‘cure’
for Long Covid, I have little knowledge. We do not even have a cure for
Covid-19 till today, let alone “Long Covid” whatever that is.
Perhaps you may try using immune modulators,
a class of drugs that help to activate, boost, or restore normal immune
function. Normally we use immune modulators after an HIV infection that has compromised
the immune system.
Scientists are not even sure whether
immune modulators can help change the immune system for the better. Some
examples of immune modulators or biological response modifiers are interferons,
interleukins, lenalidomide, pomalidomide, imiquimod, cytokines and even the banned
drug thalidomide that cause birth defects in the 1960’s
Other than these immunological modulators,
I may suggest, are moderately high doses of vitamin C, retinol (vitamin A) and
vitamin D together with echinacea, moringa, neem, turmeric, ashwagandha.
These are only suggestions, but they
need large scale RCT (Randomized Clinical Trials).
Lim ju boo
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