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October 27, 2021

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What is the long hauler?

Deaths associated with COVID-19 in the U.S. has surpassed the deaths from World War I, the Vietnam War, and the Korean War combined

By Karen L. Kier, Pharmacist
on behalf of the ONU HealthWise team

An eye opening statistic was recently reported by Harvard Health.

They reported that the number of deaths associated with COVID-19 in the United States has surpassed the deaths from World War I, the Vietnam War, and the Korean War combined.

This pandemic has had a tragic impact on illness, deaths and economies around the world. Many of the long-term consequences of COVID-19 may be felt for years to come.

Researchers are studying a phenomenon seen with some people after they recover from the acute COVID-19 illness where the infections seems to linger into a chronic form. These chronic symptoms have been called long COVID or long haulers. 

Chronic condition
The National Institutes of Health (NIH) has proposed a name for this chronic condition, which would be post-acute sequelae of SARS-CoV-2 infection or more easily abbreviated as PASC. 

This description would aptly fit the condition because post-acute would mean after the infection and sequelae is a medical term for consequences resulting from a disease. An article in the Journal of the American Medical Association (JAMA) estimated that 10-25% of COVID-19 patients may suffer from a chronic condition resulting from the infection.

The exact number is not known because we have not tracked this condition. Globally, researchers are starting studies and registries to get a better picture of PASC.

If these estimates are correct, then approximately 7 million people in the U.S. may be long haulers. These symptoms can occur weeks to months after recovery from the infection.

The most common symptoms reported by patients include tiredness (fatigue), shortness of breath, cough, joint pain, and chest pain. The fatigue has been challenging for many because they lack the energy they had prior to the COVID-19 infection.

Sleep disturbances is another common problem as well. Some people still experience smell and taste changes and this has resulted in weight loss associated with PASC. Some serious but less common side effects include heart and lung inflammation that can result in a rapid heart rate or change in heart rhythm. 

Hair loss has been attributed to the long haulers phenomenon, as well as skin rashes. Other symptoms have been related to changes in the brain including brain fog, headaches, mood changes, and depression.

Patients describe the brain fog as a difficulty in thinking, concentrating, and paying attention. A small percentage of these cases have resulted in memory changes and some researchers fear that long-term this could increase the rate of Alzheimer’s and Parkinson’s disease. Viruses have been known to cause some long-term brain issues.

People born between 1888 and 1924 during the 1918 influenza pandemic had a two-three times greater risk of developing Parkinson’s disease, which was believed to be related to exposure to the virus. 

Two theories
The underlying cause of PASC is not known but scientists have proposed two theories. One theory is that the virus or virus fragments still remain in the body even though the patient tests negative for the virus. 

Another proposed theory is that the virus causes the immune system to overreact and it stays in a vigilant state of attack.  Studies are being implemented to test these theories to determine what causes PASC. 

Since PASC symptoms seem to have a connection with chronic fatigue syndrome, the Chronic Fatigue and Immune Dysfunction Syndrome Association of America (solvecfs.org) has established a registry and a website for more information. 

Due to the lack of research, there are no specific treatments for PASC. Physicians and healthcare professionals are encouraging treatment of symptoms on an individual basis. 

Providers recommend good sleep patterns, eating a healthy diet, and exercise such as yoga. For those who have not recovered the sense of smell, the recommendation is to try nose physiotherapy. Four essential oils have been recommended to retrain the brain and the nose and they include rose, lemon, clove, and eucalyptus. 

Some medical facilities are starting post-COVID clinics to specifically treat people with PASC. The Cleveland Clinic in Ohio is one such facility. 

Resolution of symptons
Another interesting phenomenon that is now being reported is that some PASC patients have seen a resolution of their symptoms with the COVID-19 vaccine. 

These reports are showing up on social media and news reports.  Scientists suggest that this may not be a fluke but that the vaccine may help by either allowing the body to fight viral fragments or distract the immune system from attacking the body. 

As with all new information, the cause is unknown but the results may benefit some patients.  More studies need to be done to really understand PASC and the successful treatments. 

If you think you may have PASC, please contact your healthcare professional to get more information and treatment.  The ONU HealthWise team is here to help with any questions at 419-772-3784. 

Click here to visit the ONU HealthWise Pharmacy website.