Long COVID: A Neurological Perspective

 

The lingering effects of COVID-19, known as long COVID or post-acute sequelae of COVID-19 (PASC), have emerged as a complex and debilitating condition affecting millions worldwide. Research is now shedding light on its neurological dimensions and the ongoing efforts to tailor effective treatments.

 

The Human Impact of Long COVID

Many people’s lives have changed from feeling normal to dealing with long COVID. Around the world, people face the ongoing effects of the virus. They struggle with symptoms like tiredness, trouble thinking clearly, and nerve problems. In the U.S., about 15 million adults are still dealing with the lasting effects of a COVID-19 infection.

Long COVID as a Brain and Nerve Problem

Recent studies show that doctors are starting to see long COVID as a problem with the brain and nervous system. The most common and serious symptoms affect the brain and nerves. These can include feeling foggy in the head, trouble with thinking, and problems with the body’s automatic functions. These issues can cause problems like a fast heartbeat when standing up, called postural orthostatic tachycardia syndrome (POTS). Research on other viruses, like HIV, is helping scientists understand long COVID better.

Long COVID Symptoms Might Be Linked to Other Health Problems

Some of the symptoms of long COVID might actually be signs of another illness that happens after a viral infection (Post-Viral Disorder). Researchers are still learning more about how these conditions are connected.

There is another disease that proves quite similar in post-viral syndrome.  It is one that people with persistent COVID effects should consider looking at, is Mast Cell Activation Syndrome.  Many of the neurological symptoms are identical, but only a handful of studies have linked the two disorders thus far.  Consider finding an integrative health practitioner to help you get the testing you need.  They can help you to find out if MCAS is what you have.  MCAS is not limited purely to post-viral syndromes.  If you have had mold exposure, you may also want to be checked for MCAS in addition to running a mold test (mycotoxin test).  Many (if not most) functional medicine and integrative health professionals will run tests looking for mold, whereas conventional medicine providers almost never look for it.

What’s Happening in Long COVID?

Brain Inflammation, Not Just the Virus

People with long COVID often have brain-related symptoms, like trouble thinking or feeling tired all the time. Scientists believe this isn’t because the virus is still in the brain but because the immune system stays too active, causing inflammation. This happens around blood vessels in the brain, not from direct infection. Doctors are looking for ways to calm this inflammation, such as using special medicines that reduce immune system overactivity.

Could the Virus Stay in the Body?

Some studies show that tiny pieces of the virus might still be in parts of the body, like the brain, even after a person seems better. This raises the question of whether antiviral medicines could help. Also, in some people, the immune system starts attacking their own nerve cells, which is called an autoimmune response. Even after the virus is gone, the immune system keeps fighting, which may cause long-lasting symptoms.

Similarities to Chronic Fatigue Syndrome

Long COVID looks a lot like a condition called chronic fatigue syndrome (ME/CFS), where people feel extremely tired and have trouble thinking clearly. Scientists think both conditions might have the same causes, like problems with the immune system. Studying long COVID could help doctors understand chronic fatigue better and maybe even find new treatments for both conditions.

Potential Treatments for Long-Standing COVID Symptoms

Multidisciplinary Approaches and Ongoing Challenges

Comprehensive, multidisciplinary clinics, like the one at UCLA Health, are essential for treating long COVID patients. The team approach allows for tailored care, considering the diverse range of symptoms that patients present. Despite progress, challenges persist in understanding the varied manifestations of long COVID and setting realistic expectations for patients, whose lives have been dramatically altered by the condition.

The Role of Lymphatic Massage in Post-COVID Treatment

Research has shown that lymphatic massage can help people with lingering COVID symptoms such as chronic fatigue and brain fog improve.  When performed by a well-trained practitioner such as a lymphedema therapist, lymphatic massage helps to drain the cerebrospinal fluid from the brain (a process that happens in deep sleep), removing plaques, tangles, and other things such as debris left behind after a COVID infection that may be causing long-term inflammation.

The Road Ahead: Understanding and Treating Long COVID

Scientists have learned that getting vaccinated lowers the risk of developing long COVID, but it doesn’t completely prevent it. Some people still experience long-term symptoms even after being vaccinated. This means that while vaccines help, they aren’t a perfect shield against lingering effects of the virus.

Doctors and researchers are working hard to figure out why some people recover quickly from COVID-19 while others continue to struggle for months or even years. They are studying different possible causes, like whether small pieces of the virus stay hidden in the body, whether the immune system starts attacking healthy cells by mistake (autoimmunity), or how the nervous system might be affected. Understanding these factors could help create better treatments and support for people dealing with long COVID.

The journey to finding answers is not just about science—it also requires teamwork and care. Medical experts from different fields, such as neurology, immunology, and infectious diseases, need to work together to solve the puzzle of long COVID. More research is needed to develop effective treatments, and healthcare providers must continue listening to and supporting patients as they navigate these challenges.

While there is still much to learn, one thing is clear: helping people with long COVID requires patience, compassion, and dedication.With ongoing studies and collaboration, scientists hope to find better ways to prevent, treat, and manage long COVID, bringing relief to those who need it most. 

References

1. Meschino, Joseph. “The Role of Functional Medicine in Treating Long COVID.” PubMed Central, National Institutes of Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899130/.

2. Morris, Gary, et al. “Functional Medicine and Long COVID: A Comprehensive Review.” Nature Reviews Neurology, Nature Publishing Group, https://www.nature.com/articles/s41582-022-00625-w.

3. Cares, Hugo. “The Use of Integrative Medicine for Post-COVID Conditions: A Systematic Review.” National Institutes of Health, PubMed, https://pubmed.ncbi.nlm.nih.gov/34224379/.

4. Lee, Sun-Young, et al. “Exploring the Role of Autoimmunity in Long COVID: An Integrative Medicine Approach.” Examine.com, https://examine.com/nutrition/long-covid-autoimmunity/.

5. Shad, Mehrdad, et al. “The Role of Anti-inflammatory Strategies in Long COVID: A Functional Medicine Perspective.” Nature Medicine, Nature Publishing Group, https://www.nature.com/articles/s41591-021-01694-5.

6. Burch, Jason, et al. “Lymphatic Massage and its Role in Long COVID Recovery: A Functional Approach.” PubMed Central, National Institutes of Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362411/.

7. Bruch, Annette. “Chronic Fatigue Syndrome, Long COVID, and Functional Medicine: Finding the Connection.” PubMed Central, National Institutes of Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929176/.