Long COVID


What is long COVID and could you have it?

You may have or have had long COVID and not even been aware of it so it’s good to know the signs to manage recovery from it. Equally if a friend or family member has long COVID, there are some simple steps they can take to speed their recovery.

The technical name for long COVID is ‘Post Viral Fatigue’ and as the name suggests, mental and/or physical fatigue is one of the biggest tell-tale signs of it.

Is there a known reason why post-viral fatigue occurs?

Post Viral Fatigue can occur for several reasons. These include previous viral load, previous environmental exposure, genetic predisposition (such as having the APOE4 gene variant) as well as behavioural tendencies. Past exposure to viral infections may make individuals vulnerable to a heightened probability of long COVID, prior to COVID-19 exposure.

Former exposure to environmental stressors, such as mould or heavy metals, may also diminish the body’s post-infection resilience. Clinically, Post Viral Fatigue often occurs in high-achieving, multi-tasking, ‘adrenal-type’ individuals, who may have carried a burden of low-level chronic stress for an extended period, thus putting extra demands on their immune system.

This could be any body type but these characteristics are particularly strong amoung Red-Blue and Blue-Red body types and Blue body types generally.

What are the symptoms of Post Viral Fatigue?

The symptoms of Post Viral Fatigue are varied and include persistent fatigue, diffuse myalgia, depressive symptoms, and non-restorative sleep.

In the case of long COVID specifically, persistent breathlessness, issues with memory-recall and a lingering loss of taste and smell can occur. Some people have also reported altered bowel habits, stomach pains and cramps and recurring brain fog.

THE TECHNICAL NAME FOR LONG COVID IS ‘POST VIRAL FATIGUE’

What are the best foods for chronic fatigue?

Well, there are a number of natural foods that will help to build your energy and stamina back up.

Whilst a nutritional therapist can provide very tailored nutritional interventions, you can and should start with a nutrient-dense diet, built around anti-inflammatory and antioxidant principles.

Following an antioxidant-rich diet such as the Mediterranean diet, which is rich in oily fish, olive oil, a variety of vegetables and pulses, can be a great initial step to reduce neurological and systemic inflammation post infection.

Processed convenience foods can be pro-inflammatory so it is often best to keep to simple, unprocessed meals which will not exacerbate any post-viral inflammation. Including a diverse range of colourful antioxidant-rich vegetables is optimal for recovery.

Cruciferous vegetables, such as broccoli and cauliflower, can help to produce the master antioxidant glutathione, so are a useful vegetable subset to include a serving of daily. Blue body types should steam these vegetables well and add spices to help their weaker digestive systems.

A blood sugar imbalance is often a contributing issue in regulating energy in chronic fatigue and research indicates that furin, (the enzyme which allows COVID-19 to enter into the cells) is associated with hypertension (and obesity) (1). Therefore, regulating any blood sugar instability also serves to reduce furin levels and may minimise post-viral fatigue in long COVID.

I recommend that complete protein sources (pulses and grains, lean meats, oily fish, nuts and seeds) are included in every meal and lower sugar fruits such as berries are prioritised over higher sugar alternatives.

B vitamin and magnesium-rich foods, (such as dark green leafy vegetables, wholegrains, eggs, lean red meats, nuts and seeds) can help with energy production. Mushrooms, (containing beta-glucans), and bone broths can support the innate and adaptive immune response.

To support gut permeability issues, I often recommend a (temporary) gluten-free diet and offer support to the gut microbiota (which is typically imbalanced in chronic fatigue scenarios), through prebiotic and probiotic-rich foods, such as kefir, sauerkraut, live yoghurt, miso and kimchi where suitable.

B VITAMIN AND MAGNESIUM-RICH FOODS CAN HELP WITH ENERGY PRODUCTION

Which supplements may be beneficial for long COVID?

The following supplements may be beneficial for long COVID symptoms, but they be should be taken under expert supervision and not used as self-medication:

Vitamin D:
An essential vitamin to support our immunity and a natural inflammatory which many of us are deficient in during the Winter months with reduced sun exposure.

Quercetin:
Contains a rich supply of polyphenols, which have anti-viral properties and are helpful in reducing oxidative stress and inflammation of the respiratory tract.

Omega 3 (fish oil):
A natural anti-inflammatory and essential fatty acid which supports in reducing lung tissue inflammation.

Curcumin:
Found within the anti-inflammatory spice, turmeric, which helps to reduce inflammatory cytokines post infection.

Vitamin C:
With anti-inflammatory and antioxidant effects, this vitamin is well-researched for its protective role against pneumonia in clinical trials (at 2000mg daily dosage) (2).

Green Tea Extract:
Green tea extract contains a catechin, Epigallocatechin-3-Gallate, ECCG, which has known anti-inflammatory, antimicrobial and immunomodulating effects in autoimmune conditions. It is proposed to improve blood-clotting impairment associated with sepsis and lung fibrosis. (3)

Zinc:
Contains anti-viral and antioxidant properties. Adequate zinc levels are important for returning to pre-infectious levels of taste and smell post COVID-19 (as deficiency is often associated with loss of taste and smell). Supplementing with zinc can also be helpful in clearing up diarrhoea.

Berberine:
Popular in Chinese medicine for its antimicrobial, anti-motility and anti-secretory properties, Berberine has been shown in clinical studies to clear up diarrhoea post COVID-19 and support the intestinal mucosal barrier. (4)

A sense of continued anxiety can often exist post Covid-19 and in response to the ongoing pandemic. If you’re suffering from this, then vagal nerve stimulation (e.g., Sensate) can be very useful at restoring calm or using a heart rate tracker for improving heart rate variability (e.g., HeartMath).

I often recommend yogic breathing exercises to stimulate calming parasympathetic nervous system activity. Deep, slow breathing practices are also excellent for restoring respiratory ventilation capacity, which may be diminished post COVID-19 infection.

As you start to feel physically stronger, you can start incremental, restorative movement daily (walking or simple yoga stretches), are good for lymphatic drainage. Prioritising good sleep hygiene habits may help general rest and recovery, by encouraging a minimum of 8 hours of optimal sleep each night.

How long before you start feeling better from Long Covid?

Typically, I have seen it can take up to 12 weeks post COVID-19 to regain your sense of taste and smell fully. Recovery length is very much connected to the individual’s health and physiological biomarkers at the time of infection and so can vary greatly.

A full recovery is possible so if you are struggling to recover a nutritional therapist may be of help.

References:

1. Chee Y, Tan S, Yeoh E, Chee Y, Tan S and Yeoh E (2020) Dissecting the interaction between COVID‐19 and diabetes mellitus, Journal of Diabetes Investigation. 11(5) pp. 1104-1114.
2. Holford P, Carr A, Jovic T , Ali S , Whitaker I , Marik P and Smith D (7th December, 2020) Review: Vitamin C – an Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19 Nutrients. 12(12): 3760
3. Menegazzi, M, Campagnari, R, Bertoldi, M, Crupi, R, Di Paola, R and Cuzzocrea, S, (July, 2020). Protective Effect of Epigallocatechin-3-Gallate (EGCG) in Diseases with Uncontrolled Immune Activation: Could Such a Scenario Be Helpful to Counteract COVID-19? International Journal of Molecular Science. 21(14): 5171
4. Zhang, B. et al. (2020) Berberine reduces circulating inflammatory mediators in patients with severe COVID-19, British Journal of Surgery. 108(1), pp. e9-e11.