Post-Acute COVID-19 Syndrome (PACS)
For some individuals, COVID symptoms continue even after there is no evidence of the SARS-CoV-2 viral infection. Persistent post-acute COVID-19 syndrome (PACS) involves continued psychiatric, cardiovascular, physical, and respiratory symptoms following a COVID-19 infection. People with these symptoms are often called "long-haulers." The most common symptoms are fatigue, cough, chest pain, shortness of breath, and joint pain.
Psychiatric symptoms may consist of depression, anxiety, post-traumatic symptoms, and poor memory. There is a high likelihood that inflammatory changes to the brain in individuals with PACS may contribute to suicidal thoughts and feelings, according to articles posted by the CDC and QJM. COVID-19 survivors, even without post-COVID syndrome, may also be at elevated suicide risk due to changes that occurred will ill with COVID-19. Post-COVID symptoms have shown to last three weeks to several months.
Physical symptoms like continued cough may be contributed by pulmonary fibrosis, a thickening or stiffening of the lung tissues in response to the SARS-CoV-2 virus. These changes in the lungs would contribute to cough, shortness of breath, and chest pain. A significant culprit to this inflammatory change is the mast cell that creates a cytokine storm of inflammation and fibrotic changes to the lungs. It is suggestive that initiating mast cell stabilizing substances may then decrease pulmonary fibrosis and thus post-COVID syndrome. But this doesn't give insight on how to proceed after the fibrosis has commenced.
If inflammatory changes are the main symptom of PACS, utilizing anti-inflammatory treatments may help improve recuperation time. Dietary intake of foods high in antioxidants would be the best place to start. Foods like fruits, berries, vegetables, nuts, seeds, and even dark chocolate, could reduce PACS symptoms. Many medicinal herbs could be utilized for these patients as well to promote healing. Using herbs to encourage improvements in your physical and mental health should be discussed with your naturopathic doctor prior to use.
PACS treatments should be comprehensive and utilize multiple medical disciplinarians. With widespread immunization on the horizon, I am confident that we will see the decline of COVID-19 cases. But in the meantime, practitioners should prepare themselves to support patients who continue to suffer physical and psychiatric symptoms following a COVID-19 infection.
Resources:
1. Dynamed
2. Sher L. Post-COVID syndrome and suicide risk. QJM. 2021 Jan 24:hcab007. doi: 10.1093/qjmed/hcab007. Epub ahead of print. PMID: 33486531; PMCID: PMC7928695.
3. Kazama I. Stabilizing mast cells by commonly used drugs: a novel therapeutic target to relieve post-COVID syndrome? Drug discoveries & therapeutics. 2020;14(5):259-261. doi:10.5582/ddt.2020.03095
4. Carlsen, M.H., Halvorsen, B.L., Holte, K. et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutr J 9, 3 (2010).
5. Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1
