Symptoms of Long COVID

Have you been feeling more fatigued lately? Have trouble catching your breath? Or have a persistent cough or headache? If so, you might actually be suffering from chronic COVID-19. As more research is released, we are learning the surprising facts around the condition.

Even if you had an asymptomatic infection, you might have long COVID. Even if you had a negative coronavirus antibody test, you might have chronic COVID. But especially if you had a severe COVID-19 infection, you very likely are still suffering from residual symptoms.

In this blog, we'll detail the symptoms of chronic COVID and how to treat them.

An overview of Chronic COVID:

Chronic COVID is defined as “persistent symptoms and/or delayed complications of SARS-CoV-2 infection beyond 4 weeks from the onset of symptoms.” Recent studies have suggested that 25-30% of those diagnosed with COVID-19 may develop persistent symptoms.

There is no concrete link yet determined between why certain people develop chronic COVID symptoms. Researchers from around the world have been trying to answer the question of how many people suffer from long-term symptoms after a coronavirus infection, and the answer is complicated for several reasons.

For one, many people who have symptoms of chronic COVID-19 do not visit a doctor to report their symptoms. As a result, the estimates on chronic COVID percentages are likely slightly off.

The high rate of asymptomatic infections also complicates things. One study found that of those diagnosed with chronic COVID, 32% had asymptomatic infections. For those with asymptomatic coronavirus who were unaware they had the illness, if they have symptoms of chronic COVID-19, they are likely not reporting them as such.

Antibody tests are also proving to be an unreliable indicator of coronavirus infection. Many survivors of COVID-19 report having no SARS-CoV-2 antibodies. Antibody tests have a notably low accuracy rate. If someone had an asymptomatic COVID-19 reaction and no antibodies to prove it, they again are unlikely to report symptoms of chronic COVID-19.

Despite these obstacles, numerous studies have suggested the probability of developing chronic COVID-19:

• In a survey on nonhospitalized COVID-19 patients, the CDC found that 35% of patients did not return to baseline health 2 to 3 weeks after the start of symptoms. This study also found the 20% of 18-34-year-olds suffered from prolonged symptoms.

• A Chinese study, based in Wuhan, found that 76% of hospitalized patients had symptoms of chronic COVID six months after initial symptoms. The researchers also found many patients had lung damage caused by the infection.

• A study in California found that of 1,407 people who had been diagnosed with COVID-19, 27% still had symptoms over 60 days after infection. These symptoms included shortness of breath, chest pain, cough, and abdominal pain.

• According to a study in Illinois that examed over 500 hospitalized COVID-19 patients, nearly 80% had persisting neurological symptoms. Examples of such symptoms include brain fog, headache, numbness, and dizziness.

• A Swedish study found that over 1 in 10 healthcare workers with mild symptoms in their initial coronavirus infection still had “at least one moderate to severe symptom 8 months later.” This study found the longest time from initial infection to chronic symptoms.

What are the symptoms of chronic COVID-19?

The symptoms of chronic COVID-19 vary based on the individual, making it difficult to diagnose. For most, long-haulers report symptoms similar to their initial COVID-19 infection- these include brain fog, difficulty breathing, headaches, depression, sleep difficulty, and fatigue. But others report new symptoms developed after they no longer had a coronavirus infection.

The symptoms of chronic COVID-19 embody everything from hair loss to rapid heart rate. A German study found that 60% of people with chronic COVID-19 had heart inflammation two to three months after infection. Many of these patients had not been hospitalized and the average age was only 49.

New research suggests that the symptoms of chronic COVID-19 are actually more widespread and diverse than previously imagined. In fact, researchers have linked at least 50 different symptoms with the condition. Some of the most common include:

• Fatigue

• Myalgia

• Cognitive impairment & headaches

• Pulmonary symptoms

• Shortness of breath

• Decreased exercise tolerance

• Anxiety

• Depression

• Sleep disturbance

• Hair loss

• Adrenal dysfunction

• Abdominal pain

• New-onset diabetes

• Hashimoto’s & other autoimmune diseases

• Joint pain

• Coughing

The symptoms of chronic COVID are so widespread because there are many different mechanisms at play. This is largely due to the destruction of the ACE2 protein by COVID-19. ACE2 is an enzyme that is vitally important for the health of your blood vessels, brain, lungs, kidneys, and bone marrow. ACE2 also inhibits inflammation, prevents abnormal blood clotting, and enables healing without scarring. The loss of ACE2 underlies all the terrible complications of COVID-19 and contributes to the persistent symptoms of COVID-19.

The COVID-19 virus required ACE2 to infect cells. Coronavirus cells will bind to ACE2 and destroy them to enter the cells. This will reduce the amount of ACE2 in the body. With a lessened amount of this vital protein, COVID-19 will be able to cause more damage and inflammation throughout the body.

Who develops long COVID-19?

Unfortunately, we are seeing more and more young adults becoming infected with COVID-19. As we all know, Omicron is currently the most dominant coronavirus strand in the U.S. And while this COVID-19 variant has been linked to less severe symptoms, this doesn’t mean that Omicron doesn’t put you at risk for catching chronic COVID-19.

However, while everyone is potentially at risk of catching chronic COVID-19, there are some demographics that seem to be more susceptible to developing long-term symptoms. This includes:

• Those aged 50+

• Women

• People with 5+ COVID-19 symptoms

• Individuals who were hospitalized for COVID-19

• People who are obese

• Those with asthma

How can you diagnose chronic COVID?

Unfortunately, chronic COVID-19 is very hard to diagnose. Long-haulers no longer have the SARS-CoV-2 virus in their body, making chronic COVID-19 undetectable by CHOVID-19 tests. On the bright side, without active infection, long-haulers cannot spread the virus. The most effective way of testing for chronic COVID-19 is through an organic acid test or an amino acid test. Both of these tests give insight into mitochondrial health and the presence of ACE2.

The mitochondria produce over 90% of the body’s energy. Mitochondria also contribute to homeostasis, cell proliferation, cell death, and the synthesis of lipids, amino acids, and nucleotides. Researchers have already proven COVID-19 “hijack” and manipulate mitochondria in the host cell in an effort to evade host immunity. Once within the mitochondria, COVID-19 will impair mitochondrial structures and cause the cells to degrade. A high viral load (as common with the B.1.1.7 variant), will result in more infected cells and more damaged mitochondria.

Damaged mitochondria will lead to symptoms such as muscle weakness, fatigue, exercise intolerance, respiratory and breathing problems, and migraines. These symptoms are all very similar to those of chronic COVID-19. Further, as described in our earlier blog, on chronic COVID-19 and the brain, many of the neurological symptoms of chronic COVID can be explained by mitochondrial damage. We also know that COVID-19 can infiltrate the brain and inhabit it longer than other regions in our body- which may be due to the immune system's access to the brain.

Organic acid tests and amino acid tests will show evidence of mitochondrial damage and a decline in ACE2 levels.

• Organic Acid test: This test uses urine to screen for different toxic chemicals and markers. High concentrations of various acids are associated with mitochondrial dysfunction. Mitochondrial energy production is examined in detail which can highlight which supplements will be the most effective. Also tested are detoxification pathways, nutrient levels of the B vitamins, neurotransmitters such as dopamine and serotonin, and gut microbial health. Many of these factors are also affected by a decline in ACE2 function.

• Amino Acid test: This test can use either urine or blood to measure levels of 36 amino acids and intermediary metabolites. Mitochondria rely on amino acids in order to generate energy in the form of ATP. An amino acid test will highlight deficiencies or abundances that point to mitochondrial damage.

What can I do if I have long COVID?

The best thing you can do in the face of mitochondrial damage is rest and supplement with proper nutrients to stimulate mitochondrial regeneration. But unfortunately, in our busy world, it can be difficult to do so. Improper rest and nutrient supplementation will only lead to symptoms worsening- as the remaining mitochondria and ACE2 are not equipped to provide energy for daily function.

The Johnson Center offers a multi-pronged approach to treating chronic COVID. However, before treatment, it is vital to discern mitochondrial health and the presence of ACE2. An organic acid test or amino acid test will be able to tell if your mitochondria have been damaged from a COVID-19 infection. Levels of ACE2 protein do not necessarily need to be tested due to the commonplace damage caused by COVID-19. However, signs of ACE2 damage can also be seen in an organic acid test or amino acid test.

After testing, the Johnson Center undergoes the following treatment steps:

• Increase ACE2 function

• Decrease persisting inflammation

• Improve mitochondrial function

• Stimulate neuroplasticity

• Enhance depleted neurotransmitters.

Chronic COVID is not something you have to suffer through for the rest of your life. The solution lies in increasing the number of mitochondria, enhancing mitochondrial function, and restoring the ACE2 protein. At the Johnson Center, we will do our best to increase energy, metabolism, and vitality to help you live the life you’ve always wanted.

To learn more about the Johnson's Center and Chronic COVID-19, click here to contact us! If you have any more questions about your path to optimal health, email our office at thejohnsoncenter@gmail.com or call 276-235-3205.

To learn more about who’s at risk for chronic COVID, click here.

To learn more about the neurological symptoms of chronic COVID, click here.

To learn more about an overview of chronic COVID, click here.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!