Long COVID, 10 million Americans of which are estimated to have three or more symptoms of Long-Haul COVID-19, is a complex chronic illness that is only now just beginning to be understood and properly defined. (1)
A November 2021 article in Global Advances in Health and Medicine suggested that Long COVID patients require an "integrative health approach, one that combines traditional medical management, non-pharmacological approaches, and behavior and lifestyle changes." (2)
For this reason, we believe that an integrative health practitioner, such as a naturopathic physician or doctor, is an essential member of your Long COVID healthcare team.
Where holistic medicine shines most is with complex chronic illnesses, such as fibromyalgia and tick-borne illness. (3)
This article will explore four ways that Long COVID remedies are already being provided by integrative healthcare professionals.
Depending on the source, Long COVID goes by several other names, such as post-acute COVID-19, chronic COVID-19, post-COVID syndrome, and Long-Haulers or Long-Haul COVID.
The first thing we need to do is to define what we mean when we say Long COVID.
Basically, Long COVID refers to patients with symptoms that develop during or after COVID-19 and continue for more than four weeks after SARS-CoV-2 infection. There also has to be a lack of another etiology, so it is a diagnosis of exclusion. (5)
When we refer to chronic disease, we usually mean that a condition has persisted for more than one year, but if a patient has had Long COVID for three months or more, then we can refer to it as chronic COVID-19. (6)
While no lab will diagnose Long COVID, some of the top symptoms include:
The CDC estimates that Long COVID-19 affects anywhere from 7.7 million to 23 million in the US. (8) Recently, a Harvard economist estimated that Long COVID could cost the US Economy $3.7 trillion in 2023. (9)
Chris Anderson wrote a great business book in 2008 called The Long Tail, and in it, he discussed how new niche markets are emerging every day. (10)
Clinically, and as evidenced by a recent Nature study that defines four subphenotypes of Long COVID, Long COVID appears to have its own long tail. (11) Because of this, it represents an important, largely undiagnosed, and untreated population, many of whom are suffering from vague or non-specific symptoms such as those mentioned above. (12)
As a naturopathic physician, the way I've been treating Long COVID varies from person to person. The truth is that COVID-19 and Long COVID can affect each individual differently.
A recent study demonstrates that Long COVID appears to have a neuroimmune and neuro-oxidative origin. (13) We have to support the body's healing mechanisms. We have to provide antioxidant support, help reduce nutrient deficiencies, and lower inflammation and toxicity.
I've been using:
However, each Long-Haul COVID health plan is individualized to the patient.
A recent cohort study relying on machine learning in Nature defines four subphenotypes of Long COVID-19, broadly matching the four types I see in clinical practice. (14)
The first type of Long-Haul COVID-19 patient is predominantly affected in their heart and kidneys, making up approximately a third of the over 34,000 patients surveyed in the recent study mentioned above.
Circulation is also significantly impacted in these patients, leading to or associated with conditions such as anemia, electrolyte imbalance, and even endocrine disorders.
This type is predominantly older (median age, 65 years old) and about half are male (48.53%).
These types were most hospitalized and most likely to use a mechanical ventilator.
Perhaps because of age, this population also has the most pre-existing conditions.
These types of patients are most likely to need natural therapies, such as:
The second type of patient suffering from Long-Haul COVID is mainly impacted in their respiratory system, as well as with sleep and mental health, particularly anxiety.
In the recent cohort study, this type comprised just less than a third of all patients (32.75% or 6,838).
Not only do sleep orders predominate in this population, but symptoms such as headache and chest pain are more likely.
The average age is 51 years old, and 62.8% are female.
A higher incidence of comorbidity for respiratory conditions, such as sleep apnea and COPD, preponderates in this population.
These types of patients are most likely to benefit from natural therapies, such as:
The third type of Long-Haul COVID patient is impacted in their musculoskeletal and nervous systems.
Approximately a quarter of the cohort (23.37%) made up this population in the referenced study.
These patients averaged 57 years of age, and 6 out of 10 were female.
Patients in this subphenotype are most likely to experience musculoskeletal pain and autoimmune disease, such as rheumatoid arthritis.
These patients are also more likely to be on pain medications, such as ibuprofen.
These types of patients are most likely to need anti-inflammatory support and pain management therapies, such as:
The fourth subphenotype of Long-Haul COVID-19 patient is most likely to have digestive complaints, making up about 10% of the overall population.
The average age is 54, and they are 61.64% female.
This type of patient has a much lower burden of underlying conditions but a higher incidence of digestive issues, such as GERD or gastritis.
These types of patients are likely to benefit significantly from:
There are no Long COVID remedies that work for everyone, as each Long COVID patient is affected more predominantly in different organ systems, and each timeline is unique.
Good holistic medicine employs therapeutic techniques, such as case taking and effective listening, to create an individualized health protocol that will help that individual resolve their chronic issues of Long-Haul COVID-19.
Naturopathic doctors or physicians are the most educated and sought-after integrative medicine practitioners throughout the world, and they are particularly specialized in the diagnosis and treatment of complex chronic illnesses, such as Long-Haul COVID-19. We strongly recommend that you consider adding one to your Long COVID healthcare team today. At the very least, seek an integrative medicine practitioner out for a consultation if you suspect that you might be struggling with symptoms or looking for Long COVID remedies.
What therapies or modalities have you found to be most effective in treating Long-Haul COVID? Please share your thoughts below.