Tag: long covid case study

Long-COVID: A Chronic Fatigue Condition: Case Report

Abstract:

For the growing number of patients suffering from post-COVID-19 syndrome, there is little definitive guidance for treatment protocols or prognosis. Neurologic manifestations following acute COVID-19 infection are continually surfacing in the literature, with fatigue being the most common persistent symptom.

This case study follows a 44-year-old female experiencing debilitating fatigue and neurologic symptoms persisting after the resolution of an acute SARS-COV-2 infection. The complex medical history of this patient, including past Epstein-Barr Virus (EBV) infection and Myalgic Encephalomyelitis, commonly known as Chronic Fatigue Syndrome, suggests a potential predisposition for the development of neurologic long-COVID.

Through investigation of current research and treatment responses, this case report aims to gain an understanding of the complicated nature of this illness, and to propose treatments that address this specific subset of post-acute SARS-COV-2 sequelae.

Source: Lavelle , M., & Brusewitz , N. D. J. (2023). Long-COVID: A Chronic Fatigue Condition: Case Report. Journal of Complementary and Alternative Medical Research, 22(3), 1–7. https://doi.org/10.9734/jocamr/2023/v22i3457 http://stmlibrary.uk/id/eprint/2217/1/Lavelle2232023JOCAMR100443.pdf (Full text)

Long COVID is primarily a Spike protein Induced Thrombotic Vasculitis

Abstract:

Long COVID describes an array of often debilitating symptoms in the aftermath of SARS-CoV-2 infection, with similar symptomatology affecting some people post-vaccination. With an estimated > 200 million Long COVID patients worldwide and cases still rising, the effects on quality of life and the economy are significant, thus warranting urgent attention to understand the pathophysiology. Herein we describe our perspective that Long COVID is a continuation of acute COVID-19 pathology, whereby coagulopathy is the main driver of disease and can cause or exacerbate other pathologies common in Long COVID, such as mast cell activation syndrome and dysautonomia.
Considering the SARS-CoV-2 spike protein can independently induce fibrinaloid microclots, platelet activation, and endotheliitis, we predict that persistent spike protein will be a key mechanism driving the continued coagulopathy in Long COVID. We discuss several treatment targets to address the coagulopathy, and predict that (particularly early) treatment with combination anticoagulant and antiplatelet drugs will bring significant relief to many patients, supported by a case study. To help focus attention on such treatment targets, we propose Long COVID should be referred to as Spike protein Induced Thrombotic Vasculitis (SITV). These ideas require urgent testing, especially as the world tries to co-exist with COVID-19.

Source: Kerr R, Carroll HA. Long COVID is primarily a Spike protein Induced Thrombotic Vasculitis. Research Square; 2023. DOI: 10.21203/rs.3.rs-2939263/v1. https://assets.researchsquare.com/files/rs-2939263/v1_covered_7190a867-1475-4b57-b220-716a953649f1.pdf?c=1684433225 (Full text)

Corona With Lyme: A Long COVID Case Study

Abstract:

The longevity of the coronavirus disease 2019 (COVID-19) pandemic has necessitated continued discussion about the long-term impacts of SARS-CoV-2 infection. Many who develop an acute COVID-19 infection will later face a constellation of enduring symptoms of varying severity, otherwise known as long COVID. As the pandemic reaches its inevitable endemicity, the long COVID patient population will undoubtedly grow and require improved recognition and management. The case presented describes the three-year arc of a previously healthy 26-year-old female medical student from initial infection and induction of long COVID symptomology to near-total remission of the disease. In doing so, the course of this unique post-viral illness and the trials and errors of myriad treatment options will be chronologized, thereby contributing to the continued demand for understanding this mystifying disease.

Source: Thor DC, Suarez S. Corona With Lyme: A Long COVID Case Study. Cureus. 2023 Mar 24;15(3):e36624. doi: 10.7759/cureus.36624. PMID: 37155451; PMCID: PMC10122830. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122830/ (Full text)

Case Study: COVID-19 Brain Fog or Auditory Processing Disorder?

A wide array of symptoms have been directly associated with COVID-19 following recovery, but they can also occur several weeks or months after the diagnosis. These include, but are not limited to, damage to the respiratory tract as well as decreased cognition and other brain functions. The nonmedical term used to describe these post-COVID-19 problems is “brain fog.”

The symptoms of brain fog are similar to mild cognitive impairment or, of interest to audiologists, an auditory processing disorder (APD). 2 COVID-19 has neurological consequences and affects specific areas of the brain, such as the cingulate cortex (i.e. emotions, memory, depression, and decision of action). 3 Brain fog is also associated with several symptoms related to hearing and communication, which can affect the accomplishment of routine daily tasks. Many of those can be mistaken for or coexist with APD symptoms. These include “difficulty attending or staying focused, difficulty concentrating, difficulty understanding or remembering instructions, language problems, short-term memory problems,” to mention a few. 2 However, what might appear as a brain fog case could be an undiagnosed or even a pre-existing APD issue. 2 Symptoms could include struggling to keep track of conversations, forgetfulness and memory issues, problems following directions, and several cognitive difficulties. 2

This report presents the case of a 31-year-old medical doctor who was diagnosed with COVID-19 in December 2020, and later identified with APD symptoms that are now commonly seen in post-COVID-19 brain fog patients. Auditory training following the Buffalo Model 4 resolved the patient’s chief complaints following 12 treatment sessions. This issue is one of many that could shed light on the great potential auditory training has in resolving brain fog complaints that overlap with what is commonly seen in APD patients, highlighting the concerns regarding COVID-19’s direct effects on auditory processing.

Source: Alexander, Angela Loucks AuD, MNZAS, CCC-A; DiSogra, Robert M. AuD; Abbas, Fatima BS; Braund, Stacey AuD, CCC-A; Spokes, Chelsea BSpHLSc, MClinAud. Case Study: COVID-19 Brain Fog or Auditory Processing Disorder?. The Hearing Journal 76(04):p 18,19,20,22,23,24, April 2023. | DOI: 10.1097/01.HJ.0000927332.17564.4e https://journals.lww.com/thehearingjournal/Fulltext/2023/04000/Case_Study__COVID_19_Brain_Fog_or_Auditory.2.aspx (Full text)

A Case Study of Successful Application of the Principles of ME/CFS Care to an Individual with Long COVID

Abstract:

Persistent fatigue is one of the most common symptoms of post-COVID conditions, also termed long COVID. At the extreme end of the severity spectrum, some individuals with long COVID also meet the criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), raising the possibility that symptom management approaches for ME/CFS may benefit some long COVID patients.

We describe the long-term outcomes of a 19-year-old male who developed profound impairment consistent with ME/CFS after a SARS-CoV-2 infection early in the pandemic.

We evaluated and treated him using our clinic’s approach to ME/CFS. This included a history and physical examination that ascertained joint hypermobility, pathological reflexes, physical therapy maneuvers to look for a range of motion restrictions in the limbs and spine, orthostatic testing, and screening laboratory studies.

He was found to have profound postural tachycardia syndrome, several ranges of motion restrictions, and mast cell activation syndrome. He was treated according to our clinic’s guidelines for managing ME/CFS, which included manual physical therapy maneuvers and both non-pharmacologic measures and medications directed at postural tachycardia syndrome and mast cell activation.

He experienced significant improvement in his symptoms over 30 months. His case emphasizes how the application of the principles of treating ME/CFS has the potential to provide a direction for treating long COVID.

Source: Petracek LS, Broussard CA, Swope RL, Rowe PC. A Case Study of Successful Application of the Principles of ME/CFS Care to an Individual with Long COVID. Healthcare. 2023; 11(6):865. https://doi.org/10.3390/healthcare11060865 (Full text)

Stellate Ganglion Block for Long COVID Symptom Management: A Case Report

Abstract:

Stellate ganglion block (SGB) is gaining increasing acceptance as a treatment modality for various medical conditions. It works by blocking neuronal transmissions which in turn alleviates sympathetically-driven disease processes. Many of the prolonged sequelae of long COVID are thought to be mediated by dysregulation of the autonomic nervous system, and SGB is being investigated as a potential option for symptomatic management of long COVID. This case report demonstrates the efficacy of SGB in a previously healthy patient for the management of long COVID symptoms including fatigue, post-exertional malaise, shortness of breath, and gastrointestinal symptoms.

Source: Khan M H, Kirkpatrick K P, Deng Y, et al. (December 07, 2022) Stellate Ganglion Block for Long COVID Symptom Management: A Case Report. Cureus 14(12): e32295. doi:10.7759/cureus.32295 https://www.cureus.com/articles/127985-stellate-ganglion-block-for-long-covid-symptom-management-a-case-report (Full text)

Post-COVID-19 Syndrome: A Novel Diagnosis

Abstract:

Patients with post-COVID-19 syndrome have reported a wide array of symptoms that include autonomic dysfunction. It is hypothesized that this may be secondary to interruption of baroreflex pathways in the carotid arteries or nucleus tractus solitarius, however, confirming studies have yet to be performed. A limited number of studies have highlighted the presence of an exaggerated baroreflex response in patients with a post-COVID-19 syndrome that mirror other chronic autonomic dysfunction-related conditions.

Source: Kalia R, Kalia R, Musih J, Cubelo M, Popat J. Post-COVID-19 Syndrome: A Novel Diagnosis. Cureus. 2022 Aug 22;14(8):e28266. doi: 10.7759/cureus.28266. PMID: 36158335; PMCID: PMC9491485. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491485/ (Full text)

Cognitive Complications of COVID-19 Infection

Abstract:

SARS-CoV-2 is associated with a post-infectious neurocognitive syndrome characterized by fatigue and deficits in attention, memory, and executive function. As screening cognitive testing generally remains normal, the pathophysiologic basis of these symptoms remains controversial and there is no standardized treatment paradigm.

We present a clinical case demonstrative of typical neurocognitive sequelae of SARS-CoV-2 infection, highlighting medical and social factors that may have contributed to the severity of symptoms. We discuss the pathophysiologic evidence for cognitive “brain fog” following COVID-19 infection as well as lifestyle changes and rehabilitation strategies that may improve recovery. As the benefits of pharmacologic therapy remain unproven, we close with a brief discussion of medication options that might be appropriate targets for future clinical trials in the context of rehabilitative treatment.

Source: Warren S, Drake J, Wu CK. Cognitive Complications of COVID-19 Infection. R I Med J (2013). 2022 Sep 1;105(7):27-30. PMID: 35930487. https://pubmed.ncbi.nlm.nih.gov/35930487/ http://rimed.org/rimedicaljournal/2022/09/2022-09-27-covid-warren.pdf  (Full text available as PDF file)

Improvement in Long-COVID Symptoms Using Acupuncture: A Case Study

Abstract:

Background: The long-COVID syndrome (LCS), defined by residual symptoms from acute COVID-19 for <60 days, affects about one-third of all COVID survivors and is an emerging public health challenge. Empirical data about the range of symptoms or the utility of acupuncture alone for the LCS are very limited.

Case: This observational case study of a 46-year-old male with LCS was conducted to preliminarily define the range of symptoms, a Traditional Chinese Medicine (TCM) diagnostic structure, and evaluate the potential utility of prescribed acupuncture for LCS.

Results: The primary TCM diagnostic patterns from this patient’s LCS presentation included Lung Qi and Yin Deficiency, Qi and Blood Stagnation, and Spleen Qi Deficiency with dampness. Acupuncture for this patient was associated with reduced symptoms and signs of LCS.

Conclusion: A preliminary TCM diagnostic structure for LCS was defined. Acupuncture appears to have been helpful for a patient with LCS. Further research is needed to demonstrate the efficacy of acupuncture and/or other TCM modalities for LCS.

Source: Hollifield M, Cocozza K, Calloway T, Lai J, Caicedo B, Carrick K, Alpert R, Hsiao AF. Improvement in Long-COVID Symptoms Using Acupuncture: A Case Study. Med Acupunct. 2022 Jun 1;34(3):172-176. doi: 10.1089/acu.2021.0088. Epub 2022 Jun 16. PMID: 35832108; PMCID: PMC9248334. https://www.liebertpub.com/doi/10.1089/acu.2021.0088 (Full text)