Long COVID Treatment Explained: A Comprehensive Patient Guide

Summary

Dr. Michael Brode, Medical Director of the Post-COVID-19 program at UT Health Austin, outlines his approach to treating long COVID. He explains that there's no definitive test for long COVID and emphasizes a personalized diagnostic approach to rule out other conditions. Treatment focuses on four key steps: managing energy to avoid post-exertional malaise, intentional rehabilitation, symptom management with medications, and exploring experimental targeted therapies. Dr. Brode stresses the importance of individualized care and gradual recovery, highlighting that while many patients improve, full recovery may take time.

Takeaways

• 🩺 There is no definitive test for long COVID; diagnosis is based on symptoms and excluding other causes.
• ⚕️ Common symptoms of long COVID include chronic fatigue, neurological issues, shortness of breath, and palpitations.
• 🧪 Testing involves ensuring symptoms are not caused by other conditions like diabetes or thyroid problems.
• 📋 The checklist for testing varies based on age and pre-existing conditions; younger, healthier individuals have shorter checklists.
• 🕰️ Time is a crucial factor in healing from long COVID, with most recovery occurring within the first year to year and a half.
• 💊 Treatment involves managing energy, intentional rehabilitation, symptom management, and experimental therapies.
• 🪫 Managing energy is essential to avoid post-exertional malaise; pacing and planning activities can help maintain energy levels.
• 🏃‍♂️ Intentional rehabilitation, including physical therapy and cognitive therapy, helps improve symptoms by building on strengths and accommodating deficits.
• 🔬 Medications can help manage specific symptoms like fatigue, insomnia, migraines, and nerve pain, though they don't cure long COVID.
• 🧪 Experimental therapies for long COVID include antivirals, immunologic treatments, and methods to improve oxygen utilization, but these are not yet proven.

Q & A

Who is Dr. Michael Brode and what is his role?

Dr. Michael Brode is a general internist doctor and the Medical Director of the Post-COVID-19 program at UT Health Austin, part of Dell Medical School at the University of Texas.

What is the first question Dr. Brode usually gets about long COVID?

The first question Dr. Brode usually gets is about what tests should be done for long COVID.

Is there a specific test for diagnosing long COVID?

No, there is no specific test for diagnosing long COVID. Diagnosis is based on the pattern of symptoms that start after a COVID infection.

What is the importance of ruling out other conditions when diagnosing long COVID?

It is important to rule out other conditions such as diabetes or thyroid problems to ensure that the symptoms are not caused by something else.

What are some common symptoms of long COVID?

Common symptoms of long COVID include chronic fatigue, neurological issues, shortness of breath, and palpitations.

What is the general prognosis for patients with long COVID according to Dr. Brode?

Most patients with long COVID get better over time, with significant recovery usually occurring within the first year to year and a half.

What are the last symptoms of long COVID to go away according to Dr. Brode?

The last symptoms to go away are typically fatigue, brain fog, and post-exertional malaise.

What is Dr. Brode’s first step in treating long COVID?

The first step in treating long COVID is managing energy and avoiding hitting the wall of post-exertional malaise.

What does intentional rehabilitation involve?

Intentional rehabilitation involves building on strengths, accommodating deficits, and can include physical therapy, cognitive therapy, or mental health counseling.

What are some of the targeted therapies being researched for long COVID?

Targeted therapies being researched include treatments to eradicate viral fragments, reduce chronic inflammation, and improve blood flow and oxygen utilization.

Why does Dr. Brode recommend participating in clinical trials for experimental treatments?

Dr. Brode recommends participating in clinical trials to rigorously determine the efficacy of experimental treatments and contribute to the scientific understanding of long COVID.

What is Dr. Brode’s advice regarding the use of supplements for long COVID?

Dr. Brode advises trying one supplement at a time, monitoring its effects, and consulting with a doctor due to the lack of regulation and varying evidence supporting their efficacy.

How does Dr. Brode suggest patients manage their energy to avoid post-exertional malaise?

Dr. Brode suggests patients manage their energy by prioritizing activities, pacing themselves, planning ahead, taking breaks, and being mindful of how they spend their energy.

What role do mental health and cognitive therapies play in the treatment of long COVID?

Mental health and cognitive therapies help manage anxiety, stress, and cognitive deficits, which can be passive drains on energy and impede recovery.

What are some evidence-based treatments Dr. Brode mentions for managing specific symptoms of long COVID?

Evidence-based treatments for managing symptoms include medications for fatigue, insomnia, migraines, nerve pain, and treatments like acupuncture for chronic pain.