Long COVID/Post COVID has started to make an appearance as the cause of many unexplained symptoms, the most common being fatigue and brain fog, but also including breathlessness, cough, anxiety, and depression (3). At this time, 10-20% of COVID cases become long-COVID, but I wonder if that will change as we consider the health and status of herd immunity and the evolution of the virus.
Long COVID is a term ‘used to describe presence of various symptoms, even weeks or months after acquiring SARS-CoV-2 infection irrespective of the viral status’ (1). Long COVID is a common condition, with estimates identifying that between 10% and 20% of people initially diagnosed with acute COVID-19 will go on to develop symptoms of long COVID (2).
As a trained functional neurologist and seeing many patients with these long COVID symptoms, they seem to be based in dysautonomia. There is the potential for overactive immune activity, creating inflammation cascades, and respiratory (lung) health seems to be involved, but scientists have not decided exactly the cause. Clinically, I am certain the autonomic nervous system is involved and when we treat through hyperbaric oxygen therapy, patients improve, because hyperbaric Oxygen therapy(HBOT) treats all the involved potential mechanisms, dysautonomia, lung tissue, and inflammation, which is why it has been a primary treatment for Long COVID.
When HBOT is coupled with neuroplasticity treatments for dysautonomia (POTS, orthostatic intolerance, orthostatic hypotension, etc.), I noticed patients improve faster and more permanently. Functional Neurology applies neuroplasticity treatments and is able to repair disconnections and imbalances in the brain and body that interrupt communication between neurons. In combination with hyperbaric oxygen therapy, patients are completely recovering from symptoms associated with long COVID, which I would also include dizziness, digestive issues, sleep problems, orthostatic intolerance (dizzy when standing), increased heart rate (tachycardia), and slow mental processing to the list above. Brain fog and fatigue are the most common symptoms observed with long COVID, but they are also the most common I see in my office after concussions and other non-impact injuries to the brain (viral, post-surgical, etc.), which often impact the autonomic nervous system.
When we treat long-COVID with hyperbaric oxygen therapy, symptoms are typically resolving quickly and effectively.
(1) Raveendran A, Jayadevan R, Sashidharan S. Long COVID: an overview. Diabetes Metab Syndr 2021;15:869–75.
(2) Venkatesan P. NICE guideline on long COVID. Lancet Respir Med 2021;9:129.
(3) Mandal S, Barnett J, Brill SE, et al.. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax2021;76:396–8.
