I've been dealing with a few long COVID patients so have been doing some reading and listening to various trials that are still underway in the USA. Feel free to share any additional information you find as this is a new problem and the traditional approach is to treat the various symptoms and not really fix the underlying vascular inflammatory process that appears to be behind it all.

Dr Patterson is using a combination of a statin, anit-retroviral, acyclovir, and even gout medication to stop the inflammatory cascade. He also has a nice panel of inflammatory markers to help guide treatment.



This virtual rounds is a great discussion of the micro-clotting theory and treatment. They are using a combination of aspirin + Plavix +Eliquis to stop the small blood clots that seem to happen in long COVID patients. More dangerous drugs but exciting early results.

https://react19.org/virtual-rounds-session-7-microclots-anticoag/?fbclid=IwAR1dl4f_nAlzdE5c3ab0qoOxLrTOnmxcBUiUMzBYoAv0Jwn9osc7gOOycms&mibextid=Zxz2cZ


I encourage my fellow physicians to watch and listen. These are not some crockpot docs doing crazy stuff. There is growing evidence that we are not treating Long Covid appropriately.

All of my long Covid cases have been due to either reduced lung function from scarring or persistent/recurrent heart inflammation. I suspect the heart inflammation is autoimmune as it seems to get worse when they are exposed to Covid again. Treating either one with steroids as needed and the lung damage cases get pulmonary rehab.

Honestly, I haven't seen any of the other types of long Covid. But I'm pretty no nonsense about generalized malaise, fatigue and weakness. If you're not eating healthy, exercising daily and getting adequate sleep then I'm not working up your non-specific funk until you do those things for at least 2 weeks. I've seen a lot of post COVID patients and nothing so far that looks like a micro-emboli cascade or persistent inflammatory cascade. At least no more systemic inflammation than your average unhealthy American

KidDoc:
Have you treated anyone with severe leg muscle pain that migrates from one muscle group to another? Two weeks after having Covid, I developed moderate pain in my hip and buttocks area (not the joint) and it has gotten worse over the past few months, moving to deep hamstriing to quads and then peroneal group. I can do stretches for one area which relieves that particular muscle group but the pain then moves to another area within an hour. It won't respond to ibuprofen or Aleve. My doctor and pharmacist are stumped. I have taken electrolytes and gotten on a multivitamin in case I was short a particular vitamin or mineral but it hasn't helped.
Just wondering.

Not as an isolated symptom but as part of the chronic inflammation syndrome that has been one of the symptoms.

Thanks. Could it cause a constant lactic acid buildup?

oklaunion said:

---

Thanks. Could it cause a constant lactic acid buildup?

---

Absolutely

This happened to me as well. Diagnosed in December 2020. The pain was so severe it was hard to sleep. My doctor sent me to have ultrasounds done to check for blood clots. Luckily I didn't have any. It took me many months to recover. I started taking magnesium in the morning and evening. I bought large ice packs and rotated throughout the day. It seemed to help. Every evening I went to bed with ice. Sorry you are going through this.

This is an interesting article regarding the recognition of such a malady. No verified treatment suggestions yet since it is so new. It does include a mention of symptoms when there have been no pre-existing conditions.

Long COVID, FibroCOVID, and Musculoskeletal Pain: Why Pre-Existing Conditions Matter (practicalpainmanagement.com)

oklaunion said:

---

This is an interesting article regarding the recognition of such a malady. No verified treatment suggestions yet since it is so new. It does include a mention of symptoms when there have been no pre-existing conditions.

Long COVID, FibroCOVID, and Musculoskeletal Pain: Why Pre-Existing Conditions Matter (practicalpainmanagement.com)

---

Good article but I disagree with it. If you test the right things, not just a basic ESR or CRP, you can find significant abnormalities in the immune system on these patients. This article is treating symptoms not the baseline cause of the disease.

I'm talking stuff like IL-2,4,6,8,10 GM-CSF SCD40L CCL3 TNF Alpha INF gamma VEGF

Detailed immunology labs not just a sed rate.

KidDoc:
I am too ignorant to understand much of your reply but will, ultimately, a rheumatologist be the doctor who can treat the cause?

oklaunion said:

---

KidDoc:
I am too ignorant to understand much of your reply but will, ultimately, a rheumatologist be the doctor who can treat the cause?

---

It is still in the early experimental phase. Right now Dr Patterson is the only one I know of personally that is trying to address the cytokine storm. I would think an immunologist would be more knowledgeable in this specific area but if they don't keep up and stay current with medical knowledge and reading they won't be much help. A rheum doc will just try to pigeonhole it into one of the problems they are experienced in dealing with like autoimmune arthritis of fibromyalgia and just treat the symptoms I would guess at least.

Thanks for your willingness to share.

oklaunion said:

---

KidDoc:
I am too ignorant to understand much of your reply but will, ultimately, a rheumatologist be the doctor who can treat the cause?

---

I have an appointment with Patterson Wednesday night. What area do you live in? I can ask if he has been working with any docs in that area.

Brazos County.

Thank you, sir.

NIH spent $1.2B on long-Covid research (ROI=0)
NIH spent essentially nothing on:
▪️A randomized trial of the bivalent vax
▪️A study of vax compl
▪️A study of Paxlovid in vax ppl
▪️A proper trial on masks
▪️Nat imm protection against severe disease
▪️Study of boosters in young ppl https://t.co/odb5jB0spd

— Marty Makary MD, MPH (@MartyMakary) December 17, 2022

Long covid 6-7 times less likely than what CDC purports as a concern at 20%
It's less at 3%

KidDoc said:

---

oklaunion said:

---

Brazos County.

---

I asked him about it last night and he said there are several docs in the area, just get in touch with the Incell lab he works with and they can start the testing and treatment process.

Has Bruce Patterson Cracked Long COVID? - Health Rising

COVID-19 - IncellDx

---

KidDoc,

Is Patterson seeing patients or is there a network of physicians who are working with him? I am in Houston but can easily make an appointment in Brazos County, my dad lives in College Station.

Basically, my situation is that I had Covid for the third time in early January 2024. The acute phase wasn't as bad as first time I had it in January 2022, maybe a little worse than January 2023.

But the lingering aftereffects of fatigue, brain fog, lack of desire to engage socially, lack of motivation, muscle soreness even without exercise particularly the quads and calves and lats are affecting my professional and social life.

Late January saw PCP who did complete blood panel, Only abnormal result was sed rate of 28 (I am male 61) which he attributed to having just had covid in January.

Early February, due to a feeling of "fullness" in my face and head, I saw an ENT who proclaimed I had a sinus infection and did a balloon sinuplasty to clean out pus and mucus. Lab results indicated no active infection. Was on steroids briefly as part of the post surgery protocol.

Went to PCP and repeated tests last week and sed rate was down to 21, still slightly elevated. C reactive protein was also normal at 0.3 (normal less than 0.5). I feel slightly better and some days almost normal. He says it probably just still getting over the Covid, and not true "long Covid" but neither of my previous bouts were anything like this. He says I just need to apply the "tincture of time."

I really would prefer to be more aggressive about investigating and treating this. The last 2.5 months have really been a downer from my usual "quality of life."

Any steer you could give would be appreciated.


Edit to add: Thanks for the DM!