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Tuesday, Nov. 30, 2021

What’s Wrong With Me?

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Could Covid-19 be cause of new symptoms patients are experiencing?

More than a year and a half have passed since we began the battle against the worldwide pandemic that has taken more than five million lives, but it’s the mind-boggling aftereffects of COVID-19 — what many are calling “Long COVID” – that are baffling doctors and scientists. Months after having had the virus, many patients, including young ones who never required hospitalization, are experiencing a devastating second act and are asking, “What is happening to my body?”

As a Northwest Louisiana electrodiagnostic specialist, I see disturbing long-term effects of COVID-19 weeks and even months after having the coronavirus.

Studies are showing that 10-50% or more of COVID-19 patients — those who were hospitalized, those with mild to moderate disease progression, and those who were otherwise asymptomatic — are experiencing deeply concerning symptoms. The disease itself might not have been that bad for many of these patients, but symptoms like memory lapses and rapid heart rate that sometimes persist for months are causing grave concern.

The most common symptom of “Long COVID” seems to be crippling fatigue, and doctors are finding no link between the severity of the infection and the fatigue. But lingering symptoms also include nerve neuropathy, joint pain, body aches, cough, shortness of breath, headaches, brain fog and memory issues, confusion and lack of concentration, gastrointestinal issues, and new and continuing change in the senses of smell and taste. These long-term effects are usually associated with viruses like Epstein-Barr or West Nile viruses that are much less infectious than coronavirus.

Because I primarily diagnose nerve and muscle disorders, I am most likely to see neurological damage having to do with the COVID-19 virus and the ways it attacks the body. The virus may directly affect the nervous system or indirectly affect it through its effects on the immune system. Some of my patients are experiencing diabetic-like nerve neuropathy, causing their extremities — the fingers and toes – to tingle and even go numb.

According to research, some of the longterm symptoms we see from COVID-19 could be collateral damage from the body’s immune response during the acute infection.

Some patients might harbor an undetectable reservoir of infectious virus or have bits of noninfectious virus in some cells that trigger an immune response. Another possibility is that the virus causes some people’s immune systems to attack and damage their own organs and tissues. A June study from the Journal of European Alliance of Associations for Rheumatology found that roughly half of 29 hospitalized ICU patients with COVID-19 had one or more types of autoantibodies that mistakenly target and attack a patient’s own tissues or organs.

There is also some proof that several neurological issues are occurring due to the side effects of treatment during COVID-19 hospitalization. Peripheral nerve injury has been observed in patients who were placed in a prone position while on ventilators. The processes of intubation and prolonged hospitalization, though necessary at the time, may contribute to neurological damage.

I served as a member of the Mayo Clinic, Rochester, Minn., Professional Practice and Professional Program Committees of the American Association of Neuromuscular & Electrodiagnostic Medicine. The Mayo Clinic staff has published a report citing how difficult it is to predict the long-term outcomes from the new COVID-19 virus. Scientists are looking at the long-term effects seen in related viruses, such as the virus that causes severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), Ebola, H1N1 and the Spanish flu to help understand the long-term effects of the coronavirus. COVID-19 is seen as a disease that primarily affects the lungs, but it has been shown to also cause damage to the heart, kidneys and brain. Some adults and children are experiencing multisystem inflammatory syndrome leaving organs and tissues severely inflamed.

With more than 46 million cases of COVID-19 worldwide, even a low estimate of those struggling with symptoms weeks to months after becoming sick — sometimes with disabling conditions – increases the urgency to study this “long hauler” patient population.

There is still so much to learn about the long-term effects of the COVID-19 virus, and as yet there is no consensus, nor has extensive research been completed. Nonetheless, it seems that there is an association between COVID-19 and nerve neuropathy as well as other symptoms. While much uncertainty remains, existing treatments for the symptoms of long-term COVID do exist and may be helpful for those suffering from them.

Dr. Stephen W. Wheat is triple board-certified in electrodiagnostic medicine, physical medicine and rehabilitation and internal medicine with almost 30 years of experience. He specializes in nerve and muscle diagnostic testing, practices medicine in Natchitoches and Shreveport and teaches at Baylor College of Medicine, Houston, Texas. Dr. Wheat has served as a member of the Mayo Clinic, Rochester, Minn., Professional Practice and Professional Program Committees of the American Association of Neuromuscular & Electrodiagnostic Medicine.

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