Rehabilitation and lifestyle strategies for managing recovery
Dr Rosalba Courtney | ND , DO , PhD
Overview
The large scale impact of Long COVID has emerged as an unforeseen consequence of COVID 19 with devastating implications for human suffering , the health system , the economy and work places .
Long COVID , presenting as multisystem symptoms that persist beyond 3 months after acute infection , seems to affect at least 10-20 % of people recovering from COVID 19 . At this incidence rate the World Health Organization ( WHO ) predicts that there will be 10-20 million cases globally that need to be managed [ 1 ]. In Australia it is predicted that tens of thousands of individuals with Long COVID will require treatment in the coming years [ 2 ].
The most commonly reported symptoms are fatigue , breathlessness and cognitive dysfunction presenting as brain fog and memory issues , as well as mood disturbance , anxiety and depression [ 3 ]. However , this is just the tip of the iceberg and surveys of patients with Long
COVID have found that they experience an average of 55 symptoms that range across six broad patterns : ( 1 ) cognitiveemotional , ( 2 ) pain manifestations , ( 3 ) pulmonary , ( 4 ) cardiac , ( 5 ) anosmia / dysgeusia and ( 6 ) headache [ 4 ]. Despite a large amount of research internationally much is still unknown about the pathophysiology of this condition or how to successfully treat it .
Practitioners working with Long COVID report that it is difficult to predict which patients will succeed in recovering their abilities to work , study and exercise , and practitioners need to be humble in promising recovery while doing whatever can be done to support the patient to safely move towards healing [ 5 ].
Causes and Pathophysiological Processes
Naturopathic medicine has traditionally been concerned with treating disease by looking at causes and attempting to find pathophysiological processes that might be amenable to treatment with natural means and lifestyle advice where possible . In Long COVID there is a number of pathophysiological drivers that can be targeted and some of these respond to non-pharmacological therapies [ 6 ]:
1 . Residual organ / tissue damage 2 . Ongoing inflammation 3 . Persistence of virus 4 . Autoimmunity 5 . Dysautonomia
Residual organ / tissue damage can be multisystem but predominantly affects the lungs , heart , and circulatory system as well as the brain and nervous system [ 6-8 ]. Many patients develop a diagnosable disease such as asthma , heart disease or kidney disease as a sequel to COVID 19 , but this is not always the case and the organ damage is often sub-clinical . Nevertheless , in keeping with the principle of Primum Non Nocere ( first do no harm ), it is essential that patients have been cleared of organ pathologies that are medically treatable before attempts are made to support them with other non-medical strategies .
128 | vol28 | no3 | JATMS