Some preliminary studies already suggest that microbiome imbalances in long-term patients with Covid may contribute to their persistent inflammatory symptoms. But while more research is likely to be needed before drugs such as prebiotics or anti-inflammatory drugs are recommended for long-term patients with Covid as part of general clinical practice, some individual symptoms are already more treatable than others.
Heightman says patients with long-term Covid who develop allergic reactions usually respond well to antihistamines, while Amy Kontorovich, a cardiologist from Mount Sinai who specializes in treating dysautonomia, has developed a new physical therapy program known as autonomous conditioning therapy (ACT). which showed the ability to reduce symptoms of fatigue in some patients with long covid and has since been accepted by 53 physical therapy centers in the New York area. Kontorovic explains that ACT begins with a set of movement exercises before moving on to various aerobic exercises that slowly increase in intensity but never allow the patient to exceed 85% of their maximum heart rate. This is inspired by a similar recovery program that has been shown to be effective in treating a form of dysautonomy known as POTS.
“It seems to program the autonomic nervous system to redirect things,”
ACT is not a complete panacea – Kontorovic points out that some patients with particularly severe dysautonomia are often unable to complete the program because they feel too ill – but its early results suggest that this may be beneficial for patients who are able to to complete it.
Heightman adds that many Covid patients also simply recover over time as their bodies recover and heal. As SARS-CoV-2 still exists for just over a year and a half, it is too early to say how long chronic symptoms can last. “I don’t want anyone who has long symptoms of Kovid to feel really scared that this will never go away, because a very significant proportion of people recover in the first year,” she said.
For those who continue to struggle, however, the hope is that the millions of dollars provided for research will provide some viable treatment options, otherwise Covid could leave indelible social and economic consequences for society. “If we don’t find the answers, you can talk to millions of people who won’t be able to work the same way,” Kaufman said. “A very significant proportion of patients with long Covid are health professionals. These are educated, active, highly productive people who cannot function now. The impact of this will be enormous.”
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