(For Educational Purposes only)
With COVID-19 still ravaging humanity in various parts of the world, we are seeing an increasing number of so called ‘long haulers’ who evidence a complex range of symptoms that have long-term debilitating influence affecting quality of life and currently, with little recourse in conventional allopathic approaches.
In the near future, such cases could be more prevalent in our practice and this article will hopefully summarize the homeopathic approach to dealing with such cases and stopping the suffering in long haulers.
Common signs and symptoms and long term consequences in COVID-19 long haulers:
While most individuals recover completely within a few weeks of contracting COVID-19, some patients – even those with a mild version of the disease can continue to experience long-term symptoms after their initial recovery with decline in quality of life.
Such complex of symptoms encompasses fatigue; dyspnea with persistent oxygen requirement; cough; chest pain; joint pain; memory and cognitive disturbances (fogginess); concentration or sleep problems; myalgia and headache; hair loss; dermatitis; palpitation; loss of smell or taste; depression or anxiety and PTSD; fever; dizziness; chronic kidney disease, thromboembolism; worsened symptoms after physical or mental activities.
In my practice, I have seen some patients experiencing recurrence of old symptoms, often from years back. Most of these patients were not under my care or under homeopathy for their primary COVID-19 disease. I say this, since none of the patients who were under my care during their primary COVID-19 infection has ended up so far as a long hauler, which possibly augurs well and confirms the holistic response to homeopathic treatment with a better long-term outcome in terms on any lingering debilitating symptoms.
Conventional approaches to long haulers have met with limited success in palliative care. There are examples galore of how COVID-19 has affected individuals and their livelihood, as was the case of a food critic who lost her taste and smell and despite re-training efforts and conventional interventions, and did not regain her faculty till months later. Most long haulers can experience an early recovery from such complex and seemingly severe symptoms when treated using homeopathy.
The organ damages reported so far extends to:
- Heart. Damage to the heart muscle – increase the risk of heart failure or other heart complications in the future;
- Lungs. Pneumonia causing long-standing damage to the tiny air sacs (alveoli) and the resulting scar tissue -long-term breathing problems;
- Liver. Increased levels of liver enzymes seen — such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Cases with cirrhosis and pre-existing liver disease (chronic liver disease, cirrhosis, or related complications) have reportedly higher fatality after COVID-19;
- Brain. COVID-19 can cause strokes, seizures and Guillain-Barre syndrome —that causes temporary paralysis, even in young people. Increased risk of developing Parkinson’s disease and Alzheimer’s disease.
Some adults and children experience multisystem inflammatory syndrome wherein some organs and tissues become severely inflamed.
Blood clots and blood vessel problems: Blood cells more likely to clump up and form clots post COVID-19 with large clots increasing risk of heart attacks and strokes. Much of the heart damage caused by COVID-19 is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle. Blood clots can also affect the lungs, legs, liver and kidneys. COVID-19 can also weaken blood vessels and cause them to leak.
Simply surviving the experience of severe symptoms of COVID-19 needing a hospital’s intensive care unit visit, with mechanical assistance such as ventilators to breathe, can later develop PTSD, depression and anxiety.
UCLA researchers (JCI Insight. 2021;6(2):e145027. https://doi.org/10.1172/jci.insight.145027) created a version of COVID-19 in mice (the researchers first engineered mice to have the human version of ACE2 in the heart and other vital organs) to study how the disease damages organs other than the lungs and discovered that the SARS-CoV-2 virus can shut down energy production (TCA cycle) in cells of the heart, kidneys, spleen and other organs.
Within a week, all the mice with COVID-19 had stopped eating and were completely inactive, and lost, on an average, about 20% of their body weight. Moreover, the COVID-19 infected animals had altered levels of immune cells along with swelling of the heart tissue and wasting away of the spleen — symptoms that have been observed in people critically ill with COVID-19.
COVID-19 virus can temporarily alter which genes were turned on and off in some cells. The virus also made epigenetic changes — chemical alterations to the structure of DNA that cause more lasting effects.
For about a quarter of patients with smell or taste issues, the problem resolves in a couple of weeks. Some studies suggest that there’s a 60% to 80% chance that these people will see improvement in their sense of smell within a year. Chronic fatigue syndrome is another long-term consequence of COVID-19.
Some survivors of COVID-19 seem to be developing type 2 diabetes signs after they recover from COVID-19. Heart inflammation after even a mild or asymptomatic case COVID-19 is a concern, especially among young athletes.
How does COVID-19 affect so many multiple sites and organs in the human body?
SARS-CoV-2 virus that causes COVID-19, must bind the angiotensin converting enzyme 2 (ACE2) receptors for entering the host cells in humans. The expression and body localization of ACE2 is so ubiquitous that COVID-19 can affect a wide range of potential target organ/s and lead to long term consequences
While ACE2 mRNA is present in all organs; ACE2 protein expression is present in heart, kidney, testis, lung (type I and type II alveolar epithelial cells), nasal, and oral mucosa and nasopharynx (basal layer of the non-keratinizing squamous epithelium), smooth muscle cells and endothelium of vessels from stomach, small intestine and colon, in smooth muscle cells of the muscularis mucosae and the muscularis propria, in enterocytes of all parts of the small intestine including the duodenum, jejunum, and ileum (but colon), skin (basal cell layer of the epidermis extending to the basal cell layer of hair follicles smooth muscle cells surrounding the sebaceous glands, cells of the eccrine glands), endothelial, and smooth muscle cell of the brain (Front. Med., 03 December 2020 https://doi.org/10.3389/fmed.2020.594495; J Pathol. (2004) 203:631–7. doi: 10.1002/path.1570)
The current medical thinking on long haulers indicates three categories as under:
- Individuals seriously sick with COVID-19 in ICU – any such cases will have long term recovery issues (PICS, PTSD);
- Individuals with any viral infection such as flu, COVID-19 – new thoughts are that they can linger for a while and it is not COVID-19 specific but a common factor for any viral infection;
- 5% of individuals with COVID-19 without ICU can end up with a complex of symptoms and these are the long haulers that is currently not very well understood. How long is the suffering likely to be in a long hauler, is currently not well understood. While the first two categories are understandable and common in many viral illnesses, the third category is currently not well understood scientifically as to the underlying mechanisms
All patients seen were found to be unvaccinated at the time of primary COVID-19 disease and were also not known to be treated with homeopathy for the primary COCVID-19 disease:
Case I – 38 y female with COVID-19 with post COVID-19 Sequelae:
Patient had COVID-19 confirmed on Dec 9th, 2020. Symptoms started with a headache, followed in the next few days with sore throat, fatigue, shortness of breath, body aches, chills, intermittent loss of taste/smell, and full body tingling.
Returned to work Dec 21st and had intermittent headache/tiredness till Dec 24th and then Dec 25th till Jan 1st felt pretty good. Mild headaches, more tired than normal, intermittent tingling, workouts not as strong due to becoming short of breath easily.
Then started having nausea, tiredness and headaches, followed by feeling of head in the clouds and overall feeling sick. On Jan 5th woke up with flu like symptoms (nausea, chills, headache, intermittent tingling) – visited ER at advice of MD – Head CT, Chest X-ray, EKG, bloodwork done – nothing of concern in findings. Her physician advised it to be likely lingering of COVID symptoms that could take months to resolve. Symptoms kept waning and waxing.
Consulted me on Jan 19th 2021 with the following symptoms/rubrics:
Phosphorus 200C twice daily along with Variolinum 200C – 4 pills as a dose once at bedtime for three nights in a row and then once every 3 nights
Jan 21 2021: ‘Good Morning! Just checking in. Past two days mild headaches (intermittent) in one or both temples. Woke up this morning with whole head headache, strongest in the temples. Headache causing nausea today. Have been taking everything you recommended’. Advised to increase Phos 200C in water every 30-120 mins till headaches abate. Patient reported improvement and resolution after 3 doses taken 30 mins apart though experiencing tingling for a few hours.
Jan 27 2021: ‘just wanted to check in. Over past few days, have felt headaches coming on, however, they have not come to fruition. I have a very mild one at the moment on the right side. Additionally, my MD recommended an echocardiogram & stress test along with bloodwork.
The echo showed mild dilation in the ascending aorta. She recommended connecting with a cardiologist to monitor this. Also, bloodwork showed slightly elevated potassium levels (5.2 mmol/L) she is requesting repeat bloodwork next week. Not sure if it is relevant, but wanted to keep you in the loop. I am continuing to feel better’.
Feb 2 2021: Headaches are gone or often about to come and does not and if does – it is mild. Fatigue is better but still exhausted in the evening, lighter in head but feels 85% better in terms of the ‘spaced out’ feeling. Potassium re-testing came back okay. Continue as is and also start Merc iod flav 30
Feb 12 2021: ‘I just wanted to check in to let you know that I am feeling really good. I finished the BC16 yesterday. The only thing I’ve really noticed is a bit of a lump in my throat (not to the touch, but noticeable when I swallow)’. Continue as is.
Feb 16 2021: Since Sunday has the headaches again on the neck and the spacey feeling came back. Feels does not get full breath. Lump in the throat. Hippozaenium 200C – use 4 pills as a dose twice daily for 3 days
Feb 21 2021: ‘Good morning! Just checking in. Had headaches on/off past few days. Mild one at the moment’. Restart the Phos 200C
Mar 9 2021: ‘Hi! I was having headaches week before last pretty consistently. Some resolve late last week & have been daily since Sunday. I stopped taking everything last week’. Helleborus 200C and Variolinum 200C.
April 3 2021: ‘I was doing well, but have had a headache constant since Thursday night’. Restart the Variolinum 200C twice daily for 5 days
Jun 16 2021: I am feeling much better consistently
Case II – 30 y Female with post COVID-19 symptoms
Had COVID 19 in Nov 2020 around thanksgiving. Stuffiness, super tired, loss of taste and smell for a month – starting to get the taste and smell back.
Consulted me on Feb 17 2021 – Recently, it become awful – everything tastes disgusting and has COVID-19 toes – slow blood flow, red swollen and itchy. Left 2nd toe from big toe is still bad. Had Raynaud’s from before. Tired around 2-3 pm always. Need 8-8.5h of sleep.
Migraine once in a while which started in college, also had swollen lymph node in the neck – right side – in 2016. Sore on and off on swallowing. Post nasal drips for a long while. Green coryza – needs to hawk it out. Does neti pot once a day when it is bad. TMJ dislocated. Was on steroid inhaler for a while though never deemed asthmatic
Phos 200C was prescribed
March 3 2021: Stopped the remedy about 5 days back as was feeling better. But now has increased post nasal discharge, headaches are better, cannot taste things yet. Advised Tuberculinum bov 1M and Natrum sulph 6x tissue salts 4 times a day.
Mar 31 2021: Bad taste still present but smell is not as bad as before – more mild, tolerable, had coffee again which used to trigger the odd smell memory. Toes are better for swelling, but some patching going on, post nasal discharge and phlegm very less – once a day. Headaches once in a while.
Tub bov 1 dose every 7-10 days for 3 doses and continue the Natrum Sulph 6x tissue salts for 3-4 more weeks.
Aug 21 2021: Doing well. No symptoms anymore
Case III – 64 y Female with post COVID-19 symptoms
Date of consult: Aug 7, 2021 – Had COVID-19 end of Feb 2021 – loss to taste and smell, fatigue. Okay for 2 months and then on Jun 15th woke up at 4 am with diarrhea followed by vomiting and feeing weak and fatigue since then. Symptoms went away and reappeared after a while.
Has attacks of suffocation that wakes her up. Has abdominal bloating and constant burping. Feels electric like pain in the legs, biting cramping pain in the stomach along with nausea and dizziness. Frontal headache extending to the top of the head with a burning feeling.
Interrupted sleep. Heat flushes through her body and head. Stabbing pain from the chest extending to the back and under the chest. Vomiting 10-11 pm and 4 am and feels weak. Morning the vomit is yellowish green. Exhausted after that and has full day nausea.
Lachesis muta 200C twice daily for 5 days and then once daily at bedtime;
Lycopodium 30C from day 5, twice daily. Ficus Carica D1 (gemmotherapy) 20 drops in little water swish in mouth for 10 seconds before ingesting- twice daily 10 mins before meals.
Aug 24 2021: Burning of vertex is gone, headache was better but feels it back today, no vomiting but loss of appetite – forces herself to eat and then has nausea and feels worse, low energy. No shocks in the legs. Back pain is fine, sleep is better, flushes in chest feels better.
Eructation was better but with nausea is a bit back. Continue as is and add tissue salt combination BC16 tissue salts (4 tablets as chewable 3-4 times a day, and Aletris far 30C 3-4 pills 10 minutes before meals twice daily for better appetite and for reducing weakness during recuperation
Sept 7 2021: Better for all her symptoms – energy is improving and better
Sept 22 2021: No burning in the body, no pain in the body. No more shock in the legs. No nausea or eructation. No vomiting in the past 2 weeks. Sleeps well, Lumbar back pain does not bother if she is not overworking. Suggest continue BC16, Aletris far as before and Lachesis can be taken once every 3 days while Lycopodium once at bedtime.
October 20, 2021: Doing fine – amazingly no more symptoms or complaints!! Asked every individual symptom she had and she confirmed remission of those symptoms!! Advised to continue as before for 2-3 weeks and then can slowly pause the Aletris far completely, and do the Lycopodium only if required for bloated sensation of the abdomen. Lachesis once at bedtime, BC16 and Ficus carica D1 can continue for a while
Case IV – 55y Female with long term COVID-19 skin and breathing issues
Date of consult: Sept 18, 2021 – Was exposed to COVID-19 on Dec 18th 2020 through a work colleague and had COVID-19 confirmed on Dec 31st 2020. Was using basic home remedies, vit C etc. Jan 6th was severe – oximeter showed 87-89 and on deep breaths- would rise above 90. Had fever, sever vomiting, congestion, myalgia, headaches, chest pain, exhausted, palpitation – followed by decrease in O2 level to 77.
Went to emergency room where the classic ground glass appearance of lungs with pneumonia was confirmed. Was put on oxygen -given 2 iv doses of antiviral medications along with antibiotics and steroids.
Was in hospital for 4 days. During March-Apr 2021 had stomach problem – felt like a narcotic addict and had severe diarrhea with aggravation of her anal fissure for which her physician gave some medicine that offered some relief.
Low energy, loss of sleep with waking up at 3-4 am. Feeling exhausted during the day, needing nap and worst at 1-2 pm in the afternoon. Feels better by 5-6 pm. Still throwing up which started before COVID19 – possibly due to p/h of gallstones. Small nodules on liver seen. Damage seen on stomach lining. Red dots on skin. Was prescribed Pantoprazole and Propranolol.
She was hospitalized twice again during summer 2021. Skin inflamed – dermatitis. Around hair line, red irritated margin of the hair, whole scalp- itches, burns, painful, dermatitis. Lungs – still has breathing issues for which a dose of Hippozaenium 200C makes her feel better. Still feels nausea when stressed.
Hippozaenium 200C as needed for breathing issues and Oleander ner 30C four times a day. Calendula herbal tincture local application.
October 27 2021: Within couple of days, the redness went away – still dry flakiness and itching is there. Lungs are doing. Advised to continue Oleander twice daily and start Sulphur 200C one dose every other day or every 3 days.
Still takes Hippozaenium 200C as needed and feels breathing much better. Some evenings not sleeping well and feels tired. Exhausted by mid-afternoon. Cannot sleep at night – intermittent waking up, body ache. Red spots on chest and upper arm not as bad but still there.
Nov 11, 2021: Doing better, skin is healing, both in the body and on the scalp. Advised to use a more plant-based diet.
Nov 24 2021: After shifting completely to a full plant-based diets, all symptoms have resolved, skin and scalp has cleared off. Her appetite, breathing, sleep and energy are all back to normal. In fact, she has also stopped all homeopathic medications since she is feeling so much better.
Case V – 36y Female with GI plus issues post COVID-19
Date of consult – Oct 20, 2021: COVID-19 confirmed on 19 Feb 19th 2021 – 1st 4 month felt worst. Had seen many physicians for the myriads of symptoms which included anxiety, was scared due to range and intensity of symptoms. Could not sleep or eat. Felt abnormal. Aggravation at 4 am.
Stomach feels empty, weight reduced to 104 lbs from 129lbs. Sensation of emptiness in the stomach makes it feel drawn in and aggravates all her symptoms and hence ‘forced myself to eat’ at 5 am, 9am, 1:30 am then 4 or 5 pm and then at 8 – 9 pm so symptoms do not aggravate.
Unable to walk longer than 10-15 min, talk and feels drowsy and foggy. Walk or activities causes palpitation and dizziness where everything feels dark. Aversion to sweets. Likes to eat cucumbers which calms down the burning feeling. At lunch – fries, small pieces of chicken (hates smell of it), avocado, bananas.
Burning pain radiating from chest. Cold icy menthol breathing in chest – comes and goes. Nausea with heaviness of head and dizziness. Pale tongue. Drinking water aggravates nausea. Constipated (was there prior to COVID-19 but has since become worse).
Blood in stool with painful external hemorrhoids which are like bunch of grapes with low back pain. Falling asleep difficult – takes 3-4h to fall asleep and sleep is light with many nightmares of being in a high place, being pursued by something that is not visible.
Feels tired as if never slept. Feels cold all the time and feels feverish. Burning of the upper arms and head. Headaches with painful right eyes. Right leg is always in pain aggravated when stomach feels drawn in, gets heavy and numb. Blood test confirmed low WBC count, low iron, vitamin D and vitamin B12 levels. Left knee – inner side is always sore – and if she bends her leg in sleep, unbending causes excruciating in pain.
Right foot is red and swollen – had that prior to COVID-19 but is worse now. Additionally, reports hair loss – thinning, greying and with bald spots. Just diagnosed by her physician with autonomic dysfunction and was put on fludrocortisone 0.1 mg daily.
Initially Veratrum alb 200C was prescribed to be taken in water for few days when reported sleeping quicker though once woken up then difficult to fall back asleep. Since not much improvement was seen, Veratrum was stopped and Phosphorous 30C was prescribed on Nov 4, 2021 – 4 times a day
Nov 12 2021: Reports feeling a distinct difference with an increase in appetite. The burning in her chest has subsided but still the cold menthol feeling in her throat and chest is still there. She still had significant dizziness. Continue Phosphorus 30C as improvement seen in a short time.
Nov 17 2021: All symptoms have improved, stomach is better, sleep has improved, feels not as desperate, not as tired, can walk longer, no palpitation or vertigo. Eats normally including is able to eat chicken without revulsion, has no burning of stomach but feels bloated. No burning in chest.
Cold breathing icy in chest has subsided. Drinking water does not cause nausea. No blood in stool – hemorrhoids are better with no back pain. Not as tired. No burning of the upper arms and head. No pain in right leg as stomach feels better. Left knee is still an issue as is the right foot. Hair loss better. Weight has improved to 114 lbs. from 104lb.
In conclusion, I hope this article summarizes the gamut for COVID-19 long haulers including some current scientific and medical thoughts. The actual patient examples elucidate the power of a well selected homeopathic simillimum that can stop the long haul COVID-19 symptoms in its’ tracks and thereby help the patient regain his or her health back to pursue their creative goals in life.
Tuberculinum bovinum is a remedy needed often as also other tubercular remedies such as phosphorous since this illness predominantly involves the tubercular miasm. Some experts opine that SARS-CoV-2 virus will revisit and infect in an endemic way periodically like flu, and that we will get used to it though it can still kill the weak and vulnerable ones as does the flu.
This is, provided there are no mutations evolving into a worrying variant of the virus that can escape the immune mechanism put in place by a prior infection or immunization. 2022 will be crucial in determining which way the pandemic goes but the optimistic view is that it will be just another cousin of the common cold virus visiting us periodically over time.