Patients with Long Covid need treatment beyond rehab. @melheightman @sivanmanoj @YorkshireCCC @NHSEngland @NHSEnglandMedia @doctorasadkhan @sajidjavid @LongCovidWales @Doctor_IMF @drpaulwhitaker #TreatLongCovid
There is an ongoing pathological process occurring in those with LC - evidenced by inc mortality in the first the year post acute infection & prevalence of ongoing end-organ damage - in desperate need of urgent investigation & intervention.
It is not uncommon for pts with Long Covid to develop myopericarditis, encephalitis, dysautomnia, POTs, tinnitus, sensorineural hearing loss & visual deterioration, in the mths following an acute infection with SARS CoV-2.
Anxiety/deconditioning do NOT cause these symptoms. Nor will CBT/ rehab help these organic symptoms which have a biological basis.
Long Covid is too complex for pathophysiology not to be multifactorial.
Likely viral persistence (the virus has been found in cells one yr post acute infection on colonoscopy), autoimmunity (triggered by the virus and/or the body’s response to it), blood hypercoagulability & microclot formation (&others), will all play a part.
Microclots, however, ARE a significant piece of the puzzle. We know SARS CoV-2 is a thrombotic disease and therefore should not be surprised to find microclots in the blood of Long Haulers. WHY are UK Long Covid clinics not investigating and treating known pathology?
We now know at least one of the biological markers (microclots) pubmed.ncbi.nlm.nih.gov/34425843/
In this paper, @resiapretorius kindly details how to test blood for microclots. mdpi.com/2077-0383/10/2…
Dye is cheap, and the technique is easily replicated.
Normal d-dimers and imaging do NOT exclude the presence of microclots. We must not be reassured by normals tests. Simply, the wrong test is being done.
People with Long Covid are desperately unwell. Many pts are not getting better despite resting and pacing for months/yrs.
We now have more tools in our tool box, beyond advice of resting/pacing. Granted, Microclots might not the be cause of everyone’s Long Covid but it will be significant contributing factor for many. It is underlying pathology we are able to demonstrate and easily treat.
It would be negligent and unethical to leave such significant pathology untreated in any other patient group. Why should it be acceptable to ignore such significant, demonstrable pathology in those with Long COVID?
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