Long COVID
Getting COVID-19 can be hard enough to deal with but that's not always the end of it and for many, there can be lingering effects. Dr. Alan Roth discusses Long COVID, some of the symptoms, possible treatment options, and more.
Featured Speaker:
Alan Roth, DO, FAAFP
Dr. Roth is a dually certified Diplomate of the American Board of Family Medicine. He is also Board Certified in Hospice and Palliative Medicine. He presently serves as Chairman of the Department of Family Medicine and Director of the Palliative Medicine Fellowship Program. Dr. Roth’s primary goal is to develop and enrich the training experiences of physicians interested in urban Family Medicine. He has completed a Residency Program Director Fellowship with the American Academy of Family Physicians and lectures nationally on urban Family Medicine Residency training and curriculum development. His special areas of interest include cultural competency training in graduate medical education, palliative medicine, disease prevention, health promotion and procedural skills. Dr. Roth is a community-minded physician who regularly mentors many of our local youth interested in becoming Family Physicians. Transcription:
Long COVID
Maggie McKay: It's bad enough to get COVID 19, but that's not always the end of it. For many people, there are lingering effects from brain fog and sleep disruptions to dizziness. Just to name a few. It's called long COVID. And to tell us more about it is Dr. Alan Roth, chairman of family medicine, ambulatory care, and integrative medicine at Jamaica Hospital Medical Center. Welcome to Jamaica Hospital Med Talk the podcast from Jamaica Hospital Medical Center. I'm Maggie McCay, Dr. Roth thank you so much for ,being here today.
Dr. Alan Roth: Thank you for having me. I look forward to talking with you.
Maggie McKay: Diving right in, it sounds like literally millions of patients are suffering from long COVID. So for those who are not aware of what it is, what is long COVID and what are the symptoms?
Dr. Alan Roth: So you're correct. Unfortunately, there is millions of people suffering from this disorder, and the disorder and the characteristics are evolving. Long COVID is sequella of having the COVID 19 virus and people that suffered from that from the beginning of the pandemic, and the symptoms are varied. The cause is unknown, but the symptoms have been well defined at this point.
So there's kind of two different scenarios. The first scenario is the one that's worse. Those are people that were really sick with COVID, hospitalized for a period of time and have some of the sequela of the illnesses of what they were in the hospital for. So for example, those that had respiratory illnesses or respiratory failure might have shortness of breath or cough. Those that had cardiac involvement while in the hospital might have chest pain or palpitations, but the most common one we're seeing are the more generalized kind of symptoms.
What I mean by generalized symptoms is people who are suffering from fatigue or more commonly know, just being tired, myalgia or body pain, or the dreaded one for many, which is this brain fog, which is, affecting their memory as well as affecting just thought processes in general. Like naming things, like difficulty remembering the names of your friends' family or objects or things you're not commonly talking about.
Maggie McKay: And how long do symptoms typically last?
Dr. Alan Roth: So the typical symptoms are varied. To be called long COVID the general definition that's now being accepted is you have to have symptoms for at least three months after suffering from COVID. But the duration unfortunately is unknown. Most people improve in from six to 12 months, but we now have patients, unfortunately, that are suffering from postacute COVID or long COVID for going on two and a half years now, since COVID came to this country.
Maggie McKay: Oh, my goodness. You talked about people who had more severe cases of COVID. So are those people more prone to having long COVID or is it just random?
Dr. Alan Roth: So it is random in the symptoms that people get, but the differentiation is there's really no good correlation to how severe the COVID infection you had initially is. And how long or how bad the symptoms will last. So that patient, for example, that was hospitalized, that was severely ill in the hospital for days or weeks or month. Generally their long COVID symptoms will be similar to what they had in the hospital.
So if they had severe body pain and weakness that severe body pain and weakness would persist. If it's the cardiac kind with chest pain and shortness of breath that would persist. If it was neurologic problems, such as headaches, dizziness, passing out loss of smell and taste and weakness, it would be those symptoms.
Whereas the people who never were hospitalized and were never as sick to require hospitalization, those are the people that are suffering from the severe tiredness, the body pain, just someone touches you and everything hurts. And the severe brain fog and memory loss that are associated with it. That's the most common in the long COVID patients that were not as sick and were not hospitalized. And unfortunately for me, I'm one of them I had COVID in the first wave and I have that triad of the three symptoms of fatigue, myalgia and brain.
Maggie McKay: So you know exactly first hand what you're talking about.
Dr. Alan Roth: I do know what we're talking about. And, unfortunately early on, many of my colleagues were kind of not believing in the symptoms. Many people did not believe in long COVID and some people don't believe in long COVID yet. It's similar to diseases like. Chronic fatigue, or biologic encephalitis, which are these long term syndromes associated with people with other viral illnesses and are suffering from like fibromyalgia and things like that. Many doctors don't quite understand the pain people are suffering, the weakness they're suffering and the neurologic changes that are happening to people.
Maggie McKay: So what percentage of COVID patients develop long COVID symptom?
Dr. Alan Roth: So it's pretty much showing that about 20% of all patients that had any form of COVID, develop long COVID symptoms out of that 20%, the vast majority, probably 75% or so will be better in six to 12 months. But there's about a quarter of people that are suffering from unfortunately much longer symptoms.
Maggie McKay: My goodness. Have the different strains of the virus impacted long COVID symptoms or severity?
Dr. Alan Roth: So it doesn't appear to be there again, appears to be no correlation between the severity of the disease and the strain and long COVID yet. But, you know, that research is ongoing at this point, and it's not exactly clear if one strain, causes one set of symptoms, more than another set of symptoms. We are seeing some less neurologic things like less people with loss of smell and taste, for example, and more people with the fatigue and body pain that they're happening. But it's really evolving now, as we speak.
Maggie McKay: What types of treatment options are available for long COVID patients? Can you please tell our listeners about the services offered at JHCS long COVID care center?
Dr. Alan Roth: So we at, Jamaica Hospital have a post-acute COVID center in our howls tutor site. And our approach is kind of an integrative one. we first look at the symptoms that patients had and what kind of workup they've had. So if someone's already had multiple tests and things, we kind of skip that because there's no specific test for long COVID, but if there's respiratory symptoms, we might do a chest x-ray a CT scan or, breathing test.
If there's cardiac symptoms, we might go that route in evaluating it. But for most of the time we're looking more at symptom specific treatment. And general specific treatment. So if someone is coughing or short of breath, we might use steroids and other kinds of respiratory medicines like bronchodilators and inhalers. If there's neuromuscular things, we might use anti-inflammatory medication, or if there's anxiety and depression, we might use different mood agents, SSRI anti-anxiety antidepressants, or sleep aid.
The more general symptoms of fatigue, body pain and brain fog are more difficult to treat. And we use a much more holistic or integrative approach. So we know nutrition is important, especially in anti-inflammatory kind of diet. We know that long COVID and COVID in general is associated with inflammation. So an anti-inflammatory diet. Avoiding greasy, fatty foods, fried foods, much more fresh fruits and fresh vegetables are associated with lowering the body's inflammation.
We know that exercise in general, connecting with nature, being outside, taking long walks, yoga, Tai Chi, other things that will strengthen the body and relax. The muscles are important as well as the mind, body and spirit. So mind we look at things like meditation. And journaling. We use holistic kinds of therapies, such as acupuncture and massage, as well as various herbal therapies that would boost the immune system. But it really is about mind, body, spirit, diet, nutrition, and a holistic approach to care.
Maggie McKay: I love that Jamaica Hospital Medical Center is covering all the bases, not just the medical needs.
Dr. Alan Roth: Yeah, you have to, you know, the disease is evolving. We know less about the disease than we know about the disease. And it's common with some of these more vague kind of illnesses that we've seen, like fibromyalgia and chronic fatigue syndrome and others. They're not as well known. So you really have to treat the whole person in a holistic way, in an integrative way and deal with the nutrition, the exercise, the mindfulness, the spiritual aspects, where people are not gonna get better. Because there's not like I could say you have long COVID and this is the drug I'm gonna prescribe. It doesn't work that way because we don't have one.
Maggie McCay: RIght. Well, Dr. Roth, thank you so much for all this useful information and I hope you feel better soon from long COVID you
Dr. Alan Roth: Thank you so much. It's been great talking to you.
Maggie McKay: To schedule an appointment at Jamaica Hospital's post COVID center, please call 718-736-8204. That's 718-736-8204. And for more information about the services, Jamaica Hospital offers visit our website at Jamaicahospital.org/podcast. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.
This has been Jamaica Hospital Med Talk. I'm your host. Maggie McKay be well. All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.
Long COVID
Maggie McKay: It's bad enough to get COVID 19, but that's not always the end of it. For many people, there are lingering effects from brain fog and sleep disruptions to dizziness. Just to name a few. It's called long COVID. And to tell us more about it is Dr. Alan Roth, chairman of family medicine, ambulatory care, and integrative medicine at Jamaica Hospital Medical Center. Welcome to Jamaica Hospital Med Talk the podcast from Jamaica Hospital Medical Center. I'm Maggie McCay, Dr. Roth thank you so much for ,being here today.
Dr. Alan Roth: Thank you for having me. I look forward to talking with you.
Maggie McKay: Diving right in, it sounds like literally millions of patients are suffering from long COVID. So for those who are not aware of what it is, what is long COVID and what are the symptoms?
Dr. Alan Roth: So you're correct. Unfortunately, there is millions of people suffering from this disorder, and the disorder and the characteristics are evolving. Long COVID is sequella of having the COVID 19 virus and people that suffered from that from the beginning of the pandemic, and the symptoms are varied. The cause is unknown, but the symptoms have been well defined at this point.
So there's kind of two different scenarios. The first scenario is the one that's worse. Those are people that were really sick with COVID, hospitalized for a period of time and have some of the sequela of the illnesses of what they were in the hospital for. So for example, those that had respiratory illnesses or respiratory failure might have shortness of breath or cough. Those that had cardiac involvement while in the hospital might have chest pain or palpitations, but the most common one we're seeing are the more generalized kind of symptoms.
What I mean by generalized symptoms is people who are suffering from fatigue or more commonly know, just being tired, myalgia or body pain, or the dreaded one for many, which is this brain fog, which is, affecting their memory as well as affecting just thought processes in general. Like naming things, like difficulty remembering the names of your friends' family or objects or things you're not commonly talking about.
Maggie McKay: And how long do symptoms typically last?
Dr. Alan Roth: So the typical symptoms are varied. To be called long COVID the general definition that's now being accepted is you have to have symptoms for at least three months after suffering from COVID. But the duration unfortunately is unknown. Most people improve in from six to 12 months, but we now have patients, unfortunately, that are suffering from postacute COVID or long COVID for going on two and a half years now, since COVID came to this country.
Maggie McKay: Oh, my goodness. You talked about people who had more severe cases of COVID. So are those people more prone to having long COVID or is it just random?
Dr. Alan Roth: So it is random in the symptoms that people get, but the differentiation is there's really no good correlation to how severe the COVID infection you had initially is. And how long or how bad the symptoms will last. So that patient, for example, that was hospitalized, that was severely ill in the hospital for days or weeks or month. Generally their long COVID symptoms will be similar to what they had in the hospital.
So if they had severe body pain and weakness that severe body pain and weakness would persist. If it's the cardiac kind with chest pain and shortness of breath that would persist. If it was neurologic problems, such as headaches, dizziness, passing out loss of smell and taste and weakness, it would be those symptoms.
Whereas the people who never were hospitalized and were never as sick to require hospitalization, those are the people that are suffering from the severe tiredness, the body pain, just someone touches you and everything hurts. And the severe brain fog and memory loss that are associated with it. That's the most common in the long COVID patients that were not as sick and were not hospitalized. And unfortunately for me, I'm one of them I had COVID in the first wave and I have that triad of the three symptoms of fatigue, myalgia and brain.
Maggie McKay: So you know exactly first hand what you're talking about.
Dr. Alan Roth: I do know what we're talking about. And, unfortunately early on, many of my colleagues were kind of not believing in the symptoms. Many people did not believe in long COVID and some people don't believe in long COVID yet. It's similar to diseases like. Chronic fatigue, or biologic encephalitis, which are these long term syndromes associated with people with other viral illnesses and are suffering from like fibromyalgia and things like that. Many doctors don't quite understand the pain people are suffering, the weakness they're suffering and the neurologic changes that are happening to people.
Maggie McKay: So what percentage of COVID patients develop long COVID symptom?
Dr. Alan Roth: So it's pretty much showing that about 20% of all patients that had any form of COVID, develop long COVID symptoms out of that 20%, the vast majority, probably 75% or so will be better in six to 12 months. But there's about a quarter of people that are suffering from unfortunately much longer symptoms.
Maggie McKay: My goodness. Have the different strains of the virus impacted long COVID symptoms or severity?
Dr. Alan Roth: So it doesn't appear to be there again, appears to be no correlation between the severity of the disease and the strain and long COVID yet. But, you know, that research is ongoing at this point, and it's not exactly clear if one strain, causes one set of symptoms, more than another set of symptoms. We are seeing some less neurologic things like less people with loss of smell and taste, for example, and more people with the fatigue and body pain that they're happening. But it's really evolving now, as we speak.
Maggie McKay: What types of treatment options are available for long COVID patients? Can you please tell our listeners about the services offered at JHCS long COVID care center?
Dr. Alan Roth: So we at, Jamaica Hospital have a post-acute COVID center in our howls tutor site. And our approach is kind of an integrative one. we first look at the symptoms that patients had and what kind of workup they've had. So if someone's already had multiple tests and things, we kind of skip that because there's no specific test for long COVID, but if there's respiratory symptoms, we might do a chest x-ray a CT scan or, breathing test.
If there's cardiac symptoms, we might go that route in evaluating it. But for most of the time we're looking more at symptom specific treatment. And general specific treatment. So if someone is coughing or short of breath, we might use steroids and other kinds of respiratory medicines like bronchodilators and inhalers. If there's neuromuscular things, we might use anti-inflammatory medication, or if there's anxiety and depression, we might use different mood agents, SSRI anti-anxiety antidepressants, or sleep aid.
The more general symptoms of fatigue, body pain and brain fog are more difficult to treat. And we use a much more holistic or integrative approach. So we know nutrition is important, especially in anti-inflammatory kind of diet. We know that long COVID and COVID in general is associated with inflammation. So an anti-inflammatory diet. Avoiding greasy, fatty foods, fried foods, much more fresh fruits and fresh vegetables are associated with lowering the body's inflammation.
We know that exercise in general, connecting with nature, being outside, taking long walks, yoga, Tai Chi, other things that will strengthen the body and relax. The muscles are important as well as the mind, body and spirit. So mind we look at things like meditation. And journaling. We use holistic kinds of therapies, such as acupuncture and massage, as well as various herbal therapies that would boost the immune system. But it really is about mind, body, spirit, diet, nutrition, and a holistic approach to care.
Maggie McKay: I love that Jamaica Hospital Medical Center is covering all the bases, not just the medical needs.
Dr. Alan Roth: Yeah, you have to, you know, the disease is evolving. We know less about the disease than we know about the disease. And it's common with some of these more vague kind of illnesses that we've seen, like fibromyalgia and chronic fatigue syndrome and others. They're not as well known. So you really have to treat the whole person in a holistic way, in an integrative way and deal with the nutrition, the exercise, the mindfulness, the spiritual aspects, where people are not gonna get better. Because there's not like I could say you have long COVID and this is the drug I'm gonna prescribe. It doesn't work that way because we don't have one.
Maggie McCay: RIght. Well, Dr. Roth, thank you so much for all this useful information and I hope you feel better soon from long COVID you
Dr. Alan Roth: Thank you so much. It's been great talking to you.
Maggie McKay: To schedule an appointment at Jamaica Hospital's post COVID center, please call 718-736-8204. That's 718-736-8204. And for more information about the services, Jamaica Hospital offers visit our website at Jamaicahospital.org/podcast. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.
This has been Jamaica Hospital Med Talk. I'm your host. Maggie McKay be well. All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.