#61

Yale is one/the leading places for long Covid research.

One of their trials, (note) in a different context where people already have long covid, will use the Paxlovid protocol linked below, even longer than the 7-10 days I mentioned above.

Personally I’d see if any creative possibilities to get another 2-5 extra days supply (pending your individual profile, liver health, etc of course). (It’s not the standard in the US either but I know several people who did it that way).

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#62

I just had my rapamycin dose and 2 days later I contracted COVID. What should I do in this case? I’ve taken pea (600mg) and melatonin (400mg). Within 3 hours my headache is gone but I still have a general tiredness and fever. According to Doris Loh I need to take 5500mg of melatonin. Anyone has experience with this?

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#63

Just here to say I hope you get well very soon!!

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#64

i wish there is something else i can do to get better quicker … lol… like jump into the sauna or spa but I dont think that is a good idea.

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#65

Your profile doesn’t say how old you are, but if you don’t have major co-morbities and are <65 years old … this is a cold. I get exposed literally 15+ times per week to covid. Not worried and rapamycin should make your likelihood of ending up really sick from it minimal. For those over 65 years old or with complex medical history, there is a role for Paxlovid.

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#66

I’m 50 years old. About 110kg. I probably shouldn’t have gone scuba diving last night as I was beginning to feel unwell. I’m 177cm. Just the fatigue is worse than rapamycin. My wife had COVID a few days earlier but I didn’t think I’ll get it :joy:. I woke up at 2 am with a really bad headache so I took more melatonin and pea then. I’ll be fine but just annoying to be weak. This month is a seafood run to catch lots of crabs and lobster and prawns :laughing:

I’ve sporadic coughing. Green/orange phlegm. Tempting to start on amoxicillin.

On a side note because most people do not take GFJ with rapamycin, they might not have enough in their blood to get fatigue which explains why a lot of people don’t get fatigue. After all not everyone have the luxury of testing the blood level anytime they want.

I’ve a question. Since contracting COVID my blocked nose completely cleared up. A friend of mine had the same experience. I didn’t lose my taste buds this time.

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#67

@DrFraser Ive been looking into long covid recently. I’ve heard on a podcast with David Putrino PhD the director of rehabilitation innovation for the Mount Sinai Health System that we all have a 1-in-10 chance of “getting” long covid each time we are infected with covid regardless of comorbidities or vaccinations or prior covid infections. Below are more specific statistics from a paper by Eric Topol in Nature:

“The incidence is estimated at 10–30% of non-hospitalized cases, 50–70% of hospitalized cases2,3 and 10–12% of vaccinated cases4,5. Long COVID is associated with all ages and acute phase disease severities, with the highest percentage of diagnoses between the ages of 36 and 50 years, and most long COVID cases are in non-hospitalized patients with a mild acute illness6, as this population represents the majority of overall COVID-19 cases.“

This doesn’t read like a risk to disregard just because a person is healthy and young. As I am healthy and not young I am actively avoiding COVID. I had my 3 vaccine shots but no boosters. And I’ve never had Covid as far as I know.

Avoiding Covid as a way to avoid long covid seems like an important longevity and healthspan play.

Thoughts?

https://www.nature.com/articles/s41579-022-00846-2

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#68

I’d simply point out that the issue of whether long covid even exists is an area of debate. I think it does. So I have over 100 EM physicians and at least as many PA/NPs that I’ve worked with over the last 4 years. We’ve all had covid at least twice (diagnosed) and likely more than this, and I know of 1 individual out of all of this who had some longer term effects which have now resolved fully.

I have very rare patients come to me for long covid, but depending upon one’s definition, I’d simply say, in general, healthy individuals are very rarely afflicted in this way. Unhealthy individuals often just need some insult to their system to take them down and Covid, flu, pneumonia, UTI, cellulitis, trauma can all be initiating events. I don’t hear people talking about long Trauma … guess what, that will give you a syndrome pretty similar.

The punch line is look at the host and recognize that for you, being fit and healthy, this is a cold and nothing exciting, for a 400 lb 75 year old with 6 comorbidities, yes, they might get in trouble, but it wouldn’t matter what insult to their system occurred, it’ll take them down.

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#69

@DrFraser I hope you are right. I worry that you are not right.

Of course a sickly person is at risk for anything that pushed them over the edge. This seems to have another layer of risk.

The word on the street is that healthy people are brought down by long covid. 10% or higher chance. The nature paper I posted seems to agree with this (am I mistaken?).

I wouldn’t think twice about long term effects of a cold. You haven’t convinced me yet that covid is just a cold.

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#70

My experience fwiw- I’m a healthy mid 50’s person with no diagnosed comorbidities and ended up with long covid last year. I was recovering nicely until I was required to work multiple 12 hour shifts back to back in an n95 while positive and symptomatic. I was on my feet in an ICU environment most of the time and it was difficult to stay hydrated due to not wanting to remove my mask around others. I doubt I would have ended up with long covid if I’d been able to rest and hydrate properly. Honestly that was a big factor in my choice to take an early retirement. Although (thankfully) the Pfizer vaccine resolved my long covid symptoms within one week of taking the shot I felt it was not helpful for my longevity efforts to stay in a job where I could not take off work and take care of myself if necessary.

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#71

@blsm Thanks for sharing. I believe your experience is similar to many other people… millions of people, many of whom were or thought they were completely healthy prior to getting Covid and then have long term effects.

The micro blood clots was the thing I heard about first years ago. This may be the cause of the mitochondrial problems that seem (my bias?) to underlie the symptoms of fatigue and brain “fog”.

Recent studies of long covid suffers has shown that they (generally) have low morning cortisol and low serotonin (covid related gut issues?). Other studies had been described to me as showing low mitochondrial activity in long covid patients. The scientists believe it is a combination of factors from non clearance of the virus…to auto immune problems…to blood clots …to blood brain barrier damage…to gut health problems.

I don’t know what to make of all of this information. I think it’s right to be very careful. Most people will be lucky and not have problems. But past successes in getting past COVID doesn’t seem to mean you are immune to this outcome.

I’m glad I was vaccinated as that seems to reduce the chance of poor outcomes.

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#72

It depends on the case definition. My real life experience is consistent with this review in BMJ.

This discussion in the guardian which is sourced from the minister of health in Queensland reflects a reasonable summary of the facts.

Anyway, yes there are individuals who get knocked down as a result of any insult to the system. However, the case rate is very low. I personally treat over 500 patients each month between the ER and my private practice. It should be 20% of these folks with long covid (as almost everyone has had is >=2 times) if the 10% each infection were true. Yet, I’ve maybe had 3 people out of the 6000 I’ve seen in the last year with a concern about long covid - it should have been 1200.

It’s not that I don’t believe that individuals are rarely taken down by covid - very rare these days, it is the extent of this being massively overblown. It has now been 18 months since I’ve admitted a patient because of covid. I’ve admitted many with covid, but any minor insult would have been enough to get these patients in hospital.

So Jo, I’d decrease your level of worry on this. I have the luxury of being exposed to covid, flu, RSV at least 20 times per week. It’s a get thing in this setting as I haven’t had a cold in >18 months despite all this exposure.

I also don’t want to minimize this condition, for elderly/frail individuals, there are a whole bunch of things they should avoid, this being one of them.

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#73

You know I love and respect you Grant, so I believe you 100% that is your experience, and it’s why I’ve wondered if there are regional strains because in my tiny neighborhood (maybe 55 full time residents), in the last two years, I’ve known quite a few very healthy people, but not young, get VERY sick from covid. Much worse than a flu. Over the summer, two friends said it was the sickest they’ve ever been (one was 58 and is the healthiest person I know, and she came close to going to the hospital, but then paxlovid turned things around on a dime… and another aprox 70). Another guy here who is probably 53 was sick for 3 weeks. Another neighbor who is aprox 65 got covid and months later had a stroke (her doc believes it was from covid, but of course no one can ever know). This is just my sampling out of a tiny population.

Everyone is fine and has since recovered, but it was nothing like a cold for them. Of course I do know many people who say it’s almost nothing. I believe you don’t see this, and that is what is interesting to me.

And Joe, I’m with you… I don’t care about feeling awful for a week, but I fear long covid.

And wow, BLSM, having to work in that condition sounds dreadful. Glad you are fine now!!

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#74

So no significant regional variations in the U.S. if you look over longer time periods, pretty much the strains make their way across the country. The outcomes match health status. So in TN where I work, we had a higher death rate early on. It’s important to differentiate between alpha and delta variants early on and what we have now.

I was petrified working in the ER early on, and have a PAPR full face sealed in with battery pack and blower that I wore 100% of the time. So yes, early on alpha and delta were very concerning and yes, lots of people had severe consequences. I’m not seeing any of those lately, and I’m working in the setting where I’d be maximally aware of this.

From my experience, for the last 2 years, this is simply a cold for most people. Rarely (not 10%) we see some short term health complications, but not generally unexpected ones given overall health status. Back at the beginning I saw several young individuals get taken down by alpha and delta - I’ve been there as the one placing an airway and managing. Certainly scary. This however has evolved and I think for most healthy individuals, life should go on without undue worry or fear about this. If high risk or >65 (in AU it is 70 years) then getting an antiviral as early as possible is sensible.

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#75

I guess this finally makes sense to me. I am just hearing experiences of people getting it who are staying home. You are seeing if people end up at work in the ER. As sick as they were, none of my neighbors have gone to the hospital. Just wasn’t similar to a cold for this bunch. But yes, definitely, they are still the minority.

Oh, early on was scary scary! I can’t imagine having to work in the ER… so thank you for your service!!

Way back when, in the olden days, no one I knew of in CA died (one person was close but he pulled through). Another friend here, who is an uber healthy early 50’s guy, was the first person in my town to get it and was in the hospital briefly and had symptoms for my months.

But then my sister, on the east coast, knew SEVERAL people who died. A couple were under 65, and very, seemingly, healthy. In fact, the aprox 60yo athletic and thin guy she had dated was the first person to die in VA. People here, because they didn’t know anyone, kept pooh pooing me saying it’s only the frail elderly dying. I said my sister’s friends are dropping like flies!

Edit: i was curious and googled and he was not the first guy in VA… perhaps it was in his city in VA… he didn’t feel well and went to the hospital but they said he wasn’t sick enough and wouldn’t admit him… he died at home that night.

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#76

Perhaps there is something a bit unique about me that made me vulnerable to long covid? I did have CFS/ME, another post viral syndrome, for 13 years from 1999-2012 and was basically belittled and dismissed as a hypochondriac during that time and had to figure out how to help my body heal on my own. I can’t help but feel that my inhumane work conditions played a large part in my long covid though. Thankfully it wasn’t nearly as severe or long lasting as the CFS/ME.

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#77

I’ve continued to explore this topic as I am confused about the wide range of opinions from credible sources.

I’ll share some links to illustrate the range. The idea that COVID is just a cold if you are a healthy person hasn’t been expressed anywhere but on this forum so I don’t have any information in support of that opinion.

The article in Slate which downplays Long Covid as “overblown” (and which resulted in a vigorous backlash letter to editors shared below), actually says long covid is real…it’s just not as prevalent as feared. Still, ~10% of Americans believe they suffer from some form of long covid. Are they right? It’s a poor source of info but something is going on.

Ben Levine (with Rhonda Patrick) says briefly that of ~1600 college athletes tracked after getting COVID, <1% had lingering symptoms. Levine says exercise is the key to full and fast recovery. The NIH has invested in this idea but many experts say it backfires (worsens symptoms) too often.

Covid still feels like an unknown to me. Since I rarely get sick at all perhaps my risk of infection is low. Perhaps that also means I will not have blood clots and mitochondrial dysfunction post infection. But it does feel like some risk remains. I don’t think about getting cancer every day but I do manage my life to avoid carcinogens.

Slate Retraction Letter.pdf.pdf (177.5 KB)

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#78

My sister-in-law got one of the earlier versions of COVID at the start of the pandemic and it caused her kidneys to fail. Now she’s on constant dialysis and she’s only 45. Poor girl.

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#79

Sorry about that. I think at the time nobody knows what to do. I’m in Australia at the time and we were locked down from the rest of the world. As soon as I hear of an outbreak I was tempted to catch it because no. 1 there are not a lot of people here infected. 2. It is the best way to gain immunity

#80

I’m a huge fan of Dr. Seheult and certainly respect his opinion as a pulmonologist.

To be perfectly honest I don’t think there is a huge worry of long covid for someone as healthy as you Joe but of course I’m no one-just an unqualified retired respiratory therapist/stranger on the internet. Like Dr. Fraser I was exposed regularly and nothing terrible happened until I was required to sacrifice my own wellbeing and work when I should have been resting. While that’s noble and all and I’d do it again for my family and friends I will never do it again for a hospital corporation that only cares about their bottom line.

The backlash against long covid is understandable because there are always people who will latch onto any excuse they can find to not work. Just because there are people who will try to take advantage doesn’t mean it doesn’t exist though. I personally did not receive any compensation whatsoever from my employer or government when my ability to work was impacted. It would have been much better for me financially if I’d been able to continue working full time. I made the difficult choice to sacrifice financially for my health.

I’m not surprised that the views on long covid are all over the place. When I was diagnosed with CFS/ME in 2002 it was viewed very disparagingly and basically treated as a psychiatric illness. Medicine notoriously doesn’t do well with things they don’t fully understand and/or can’t easily treat and those conditions usually get thrown in the psych bucket.

Please forgive me if this is offensive to you or anyone. It’s just my personal opinion fwiw.

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