Volume 9, Issue 2

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Page 4 of 35 | # 46 | Page 5 of COVID-19 Analysis By Dr. Joseph Mercola You may have seen reports about COVID-19 pa ents who seem unable to fully recover. Some complain of lingering chronic fa gue symptoms. Others struggle with mental health problems. In fact, a study from Oxford University published online November 9, 2020, in The Lancet Psychiatry, found 18.1% of individuals diagnosed with COVID-19 also received a first- me psychiatric diagnosis in the 14 to 90 days a erward. Most common were anxiety disorders, insomnia and demen a. A similar trend was also observable a er COVID-19 relapses. Interes ngly, people with pre-exis ng mental illness were also found to be 65% more likely to be diagnosed with COVID-19 than those who did not have a pre-exis ng psychiatric problem. Now, while this may sound terrifying, I would point out that, given the fear mongering surrounding COVID-19, it's not surprising that receiving a diagnosis would trigger anxiety and insomnia in many. It doesn't mean you end up with a chronic psychiatric disorder. It just tells us that ge ng a COVID-19 diagnosis is very stressful, even if you remain asymptoma c. The link to demen a is interes ng, however, and likely needs to be looked into further. This also applies to the higher risk of COVID-19 if you have a pre-exis ng mental health problem. It's possible that people struggling with depression, anxiety and similar disorders are simply more likely to get tested for COVID-19 — and end up receiving false posi ve diagnoses. As discussed in "Asymptoma c 'Casedemic' Is a Perpetua on of Needless Fear," mass tes ng of asymptoma c people doesn't tell us anything of value since the test cannot discern between an ac ve infec on and the presence of nonreproduc ve (harmless) virus. It only makes the pandemic appear graver than it is. That said, going through a severe bout of COVID-19 is also going to take a mental toll. As reported by a 40-year-old previously healthy man who underwent an apparent recurrence of COVID-19, a er three weeks of fa gue, he started feeling "completely overwhelmed" and for the next 72 hours, he "felt unwell in a way that was bordering on not coping." He says he "felt physically exhausted" and "mentally drained." Severe illness will do that. He says it took him nearly eight weeks before he started feeling "close to my normal self again," but even then, he s ll struggled with "fa gue to the point of having to sleep in the day" and an inability to exercise. COVID-19 'Long-Haulers' He's not alone in repor ng such symptoms. An es mated 10% of pa ents treated for COVID-19 report fa gue, breathlessness, brain fog and/or chronic pain for three weeks or longer. This phenomenon occurs even among pa ents who had mild cases of COVID-19. Lingering Side Effects U.S. Centers for Disease Control and Preven on data show the rate of COVID-19 pa ents who con nue experiencing lingering health problems a er recovering from acute COVID-19 may be as high as 45%. Only 65% report having returned to their previous level of health within 14 to 21 days a er receiving a posi ve test result. Treatment Guidance for Post-Acute COVID-19 The good news is that, according to an August 11, 2020, ar cle in The BMJ, which provides post-acute COVID-19 primary care guidance, many of these "long COVID" pa ents do spontaneously recover — albeit slowly — "with holis c support, rest, symptoma c treatment and gradual increase in ac vity." To support recovery, the ar cle suggests that: "… pa ents should be managed pragma cally and symptoma cally with an emphasis on holis c support while avoiding over-inves ga on. Fever, for example, may be treated symptoma cally with paracetamol or non-steroidal an -inflammatory drugs. Monitoring func onal status in post-acute COVID-19 pa ents is not yet an exact science. A post-COVID-19 func onal status scale has been developed pragma cally but not formally validated … Referral to a specialist rehabilita on service does not seem to be needed for most pa ents, who can expect a gradual, if some mes protracted, improvement in energy levels and breathlessness, aided by careful pacing, priori za on, and modest goal se ng. In our experience, most but not all pa ents who were not admi ed to hospital recover well with four to six weeks of light aerobic exercise (such as walking or Pilates), gradually increasing in intensity as tolerated. Those returning to employment may need support to nego ate a phased return."

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