Helping patients recover with ongoing support

Photo Cred: Kelli Tungay/Unsplash

By Carolina Brooks, BA, IFMCP

As the world slowly begins to reopen amid the novel coronavirus (COVID-19) pandemic, many patients are seeking advice from their practitioners on what they can do to continue to prevent severe infection as we continue to learn more about how the virus presents and who may be vulnerable to severe symptoms.

The April 2020 research letter in the Journal of the American Medical Association looked at a sample of adult patients in California who tested positive in March for SARS-CoV-2, the strain of coronavirus that causes COVID-19, and the most common comorbidities present. These included hypertension, diabetes, chronic kidney disease, chronic obstructive pulmonary disease (COPD) or asthma, and congestive heart failure, which are all diseases of inflammation and oxidative stress.

A June 2020 original investigation in the journal JAMA Pediatrics looked at the epidemiology, clinical features, and disease severity in pediatric hospital patients who tested positive for SARS-CoV-2 in New York and discovered that obesity was the most common comorbidity, and acute inflammatory markers and lymphopenia were common, but interestingly, immunocompromised patients were not presenting with severe disease.  

The overriding message that must be emphasized is that we, as practitioners, should encourage patients to commit to significant lifestyle changes to address these comorbidities such as hypercoagulabilty and obesity to reduce risk of severe disease complications from COVID-19.

For example, I am advising these patients, and everyone for that matter, to adopt healthy practices and ramp up the plant foods in their diet to maximize intake of antioxidant compounds, which favor endothelial health, such as polyphenols, carotenoids, lignans, and stilbenoids.

As case numbers in some regions start to fall, I am now seeing new patients who received positive diagnoses, and are finding it extremely difficult to shake certain symptoms, namely pulmonary pain and fibrosis, and continued difficulty breathing, significant post-viral fatigue, suppressed immune function, and tissue damage. Common clinical findings on blood markers tested approximately four to six weeks after a positive result has been confirmed include raised monocytes, suppressed lymphocytes, slightly raised red blood cells, and low haemoglobin levels, while inflammatory markers are often raised. Medicinal mushrooms such as reishi, maitake, and cordyceps have been extremely valuable in restoring white blood cell function, while herbs such as milletia and dong quai support red blood cell restoration.

For broad immune support, I have recommended echinacea, cat’s claw, eleuthero, tinispora, and astragalus. Dong quai is also a useful lung tonic, particularly when combined with licorice, cinnamon, and thyme, as a persistent cough lasting weeks after severe symptoms have passed has been a frequent complaint. Anti-histaminic, demulcent, and anti-inflammatory herbs such as tulsi, lavender, and plantain are useful to reduce irritation and inflammation and these can be used in a spray bottle directly on the throat.

Several patients who previously had their autoimmune diseases in remission are finding they are flaring again and are not responding to their immune-stabilizing protocols as they were before. A 2020 letter in Clinical Immunology discussed patterns of cross-reactivity between SARS-CoV-2 spike protein and the discovery of reactivity with autoimmune target proteins, including transglutaminase 2, transglutaminase 3, myelin basic protein, thyroid peroxidase, and collagen. This reactivity may explain why tissue damage caused by the virus affects organs and tissues beyond the respiratory system. For these patients, I have been using high doses of vitamins A, vitamin D, and quercetin, alongside omega 3 fatty acids, zinc, and short-chain fatty acids to support microbiome health and immune stabilization.

To restore energy levels and correct hypothalamic-pituitary-adrenal function, I’ve been using a lot of different adaptogens, such as maral root, eleuthero, and gotu kola. These herbs also enhance tissue restoration and help to reduce scar tissue, while many of these herbs also have good anti-viral action. For those who had experienced anosmia, we used bitter herbs such as berberine, gentian and artichoke to stimulate secretions and restore their sense of smell.

Sleep and stress management are key, particularly as many patients have reported serious difficulties with sleep due to financial worries and concern for their parents as restrictions lift,  and I am using herbal tisane combinations including herbs such as hawthorn, lime flower, passionflower, and agrimony, as well as lavender for antimicrobial, cardiovascular, nervous system, and gut support, along with more aggressive tincture blends where necessary. Many female patients also complained of menstrual irregularities during their April cycle, noticing it had either become extremely short or it did not appear at all. These irregular cycles have lengthened or reappeared. A loss of libido has also been a common complaint amongst patients.

Castor oil packs on the lung area and repeated sessions of frequency specific microcurrent has been an extremely useful tool for those who have experienced lung fibrosis secondary to SARS-CoV-2. Sadly, hyperbaric oxygen therapy has not been an option for most as the centers have all remained closed, although as we return to some semblance of normality once more, patients should start to be able to access crucial resources and centers.

References

Myers LC, Parodi SM, Escobar GJ, Liu VX. (2020) Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California. JAMA. 2020;323(21):2195–2198. Retrieved from: doi:10.1001/jama.2020.7202

Vojdani A, Kharrazian D (2020) Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clinical Immunology Volume 217, August 2020,   Retrieved from: https://doi.org/10.1016/j.clim.2020.108480  

Zachariah P, Johnson CL, Halabi KC, Ahn D, Sen AI, Fischer A, Banker SL, Giordano M, Manice CS, Diamond R, Sewell TB, Schweickert AJ, Babineau JR, Carter RC, Benster DB, Orange JS, McCann TA, Kernie SG, Saiman L (2020) Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York. JAMA Pediatr. Retrieved from: doi:10.1001/jamapediatrics.2020.2430