Dr. Shai Efrati, director of the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center in Israel, founded Aviv Clinics in The Villages. Efrati spoke to Villages residents Tuesday about how hyperbaric medicine may hold the answer for long COVID patients. Bill Mitchell, Daily Sun
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Long COVID patients stuck with symptoms seek treatment clues

By Curt Hills, Daily Sun Managing Editor |  Feb 23, 2022 Updated Feb 23, 2022

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COVID-19 symptoms are not going away for millions of patients worldwide.

They’re forced into a long haul of continued fatigue, brain fog, loss of taste or a laundry list of other symptoms weeks after their initial infection — thus the term long-COVID is attached to them. 

Both clinicians and researchers say living with lingering COVID-19 symptoms shouldn’t be a life sentence,  because viable treatment plans exist and breakthrough findings offer more optimism for the future. 

The World Health Organization defines long COVID or post-COVID as three months of persistent symptoms, although Dr. Irene Estores, Medical Director of the Integrative Medicine Program at the University of Florida, said symptoms that stretch beyond four weeks is not part of the normal recovery process for the body. 

That’s why Estores and her colleagues at UF Health’s COVID Restore Treatment Program launched it last May to support COVID “long haulers” with a multi-faceted approach, working with patients going beyond four weeks with those agonizing or annoying symptoms. 

“The response should not just be medical,” Estores said of helping long COVID patients. “It’s part of an overall outreach.” 

This UF Health program looks at rehabilitation, evaluation, emotional support, training and outreach to get those with long COVID some relief and answers. 

Although her team isn’t involved in clinical studies, Estores said “research is exploding.”

“We know more than we did two years ago,” she said. 

One researched option is at The Villages. 

Dr. Shai Efrati, director of the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center in Israel, who founded Aviv Clinics in The Villages, said his team’s newly developed research shows that hyperbaric oxygen treatment can regenerate diminished cognitive abilities and rid mental fatigue. 

“This is huge,” Efrati said. “The treatment improved patients significantly.” 

Efrati said his research findings on hyperbaric oxygen treatment will soon be published for other physicians to review. His research targeted 73 patients who had symptoms persist for more than three months, which makes it a chronic condition. His study focused on brain-related symptoms.

Half who received the hyperbaric oxygen treatment reported improvement, participants in the control half of the experiment didn’t. 

“The treatment group improved significantly with everything related to the cognitive function and everything related to the psychological function,” Efrati said.

After control study ended, the other half of participants received the treatment and reported improvement too, he said. 

“The virus can penetrate the cribriform plate, which is right here,” Efrati said, tapping on his forehead above the bridge of his nose. “This is where we are smelling.”

That bone has holes which allow smells to go directly to the brain. Efrati said the COVID virus is entering there with direct access to the brain, penetrating neurons, causing them to malfunction. Certain cells can also become inflammed. It all leads to symptoms such as inability to concentrate, loss of smell, short memory and conditions in which the virus mimics post-traumatic stress disorder. Additionally, the part of the brain that allows us sensory processing, decision-making, and motor control can become damaged, generating body pain.

Efrati said if not for the COVID pandemic, the various symptoms may not have been connected together, and treatment options would have only addressed one symptom at a time. 

“Once we saw biological damage in the brain, we said this wound needs biological intervention to regenerate the tissue. And we can regenerate the tissue with hyperbaric medicine,” Efrati said.

There’s other research quests as well. UF Health Precision Health Research Center’s participation in the Activ 6 clnical trial, that is investigating whether approved FDA-drugs Ivertmectin, Fluvoxamine or Fluticasone can also provide a benefit to COVID-19 patients, accepts study participants for up to 90 days after their initial COVID diagnosis, if they are still experiencing symptoms.

At one stage of research, Director Carla Vandeweerd and her team sent surveys to more than a thousand participants more than 30 days after their original positive COVID test result. Slightly more than half told researchers they still had one lingering symptom, 22.2% said they had two symptoms and 24.7% reported three or more symptoms were ongoing. Two-thirds said confusion or brain fog was still persistent, 40% said breathing was troubled and 38% said they had persistent chest pain or pressure. Loss of taste or smell, fatigue, diarrhea and cough were also reported. 

For severe cases, the problems can run deeper, such as damage to lungs, heart, kidneys, neurological, circulatory system and lingering emotional illness or other mental conditions. It is possible for long COVID to be a disability under the Americans with Disabilities Act, if it substantially limits one or more major life activities. A physical impairment includes any physiological disorder or condition affecting one or more body systems, including, among others, the neurological, respiratory, cardiovascular, and circulatory systems. A mental impairment includes any mental or psychological disorder, such as an emotional or mental illness, according to federal guidelines. 

Long COVID isn’t confined to those who required extensive hospitalization. 

“Interestingly, patients I see had mild symptoms,” Estores said of onset conditions of some of her patients in Gainesville. 

Estores said although there is not an “approved” treatment specifically earmarked for long COVID, experts are finding approved medications for treatment for such diagnoses as chronic fatigue syndrome, are effective for COVID long haulers. 

Long COVID patients are encouraged to ask their primary care physicians if they qualify for COVID Restore treatment program. With a referral within the last 30 days, patients can call 352-265-WELL (9355) to make an appointment. Telemedicine appointments are also available for those who live outside of Alachua County. 

Part of Estores’ effort extends beyond treatment and patient support. Her team provides training for health care professionals in how to better take care of the condition. 

“We want to make sure (the patients) do not feel dismissed or not heard,” she said. “Listening is a part of good doctoring, no matter the condition.” 

Curt Hills is a managing editor with the Daily Sun. He can be reached at (352) 753-1119, ext. 5287, or curt.hills@thevillagesmedia.com.