Holistic methods are at the root of long COVID

The COVID-19 pandemic was a threat to public health and safety around the world. The outbreak and spread of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has caused loss of life worldwide.

Long COVID is a term used to describe post-COVID symptoms that may remain present despite recovery from COVID-19 infection. These symptoms vary from person to person and include, but are not limited to: anxiety and depression, extreme fatigue, chest pain and tightness, memory and concentration problems, trouble sleeping, dizziness, joint pain and others. .

More than 20 million American adults are estimated to be living with long COVID, while about 7 million suffer from crippling long COVID.

In January 2022, the long COVID was estimated to have caused a cumulative loss of around $400 billion. This estimate includes medical expenses, lost wages and lost savings incurred by individuals. It does not include costs incurred by government agencies or businesses.

These alarming figures reinforce the need for an urgent holistic approach to the treatment of COVID-19 infection and long COVID.

The causes of long COVID are not easily explained by Western medicine. Theories include excessive inflammation mediated by mast cell activation. However, in Chinese medicine, long COVID is considered to be caused by the exhaustion of the body resulting from the fight against the initial infection, and in some cases the COVID pathogen is still present in the body.

The role of acupuncture in the treatment of long COVID

Several studies have shown that acupuncture can improve long COVID symptoms such as shortness of breath, nausea, insomnia, fatigue, etc. Some of these studies have demonstrated that acupuncture increases the production of nitric oxide which in turn inhibits the replication cycle of the first Severe Acute Respiratory Syndrome (SARS) virus which is similar to SARS-COV2. Clinical features and pathophysiology have also shown that endothelial dysfunction and nitric oxide deficiency contribute to the development of COVID-19. Nitric oxide is suggested to play an important role in protective effects against inflammation and acute lung injury.

In Chinese medicine, it is understood that when the body encounters a pathogen, the body engages its defensive energy layer or Wei Qi in response to the pathogen. This helps push the pathogen out of the body. This defensive response can manifest as fever, sweating, coughing, sneezing, and a runny nose.

With a strong immune system, a person may not even notice that a pathogen has been encountered and eliminated beyond a few sneezes or a light sweat. Alternatively, the patient’s Wei Qi may fight the pathogen for a time before eventually eradicating it from the body. This can make the patient uncomfortable for a long period of time.

When a pathogen is particularly virulent, such as COVID-19, it is able to overcome these defenses and penetrate deeper into the body. Here, certain acupuncture channels will come into action to prevent the pathogen from reaching the most critical areas of the body, i.e. the internal organs.

These channels, called Luo and divergent channels, use the medium of blood and body fluids as a buffer that wraps around the pathogen to keep it in check. At this point, the virus is no longer circulating in the body, so tests may be negative. If the person is relaxed, well rested and nourished, the buffering capacity will be abundant, the pathogen can be successfully controlled and no symptoms will appear.

In cases where the body is strong enough, it will mount what is often called a “healing crisis”, which is an attempt to eject the pathogen outside the body. Symptoms such as high fever with sweating or vomiting and diarrhea are observed when the pathogen is ejected from the body.

When treating long COVID with acupuncture, it is important to determine which body resources are deficient and nurture them accordingly. This diagnosis can be made based on an analysis of the patient’s signs, symptoms, and history. Two indispensable diagnostic tools in Chinese medicine are tongue diagnosis and pulse palpation. After a good diagnosis, an acupuncture treatment can then nourish these overloaded resources.

Chinese herbal medicine and long COVID

Traditional Chinese medicine has been widely used in the treatment of COVID-19 since January 2020. Chinese medicine has a long history in the prevention and control of infectious diseases, such as COVID-19.

There are many herbs that can easily be obtained and taken regularly to prevent COVID infection and even improve immunity. Some of them include ginseng (Ren Shen), astragalus (Huang Qi), Chinese red dates (Jujube), brown sugar and ginger (Sheng Jiang), among others.

In the early stage of COVID-19, there is the manifestation of heat, cold or dampness of the lungs which causes most patients to experience symptoms such as fever, cough, sore throat and chills. Baidoukou (Amomum kravanh), Kuxingren (Semen Armeniacae Amarum) and Houpo (Magnolia Officinalis Cortex) are the three main Chinese herbs used at this stage.

In the middle stage, most patients will have the traditional Chinese medicine plague poison syndrome that clogs the lungs. Kuxingren (Semen Armeniacae Amarum), Shigao (Gypsum Fibrosum), and Tinglizi (Descurainiae Semen) are the most commonly used Chinese herbs at this stage.

In the severe stage, the most common symptoms are dyspnea and coma. Mechanical ventilator and ECMO (extracorporeal membrane oxygenation) are often used. Renshen (Ginseng Radix and Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata) and Shanyurou (Fructus Corni) are the three most used Chinese herbs at this stage.

One herb, Fuzi, has the effect of decreasing heart failure, however, according to some studies, it also has neurotoxicity and cardiac toxicity. Fortunately, the combination with Gancao and Ganjiang can regulate the herb’s efficacy and toxicity.

During the recovery phase, patients often present with the traditional Chinese medicine syndromes of lung-spleen Qi deficiency and Qi-yin deficiency. Fuling (Poria), Fabanxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) are the most commonly used Chinese herbs at this stage.

Lifestyle Modifications in the Treatment of Long COVID

In addition to treating long COVIDs with acupuncture and Chinese herbal medicines, patients are advised to make lifestyle changes. These are generally tailored to individual cases, but there are general tips that will benefit most patients. These include:

  • Diet: food and drink should be taken at warm temperatures. This is to aid in proper digestion. Cold, raw foods should be avoided for people with long-term COVID. In addition, certain foods and drinks are particularly inflammatory and should be avoided. They include alcohol, caffeine, and sugary foods. Foods like chili peppers, garlic and onions should be used with caution. Although they trigger an immune response and may be helpful initially, their continued use strains the immune system and can lead to later depletion of vital energy.
  • Hydration: this is essential as it forms the basis of the blood and fluids the body needs. Body fluids serve both as a vehicle to transport a pathogen out of the body and help create the buffer that holds a pathogen in check. Hydration must go beyond the simple consumption of water. Indeed, it is necessary to consume water in a slower form, which gives the body the possibility of better absorbing it. Therefore, the consumption of moist foods like porridges, broths, soups and stews is encouraged.
  • Sleep: the need for adequate sleep cannot be overstated. Immunity is usually built during sleep. Going to bed before 11 p.m. is advisable, especially in cases where the body’s resources are already quite exhausted.

References

Keng-Chang Tsai, et al. A NRICM101 Traditional Chinese Medicine Formula to Target COVID-19 Through Multiple Routes: A Bedside-to-Bench Study, Biomedicine and Drug Therapy, Volume 133, 2021, 111037, ISSN 0753-3322, https://doi.org/10.1016/ j.biopha.2020.111037. (https://www.sciencedirect.com/science/article/pii/S0753332220312294)

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