Long Haul COVID Syndrome (LHCS)—commonly known as long COVID—is characterized by prolonged malaise, headaches, generalized fatigue, sleep difficulties, hair loss, smell disorder, decreased appetite, painful joints, dyspnea, chest pain and cognitive dysfunction.
Up to 80% of patients experience prolonged illness after COVID-19. Long COVID is not only seen after COVID infection but is also being observed in some people who have received vaccines (likely due to monocyte/microglia activation by the spike protein from the vaccine). Long COVID may persist for months after the acute infection and almost half of patients report reduced quality of life.
Patients may suffer prolonged neuropsychological symptoms, including multiple domains of cognition. A puzzling feature of long COVID is that it is not predicted by initial disease severity; it frequently affects mild-to-moderate cases and younger adults who did not require respiratory support or intensive care.
The symptom set of long COVID is, in the majority of cases, very similar to chronic inflammatory response syndrome (CIRS)/myalgic encephalomyelitis/chronic fatigue syndrome. An important differentiating factor from CIRS is the observation that long COVID continues to improve on its own, albeit slowly in the majority of cases.
Another important observation is that long COVID includes more young people compared to severe COVID, which affects older people or persons with co-morbidities.
Long COVID is highly heterogeneous and likely results from a variety of pathogenetic mechanisms. Furthermore, it is likely that delayed treatment (with ivermectin, etc.) in the early symptomatic phase results in a high viral load (high spike protein load), which increases the risk and severity of long COVID.
The approach outlined in the I-RECOVER: Long COVID Treatment Protocol is a consensus based on a collaboration led by Dr. Mobeen Syed (“Dr. Been”), Dr. Tina Peers, and the FLCCC Alliance. The approach should be individualized according to the patient’s clinical signs and symptoms.
As with all FLCCC protocols, aspects may change as scientific data and clinical experience in this condition evolve. Thus it is important to check back frequently to receive notification of any protocol changes.