Unravelling Long COVID
An authoritative medical reference on the various ways in which Long-COVID presents and an in-depth discussion of its mechanisms and potential therapeutic options.
Unravelling Long COVID aims to provide a better awareness and understanding of the persistent health problems that can arise following SARS-CoV-2 infection. Variously described as Long-COVID, Long-Haulers’ Syndrome, and Post-Acute Sequelae of SARS-CoV-2, this newly-designated disorder is estimated to have affected somewhere between 50 to 250 million people. It is in fact considered by many as the next global public health disaster.
With such a broad and important topic, the authors of Unravelling Long COVID have focused primarily on two major problems in the current understanding of Long-COVID: 1.) the failure to distinguish patients with organ damage—here called Long-COVID Disease – and those with unexplained, persistent symptoms—what is termed Long-COVID syndrome, and 2.) the failure of current medical approaches to comprehend and treat those persistent unexplained symptoms.
Unravelling Long COVID is:
- One of the first books focused specifically on defining and understanding Long-COVID with the goal of establishing optimal management
- A unique reference to distinguish patients with organ damage caused by Long-COVID disease from those with unexplained, persistent symptoms that manifest as Long-COVID syndrome
- An in-depth exploration of neuroimmune pathways to help clarify the previously unexplained symptoms of Long-COVID
Unravelling Long COVID isan essential reference for anyone interested in Long-COVID and the impact that this condition has had on the population. It will be a useful resource for both patients suffering from the Long-Covid syndrome, their physicians and for the growing number of Long-COVID clinics that have been established across the US, the UK, and other countries.
Table of contents :
Section 1 Long-COVID Disease
Chapter 1 Long-COVID Disease or Long-COVID Syndrome?
Defining Long COVID
Long-COVID Disease or Syndrome?
Long COVID in Hospitalized Patients
Long COVID in Non-hospitalized Patients
Comparing Hospitalized and Non-hospitalized Patients
Long COVID in Children
Chapter 2 Lung, Heart Disease, and Other Organ Damage
Persistent Dyspnea, Not Always Correlated with Pulmonary Damage
Is There Unanticipated Long-term Cardiac Damage?
Other Organ Disease
Chapter 3 COVID-19 Direct Effects on the Central Nervous System
There are Multiple Ways for Infections to Disturb the Nervous System
Loss of Senses of Smell and Taste
Hypoxic Brain Damage and the Post-ICU Syndrome
Guillian-Barre Syndrome and Other Neuropathies – Effects of COVID-19 on Peripheral Nerves
Other Neurological Disorders Due to Acute COVID-19
Section 2 Long-COVID Syndrome and Unexplained Symptoms
Chapter 4 Unexplained Symptoms: Medicine’s Blind Spot
Chronic Fatigue in the General Population
Chronic Fatigue in Long-COVID Syndrome
Cognitive Disturbances in the General Population
Cognitive Disturbances in Long-COVID Syndrome
In the General Population
Unexplained Dyspnea in Long COVID
Chronic Pain in the General Population
Chronic Pain in Long-COVID Syndrome
Headaches in the General Population
Headaches in Long-COVID Syndrome
Sleep Disturbances in the General Population
Sleep Disturbances in Long-COVID Syndrome
In the General Population
Mood Disturbances in Long COVID
Chapter 5 Historical Perspectives, Including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Fibromyalgia
Chronic Fatigue Syndrome, Myalgic Encephalomyelitis (CFS/ME)
CFS/ME, Fibromyalgia in Long-COVID
Post-treatment Lyme-disease Syndrome (PTLDS)
Similar Patient Characteristics
Shared Illness Mechanisms
Lessons Learned from CFS/ME, Fibromyalgia, PTLDS
Syndrome, Disease, and Diagnostic Labels
Infection and Causation
Patient-Physician Information and Misinformation
Mind or Body?
Section 3 Mechanisms and Pathways
Chapter 6 Brain Homeostasis Run Amok
Brain Homeostasis in Health and Disease
Our Physical Brain Regulates Our Thoughts
Brain Circuits and Networks
Detecting Structural and Functional Brain Changes
Changes in the Autonomic Nervous System, Neurohormones, and the Stress Response
Chapter 7 Neuroimmune Dysfunction
Is Long COVID an Autoimmune Disease?
Evidence that Long-COVID Syndrome is a Neuroimmune Disorder
Cytokines and the Brain
Autoantibodies in Long-COVID Syndrome
Can Vaccines also Cause Autoimmune Reactions?
Immune Tests for Long COVID
Neuroimmune Studies in CFS/ME, Fibromyalgia, and Depression
Is a Unifying Theory of How Long-COVID Syndrome Develops Possible?
Section 4 Evaluation and Management
Chapter 8 Patient Evaluation and Research
Need: Widely Accepted Long-COVID Term and Case Definition
Need: Uniform Symptom and Outcome Measures
Initial Evaluation, Primary Care Role
General Clinical Research
Chapter 9 Patient Management and Rethinking Healthcare Amid Long COVID
Pulmonary and Physical Rehabilitation
Evaluate and Treat Autonomic Dysfunctions and Postural Orthostatic Tachycardia Syndrome
Medications and Other Therapies
Health Coverage, Disability
Rethinking Healthcare Amid Long COVID
Dealing with Medical Uncertainty
Integrated, Patient-centric Care
A Biopsychosocial Illness Model
Chapter 10 The Way Forward: For Patients, Healthcare Providers, and Research
Do I have Long COVID?
Where Do I Go for a Diagnosis?
Assessing Illness Severity
General Principles You Should Know
Who Do You Listen To?
Avoiding Misinformation and Disinformation
Disability and Disability Insurance
Biopsychological Perspectives to Remember
For Healthcare Providers
Making the Diagnosis
Research, Patients, and the Public
Basic Scientific Issues
Bringing Long-COVID Patients and Researchers Together
A New Chronic Illness Strategy
Appendix A Long-COVID Clinics in the US and Europe
Appendix B Suggestions for Future Research Focused on the Cellular and Molecular Basis of Long-COVID Syndrome
Hypothesis 1: Brain-restricted Autoimmunity causes Long-COVID Syndrome
Evidence in Long- COVID
How Else Might SARS-CoV-2 Infection Influence the Immune Response Leading to Long COVID?
Hypotheses 2: SARS-CoV-2 Infection Alters the Microbiome, which in turn Initiates Long-COVID Syndrome
What is the Microbiome and How does it Affect Immunity and the Brain?
The Microbiome in COVID-19 Patients and in Individuals with Long-COVID Syndrome
Hypothesis 3: Long-COVID Syndrome is Related to Persistent SARS-CoV-2 Virus or Virus Fragments Sequestered in Brain Cells