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Long COVID Syndrome

Acute COVID infections may be on the decline but chronic or long hauler COVID is becoming more apparent and disabling for many individuals. Post-COVID Syndrome is characterized by persisting symptoms of fatigue, brain fog, shortness of breath, and malaise following COVID-19 infection. These negative effects often last weeks and even months beyond the acute and natural course of the infection. New research is beginning to unravel the mystery of these debilitating and persisting symptoms as well as providing direction and treatments that can help individuals recover while eliminating the chronic symptoms. 

Risks and symptoms of having long COVID

The risk of developing post-COVID symptoms increases with the severity of the initial infection, with half of hospitalized patients having at least one persisting symptom 30 days post-discharge. For symptomatic patients who were not hospitalized, approximately 27% had at least one lingering symptom lasting beyond 30 days. Specific symptoms also varied between children and adults with children more likely to have GI symptoms and adults more likely to have elevated cholesterol post-COVID.

It is estimated that 10-30% of COVID-19 patients will become long haulers, indicated by the persistence of at least one symptom.1,2  The most commonly reported symptoms have been chronic pain, debilitating fatigue, malaise or lethargy, and brain fog or concentration problems. Other individual symptoms have included coughing and shortness of breath, cardiac dysrhythmias, insomnia, anxiety, depression, joint pain, headaches, hypertension, hair loss, GI discomfort including diarrhea, loss of appetite, and weight loss.

Causes of Long Covid

  • Chronic inflammation

One of the leading theories on the root cause of post-COVID symptoms arises from decades of research on how viruses elevate pro-inflammatory cytokines within the immune system. The immune activation arises from a persistent virus, viral fragments, or reactivation of a latent virus (think about shingles or Epstein-Barr Virus as examples) which increases the production of immune cytokines leading to elevating inflammation as a result. It is clear based on a preponderance of symptoms that much of the inflammation often settles in the brain or spinal cord, lungs, and heart.

  • Chronic hypoxia(low oxygen)

In other studies, COVID-19 has been associated with neurovascular and genetic changes in the brain cells that affect the distribution of oxygen in the brain. The result is chronic hypoxia resulting in reduced cognitive functioning as well as mental well-being.3

  • Vagus nerve dysfunction

In other new research on long COVID, symptoms have been correlated with functional changes in the vagus nerve. The vagus nerve originates from the brain and travels through the body to connect and control the heart, lungs, intestines, and muscles of the esophagus. Special imaging of the vagus nerve in the neck, and torso found evidence of nerve thickening suggestive of chronic inflammation. Symptoms of vagus nerve dysfunction (VND) include a high heart rate, dizziness, impaired breathing, low blood pressure, diarrhea, difficulty swallowing, issues with the voice, and changes in sweating.

Therapies for recovery from Long Covid

With fatigue and brain fog as the two most commonly reported symptoms following COVID-19 infection, and with inflammation and hypoxia as the leading root causes of fatigue and brain fog, trials of hyperbaric oxygen therapy (HBOT) have been encouraging. HBOT is validated to lower inflammation by increasing levels of oxygen within the blood and tissues of the body, including the brain. This creates an ideal environment for the body to heal and repair. Hyperbaric oxygen therapy has been demonstrated to reduce hypoxia(low oxygen) and neuroinflammation, while increasing circulation in the brain, supporting the blood-brain barrier, and promoting angiogenesis (new blood vessels) and neurogenesis (the growth and development of nervous tissue). Studies conducted with HBOT for the treatment of traumatic brain injuries, which result in significant inflammation in the brain and hypoxia, show a reduction of brain edema even after three 45-minute sessions. In the first published study of HBOT for evaluation of long COVID-related fatigue and brain fog, a significant benefit was found in just 10 sessions over a two week period.4 HBOT is an extremely safe and effective therapy that holds great promise for recovery from the leading long COVID symptoms.

  • Anticoagulant Therapy

A leading root cause and concern for long COVID symptoms is associated with persisting circulating microclots.5 Microclots are a result of inflammation leading to an increase in hypercoagulation (thicker blood) and platelet hyperactivation (more clotting) secondary to COVID infection. Microclots are known to block the smallest vessels known as the microcapillaries and as a result, block oxygen exchange leading to hypoxia. This fits with the findings and potential benefits of HBOT in improving circulation by increasing oxygen in the body. In addition to HBOT, OTC prescriptions, and natural enzymes can be dosed to improve blood flow and reduce the effects of microclots. 

One of the most frequently evaluated therapies outside of antivirals and vaccines for treatment and recovery from COVID has been ozone therapy. Ozone therapy applications have varied between rectal ozone to a special form delivered by treating an individual’s blood with ozone to enhance immunity and reduce inflammation. In a recent study on patients with long COVID symptoms, 67% were able to recover normal functionality and relieve the pain and discomfort with blood-treated ozone therapy.6 Our experience in the clinic since the onset of COVID is consistent with these findings with the most frequently reported improvements being recovery of energy and diminished brain fog and clearer cognition. 

The location and effect of long COVID symptoms have been broad, varied, and often multisystem including the brain, lungs, heart, sense of smell, speech, and peripheral nerves, to name a few. With the variety of locations and unknown long-term effects from COVID still mostly unknown, FSM therapy allows us to treat a variety of concerns simultaneously and in ways not available from herbs, nutrients, or medications. FSM therapy delivers precise frequencies, based on reported symptoms, to reduce inflammation, increase ATP, and restore normal function. The treatment involves applying electrodes or warm towels to conduct a small current from head to toe in order to restore optimal function to malfunctioning tissues. FSM therapy is synergistic with HBOT and Ozone therapy and supports reducing inflammation in the brain.

We still have much to learn, but research from around the world is expanding our view and allowing us to provide therapies and hope for those with persisting or long COVID symptoms. Newer options for lab testing now include panels for Long COVID and pathways of inflammation triggered by long COVID beyond just C-Reactive protein and sedimentation rate. Please call to schedule a consultation and meet with our physicians trained to help you recover your best self.


  1. Rita Rubin, MA, As Their Numbers Grow, COVID-29 “Long Haulers” Stump Experts. JAMA. 2020;324(14):1381-1383.
  2. A Detailed Study of Patients with Long-Haul COVID. A FAIR Health White Paper, June 15, 2021
  3. Kamen A Tsvetanov et al. Hospitalization for COVID-19 predicts long lasting cerebrovascular impairment: A prospective observational cohort study. medRxiv. February 11, 2022.
  4. Tim Robbins et al. Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention. Clinical Medicine. 2021; Vol 21(6):629-32.
  5. Etheresia Pretorius et al. Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin. Cardiovascular Diabetology. 2021; Vol 20: 172.
  6. U Tirelli et al.  Fatigue in post-acute sequelae of SARS-CoV2 (PASC) treated with oxygen-ozone autohemotherapy – preliminary results on 100 patients. Eur Rev Med Pharmacol Sci. . 2021 Sep;25(18):5871-5875. doi: 10.26355/eurrev_202109_26809.