Dr. Emma Tippett discusses long COVID, Clinic 19 for long COVID patients, challenges in diagnosis and treatment, viral rebound post Paxlovid, metformin efficacy, ivermectin use, POTS, low-dose naltrexone in fibromyalgia, lifestyle factors, hypobaric oxygen therapy, plasmapheresis, Australian government's response to long COVID, and importance of peer support.
Long COVID diagnosis and treatment focus on understanding and managing lingering symptoms post-infection.
Potential predispositions like childhood asthma may increase the risk of developing long COVID.
Treatment strategies for long COVID include addressing symptoms like fatigue, pain, sleep disturbances, and gastrointestinal issues.
Deep dives
Long COVID Diagnosis and Treatment Insights
Long COVID diagnosis and treatment, discussed in the podcast episode with Dr. Emma Tippett, focuses on the challenges faced in understanding and managing lingering symptoms post-COVID infection. Dr. Tippett established a telehealth clinic, Clinic 19, after discovering that 40% of frontline workers developed long COVID. This highlights the need for recognition and treatment options for this condition.
Risk Factors and Protective Measures for Long COVID
Severe acute infection and potential predispositions like childhood asthma may increase the risk of developing long COVID. Protective factors such as vaccination and antiviral treatments like Paxlovid could help reduce the likelihood of long COVID. Factors like mitochondrial dysfunction and viral persistence are being explored as potential causes.
Treatment Approaches and Management Strategies
Treatment strategies for long COVID focus on addressing symptoms like fatigue, pain, and sleep disturbances. Improving sleep quality with supplements like melatonin and managing symptoms using medications like amitriptyline are common approaches. Additionally, addressing gastrointestinal symptoms and considering mitochondrial dysfunction play a role in the holistic management of long COVID.
Diagnosing and Treating POTS
Diagnosing and treating POTS, or Postural Orthostatic Tachycardia Syndrome, can be simplified by using an active stand test that can be done at home with a smartwatch or blood pressure cuff. By measuring heart rate changes and symptoms like dizziness and coloration changes, a diagnosis can be made. Treatment involves high salt intake, up to 3000 milligrams of sodium daily, along with proper hydration. Compression garments can be used, especially for abdominal compression, and pharmacological options like fludrocortisone or midodrine can be considered.
Gastrointestinal Symptoms in Long COVID
Long COVID patients often experience gastrointestinal issues that may stem from gut dysbiosis or mast cell activation syndrome. Treatments like simvastatin, H1 and H2 antagonists, and dietary changes such as probiotics have shown some benefit. Some patients have found relief through small bowel bacterial overgrowth tests and integrative GP treatments. However, a one-size-fits-all solution for gastrointestinal problems in Long COVID remains elusive, with ongoing research exploring various potential therapies.
Dr Emma Tippett MBBS FRACP, PhD completed her medical degree in 2012 and underwent specialist Infectious Disease Physician training in Melbourne and completed her PhD at the Burnet Institute. Since the beginning of the pandemic she has been immersed in all facets of COVID-19 and established one of the first long COVID telehealth clinics in Victoria in 2020 called Clinic Nineteen. In addition, she currently holds appointments at two Melbourne Hospitals.
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