The world clock has just ticked past two years since the COVID-19 pandemic started. And while news has focused largely on prevention and acute care, with many a business or livelihood thrown into the balance due to prolonged lockdowns, a lesser discussed issue has been waiting to surface. That is the issue of long-covid and how we care for people whose systems have failed to bounce back to their prior strength post-virus.
It has been reported in literature that some 27% of sufferers may experience symptoms after 60 days, with women more likely to fall victim to long covid . Symptoms that may appear as part of long covid include “palpitations, chronic rhinitis, dysgeusia, chills, insomnia, hyperhidrosis, anxiety, sore throat, and headache among others ”.
The phenomenon is still emergent and thus the lack of guidelines for diagnosis and management means this is an important area for discussion. When taking on this complex issue, a recent paper authored by Charles Blum, pointed out the following :
“One huge challenge in treatment of Long COVID disorders in the future will be unravelling the tangled threads of whether a presenting condition is directly related to the virus’ affect on the body or possibly just the social implications of dealing with the pandemic and the ability of a subset of patients to cope.
For instance, a syndrome termed Covid Stress Disorder, ‘consists of five inter-correlated elements: (a) fear of SARSCoV2 infection and fear of coming into contact with objects or surfaces contaminated with the coronavirus; (b) fear of socio-economic impacts of the pandemic; (c) fear of foreigners for fear that they are infected; (d) pandemic-related compulsive checking and reassurance-seeking; and (e) pandemic-related traumatic stress symptoms. A severe form of the syndrome, characterized by clinically significant distress and impairment in functioning,’ ‘ ... is regarded as a pandemic-related adjustment disorder.’
Now, the impact of stress on nervous system function, and by virtue of that, subluxation presentations is something chiropractors are very well acquainted with, and we are beginning to see the discussion around chiropractic’s potential contribution to immunity and adaptability turn out some very promising discussion. However, the area of Chiropractic and the covid long hauler is very much in its infancy. Thus, Blum suggests ‘extreme caution’ in the care of those who are suffering from cardiovascular, pulmonary or renal system issues in Covid survivors and urges collaborative care with multidisciplinary doctors.
While this is without doubt, Blum does allude to the interrelationship of psychosomatic and somatopsychic aspects of long covid – that it’s important to understand that a “mind body approach for some patients with long COVID may be crucial to long term care of this patient subset group. That may mean that patients with anxiety and other persisting emotional disorders may benefit from chiropractic care. And conversely, patients with persisting somatic disorders presenting for chiropractic care may need psychotherapeutic care to facilitate their recovery. Long covid that affects the mind and body may represent a complex group of disorders related to neurological compromise, dysautonomia, and post-traumatic stress due to having had or living with fear of COVID-19.”
The full, three-part paper can be found at the reference below (2), and is well worth the read as the impacts of such a profound, global phenomenon is yet to be fully appreciated or discussed in literature. How we support our practice members, not only by subluxation-based care, but by cross-referring to other healthcare practitioners and considering the mental, emotional and physical health of the person under care is paramount.
While a wider conversation about chiropractic’s ability to support the return of nervous system adaptability to the covid survivor is important (and a topic for another day), one thing is without doubt – chiropractors will begin to see COVID survivors very soon if not already, and to that end, knowledge is power. We are, after all, caring for a whole person who has been through an ordeal that includes physical, mental, and emotional stressors. A recipe for subluxation indeed.
- Huang Y, Pinto MD, Borelli JL, et al. COVID Symptoms, Symptom Clusters, and Predictors for Becoming a Long-Hauler: Looking for Clarity in the Haze of the Pandemic. medRxiv [Preprint]. 2021et alRiera R. Frequency, signs and symptoms, and criteria adopted for long COVID-19: A systematic review. Int J Clin Pract. 2021 Oct;75(10):e14357.
- Blum C. COVID-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with Long COVID syndromes: Part Three – Long COVID. Asia-Pac Chiropr J. 2021;2.5. URL apcj.net/papers-issue-2-5/#BlumLongCovid