Long COVID Treatment Explained: A Comprehensive Patient Guide

Michael Brode, MD, a board-certified internal medicine specialist and the Medical Director of UT Health Austin’s Post-COVID-19 Program, shares his framework for treating long COVID as well as valuable insights on guiding patients in the journey toward recovery.

Video filmed and edited by: Shriya Alli

[spiritualkings]

This is the most accurate description of exactly what I'm going through. He hit everything right on the head. Every time I have a good day, I then have a 'setback' day. It's very frustrating. I have had symptoms for 4 months now. Right before I got covid 11/21/2023 I was in the best shape of my life. I was weight training and showing real muscle gain. I was becoming lean and mean and my cardio was doing great. Then I got covid and it has ALL turned to fat and I have lost everything that I have gained. Not only that, but the first 3 weeks I got covid, the 'FOG' sympotms were SO bad that I could barley even leave the house. It was so bad that I could hardly even hold a conversation without losing track of what I was even saying. The first 3 times I got covid it was NOT nearly this bad. This last time it has been just horrible.

Luckily for me, I have gotten progressively better each week. It has been SO frustrating as I am a very active person and I thrive on physical activity and keeping up on my workouts. All I can do is pray and take it one day at a time and hope that I recover fully and be ready for spring. Ugh, this has been NO FUN at all. I will never forget this. I pray you are all getting better. God bless.

[genegarneau]

2 years for me. Now it is in my heart, lungs, nerves and brain fog, always forgetting. I am getting my energy back. I hope I do not have much longer to go. 2 years of this has been hell.

[dougfuller]

I had Covid-19 in September 2023. I still can't focus, have frequent major headaches, trouble sleeping and walk into walls when I get up in the morning since I'm so dizzy. I still work, but feel that my job is in jeopardy since I'm probably about 40% as functional as I was pre-Covid. This subject needs to be explored and I thank Dr. Brode for his dedication in research of this issue.

[GungaLaGunga]

First infection May 2021. Dysautonomia, tachycardia, devasating fatigue and post activity crashes. I'll feel better over a few months, try to get back to life, then crash again. What a nightmare.

[meaganmorin]

Thank you for this overview. Very clear and understandable. My biggest struggle is with fatigue, but also widespread weakness and occasional numbness. For a “healthy” person, it’s been quite debilitating and disheartening. Wishing all long COVID sufferers a speedy return to health.

[soal-ltrf]

Thank you so much for your simple yet logical approach to deal with this silent and debilitating condition. Many doctors have chosen to dismiss it -hoping it will go away magically.I think part of the healing process is radical acceptance.

[sebek]

🎯 Key Takeaways for quick navigation:

00:01 *🩺 Long COVID Diagnosis and Testing*
- Long COVID diagnosis relies on symptom patterns rather than specific tests.
- Testing aims to rule out other potential causes of symptoms, such as diabetes or thyroid problems.
- Diagnosis and testing methods are individualized based on medical history and risk factors.
03:23 *📈 Long COVID Recovery Trends*
- Most patients with long COVID show improvement over time, with about 60% fully recovering.
- Recovery typically occurs within the first one to two years post-infection.
- Symptoms like fatigue, brain fog, and post-exertional malaise may persist but tend to improve gradually.
04:50 *💊 Fundamental Steps in Long COVID Treatment*
- Treatment involves managing energy levels and avoiding post-exertional malaise.
- Intentional rehabilitation focuses on physical, cognitive, and emotional strengths and deficits.
- Symptomatic management includes using evidence-based treatments and medications to alleviate specific symptoms.
11:01 *🏋️‍♂️ Intentional Rehabilitation for Long COVID*
- Rehabilitation encompasses physical therapy, cognitive therapy, and mental health counseling.
- Balancing exercise to avoid exacerbating symptoms while promoting physical health is crucial.
- Cognitive therapy helps in managing attention, memory, and breaking tasks into manageable parts.
12:29 *🩹 Symptomatic Management with Medications*
- Evidence-based medications target common long COVID symptoms like fatigue, insomnia, and nerve pain.
- Medications may not cure long COVID but can improve daily functioning for some individuals.
- Treatment plans are tailored to individual needs and may involve trial and error to find effective medications.
13:54 *🎯 Exploring Targeted Therapies for Long COVID*
- Experimental targeted therapies aim to address viral fragments, chronic inflammation, and blood flow issues.
- Participation in clinical trials is encouraged to assess the efficacy of these treatments.
- Patients should have thorough discussions with healthcare providers regarding risks, benefits, and costs of experimental therapies.

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[JudyWilson-SiteShackDesign]

This is truly first-rate, excellent: Clear, plain language that fits amazingly well with what I have experienced since December, 2023 when I tested positive (my first time) for COVID. Following this positive test, I immediately developed asthma and bronchitis (which I have had randomly for years). I was not, fortunately, hospitalized and at this time (5/17/24) my asthma & bronchitis have almost completely tapered off. What remains is almost exclusively PEM. I have a tendency to begin to feel slightly more energetic, then rush off to "drain the battery" — complete numerous big and little tasks — tasks that become exhausting and send me quickly back to PEM and bed rest. This is perhaps my main challenge in trying to heal: Getting enough rest, tempered with a moderate, carefully planned exercise plan etc.👍👍👍

[sharonkane]

He explained everything so well. Post exertion malaise for me is the worst and he reiterated all I've learned, from UK LC services, and I'm trying to apply. So complex and different degrees for everyone. Very informative, helpful and clear. Thank you.

[darlasue]

You seem leaps ahead of the Baylor Long Covid Clinic where I am a patient. I appreciate your explanation and overview of Long Covid and it's treatment.

[gorilla]

Just starting my long Covid journey. Third round of Covid mid-July...took Paxlovid...fighting shortness of breath, arrhythmia (tachycardia), fatigue, brain fog, having bad days with an occasional good day, and depression. I was in very good cardio shape prior and now virtually disabled. I realize it's only been four weeks but I don't see a rapid recovery going forward. This video was very helpful.

[itsdavidmora]

This is the clearest explanation, from a doctor, about what works for managing Long COVID symptoms & why (on a high level). This completely matches my experience.

[aurorasurrealis]

Almost 3 years into long covid 😵‍💫 I'm getting better, but extremely slowly

[lukepearson]

I'm a cross country athlete at the college level. Since Covid, I'd get these spouts of fatigue that'd last for a week then I'd be fine again. I'm a sophomore in college now and I've been fatigued with brain fog for the past 3 months straight. I haven't been able to run or compete. My life has been taken away. I've had various blood tests and sonograms done only to conclude I am "in perfect health." I'm finally trying to reach a long covid clinic, but I'm worried I'll never run again.

[keegsmum]

Thank you so much for this organized, comprehensive and balanced overview of the subject. I am a 68 year old female triathlete dealing with long COVID symptoms, not from having contracted COVID, but rather from the 5 mRNA vaccines I got. Vaccine #5 (bivalent) pushed me over the edge. Still not recovered- I am 12 months out since my last and final vaccine), but I am now on a good recovery track using a variety of OTC supplements including botanicals (I tried each individually and assessed their usefulness one at a time- discarding some and replacing with others) because I was getting no guidance at all from my family doctor. Because there was no definitive test result (lab work, neurology, cardiology as you mentioned), no treatment approach or medication was offered to me, even when I requested same. I was left on my own to figure it out- with only the suggestion that I might have Chronic Fatigue Syndrome or some vague allergy. I asked about participating in a clinical trial re vaccine injury and got no where. I started making real progress in my recovery once I started to suspect the vaccine might have triggered a condition like histamine intolerance- MCAS even though my labs were negative for MCAS. Bioflavonoids, DAO and Augmented NAC have been the most useful supplements for me in relieving the neuropathy, cardiovascular issues and brain fog. I am slowly working back to regular cardio and strength work in short sessions, and I have to monitor how it goes, to avoid fatigue and relapse. My heat tolerance is still a challenge when I work out - it triggers bad brain fog for some reason, so last summer was pretty tough. A long road indeed...

[zpdldhk]

What a difference this video has made in my life!! From the bottom of my heart, thank you, Dr. Brode. Vaccinations and vigilance kept Covid at bay until Feb. 2024. 12 days out developed new onset hypertension. Medication is controlling it well. Fatigue and brain fog are biggest roadblocks. Your presentation is the best medical consult I have had!! I feel you have given me a logical and hopeful treatment plan. Priceless👍I will share this video!!

[jgonsalk]

Great video. Very thorough and provides clear priorities. Really appreciate it! I hit the wall too many times and need to slow it down. I have recovered about 60 to 70% but the recovery has slowed which is extremely frustrating. I want my life back but need to give my body time.

[sakinahabdulbari]

Thank you for the timely information and suggestions about covid-19 and where treatments are at this moment. I had covid-19 in March 2020, and January 2022. I have long-covid since the 2020 infection, I am not doing good. I need more medical help. I was already disabled before covid-19. I am 66, female, and I want and need help. My brain and energy is getting worse. I have doctors, however, they are saying that "people my age get these illnesses" but I did not have them before Covid-19, my prior MRI proves it. I keep my doctors appts. plus I have all my vaccines up to date. I have the muscle wasting you spoke about, I cry almost every day because I have life in my heart, but my brain and body says no more after 2-3 hrs. Please help me.

[skooflefloofandfriends]

Whats sad is if you work for yourself there is no disability qualifications. You just cant work as much and then you struggle

[AC_.-]

What a helpful and thorough video - thank you so much! So validating and gives me a tiny bit more hope... Been dealing with ME/CFS for years, and now long COVID. My life has become so limited and if it were not for my faith and trust in God, I don't believe I would have made it this far. Every day is a challenge, and I often pray to just "make it through" another one. 😢