Long Haulers

Long haulers of COVID-19

Managing Inflammation: Evidence Based Self Care

Our ability to care for ourselves is a key piece in augmenting the care we receive from our doctors and controlling the cost of our care. It also fosters good mental health by contributing to our sense of control over aspects of our lives and about our destiny. This has led to investigation into the usefulness of self-care practices that anyone can use to prevent or improve COVID-19 symptoms. While there are no clinical trials to date on vitamins, supplements, or other self-care modalities specifically for the treatment of COVID-19, there is good reason to believe that some or a combination of evidence-based practices could be beneficial. For people experiencing the lingering symptoms of COVID-19, often called long haulers, ther

Anti-inflammatory diets.

Inflammation is the calling card of COVID-19 and so theoretically, behaviors and practices that help modulate inflammatory pathways may be of benefit in treatment and recovery. A low glycemic diet that is also low in saturated fat can generally lower inflammation in the body. Having a nutrition routine that includes a high consumption of vegetables, fruit, legumes, fish, lean protein, whole grains, spices, nuts and seeds, combined with a low consumption of refined grains and processed foods has been found to modulate inflammation.

Common pathways of inflammation have been found for chronic diseases, infections, and SARS-CoV-2.  The interaction of the ACE2 receptor and NLRP3 inflammasone are two such pathways and are involved in the cascade of events that induce pulmonary fibrosis in COVID-19. NLRP3 is also a contributor to chronic obstructive pulmonary disease or COPD. Anti-Inflammatory diets have been found to improve lung function and lower mortality rates in people with COPD. Other studies have found reduced airway inflammation and oxidative stress associated with a higher consumption of fruit and vegetables.

Anti-inflammatory diets encourage the use of herbs and spices that have known antioxidant and anti-inflammatory effects. These effects may be the key to slowing down the progression of disease. The Anti-inflammatory diet has been shown to be beneficial in reducing C-reactive protein, IL-6 and other common markers of inflammation associated with heart disease, autoimmune disorders and other chronic diseases.

Dietary adequacy.

Infections in general are catabolic processes that lead to temporary nutrient deficiencies of protein, B vitamins, zinc, iron, and copper. Additional protein consumption could improve recovery for older adults. As recommended in the PROT-AGE Study Group, individuals 65 years of age and older may best benefit from 1.0-1.2 g of protein per kilogram of body weight (2.2- 2.6 g per pound) to maintain lean body mass and function.  One study on hospitalized COVID-19 patients reported that as many as 76% of patients were deficient in Vitamin D and 42% deficient in selenium. Diets that provide adequate Vitamin D are associated with lower rates of upper respiratory infections. Vitamin D needs are not always easily met with food and often require supplementation.

Food sources of Vitamin D: fortified nut milks and dairy products, organ meats, and mushrooms

Food sources of selenium: halibut, tuna, oysters, whole grains, eggs, particularly high in Brazil nuts

Those that are undernourished prior to infection are at greater risk for these nutrient depletions. It is believed that it may take three times as long to restore nutrient deficiencies as it takes to become depleted.

Creative expression.

What does a journal, crafting, playing or listening to music, and creating or viewing artwork have in common?  A body of scientific evidence supports the use of the visual arts, music, and expressive writing in enhancing immunity and improving psychological well-being. In addition, creative expression was found to improve chronic pain and increase lung function.

Easy ways to exercise your creative side include keeping a gratitude journal, finger painting with your kids, using doodling or coloring books, and DIY home projects. When you listen to your favorite music, dance, or view beautiful photographs, you can support healing and lessen the sensation of pain. 

Nature and optimizing your environment.

Noise, light, humidity, and crowding can all contribute to our allostatic load of stress. Cumulative exposure to stressful environments can impair our immune function. Environmental effects like nature sounds and full spectrum sunlight in the morning can counter the stress response. Our natural Circadian rhythm directs much of our bodily processes including wake to sleep cycles, hunger, and immune function and is highly dependent on exposure to full spectrum day light. Humans also have a preference for green spaces. Views of nature and being in nature were shown to speed post-surgical recovery and forest bathing has garnered much interest due to the research linking it to improved immune function.

Nature can be as close as your front door.  Gather some beautiful leaves, sprigs of rosemary, or pinecones from your yard. Bring snips of greenery indoors or invest in some houseplants. Use a humidifier in dry weather, and try to get outdoors for a few minutes each morning to experience the full spectrum of sunlight that influences our sleep at night and immune function.

Exercise and Qigong.

Many studies have found that moderate exercise prior to viral infection is correlated with lowering the severity of illness. People recovering from lung infections were found to significantly increase their 6-minute walk distance when combining diaphragmatic breathing exercises prior to exercise. If you are recovering from COVID-19 it is recommended that you consult with your doctor to determine if you are ready to begin exercise and when you can safely incorporate breathing exercises.

Qigong is an ancient practice of meditation, breathing and slow movements. Researchers assessed the benefits of Qigong for its potential in prevention and treatment of COVID-19. They concluded that Qigong can be effective in strengthening respiratory muscles, management of stress, reduction of inflammation, and improved immune function.

Whether you are healthy or recovering from illness, self-care can provide relief and speed recovery. Beyond improving your physical health, self-care has also been shown to improve our mental health. I encourage you to practice self-care and do the things that make you feel good. Get out into nature, get plenty of sleep, have fun, and find ways to move your body. What’s most important is to take time each day to practice some form of self-care. As the evidence shows, self-care practices can help you lead a healthier and happier life.