The race to find a cure—or at least some relief—for Long COVID is on, as up to 30% of those who get COVID will develop Long COVID. The syndrome, formally called post-acute sequelae of SARS-CoV-2 infection (PASC), can result in fatigue, migraines, brain fog, post-exertional malaise and 200-odd symptoms, many of which can ruin your life. As researchers around the world try to solve the problem, Dr. Bruce Patterson, of IncellDX, thinks his team has cracked it. Long COVID is a vascular issue, he says, and treating it with a combination of existing medications can lead to a quick recovery. He’s set up the blood panels and infrastructure, working with doctors in your state; now it’s just a matter of scaling up, he says. Read on for his take, and how you might try it (keeping in mind it’s still early stages)—and to ensure your health and the health of others, don’t miss these Sure Signs You Have “Long” COVID and May Not Even Know It.
Is there actually any kind of hope on the horizon, whether it’s from you or someone else, and how far is that horizon?
Dr. Patterson: Oh my God. Yes. So I’ll give you a little bit of a narrative. Around June of 2020, we had finished up a number of different clinical trials. And what we noticed was that people were being released from the hospital, they were alive, but by no stretch of the imagination, was their immune system normal. And then we started hearing about patients, some of which were in some of these trials, that were still having symptoms three and four months out— again, that was in the early days. So we started investigating what their immune profile looked like. And then we developed a machine learning AI computer program. And what we did is we compared the immune profiles of acute COVID with, basically, long haulers. And it was completely different and abnormal.
Us long haulers knew that but doctors didn’t know at first.
Dr. Patterson: As I’ll tell you, where are we, we’ve already treated over 2,000 long haulers. And I would say with 98% success, getting them better and getting them back on their feet. The fact is we noticed this immunologic abnormality, we applied machine learning and AI, and indeed it was a very distinct immunologic entity. And so the hallmark was this vascular inflammation. Now, why is that so important? Well, blood vessels are ubiquitous and this vascular inflammation is happening in the brain. It’s happening in your organs, it’s happening in the lungs, the chest, the heart. I mean, it is a unifying hypothesis that these blood vessels are doing, damage and causing inflammation in this widespread geography that we call the human body and can account for all the symptoms.
So why is this happening?
Dr. Patterson: We saw some abnormalities in some white blood cells called monocytes. We looked further and we found the one protein in monocytes, 15 months after infection, with no virus. There’s no RNA, there’s no replication competence. We proved that in the latest paper using next gen sequencing but we sequence the whole genome of the virus and found that there was just fragments of RNA and nothing to be able to create a new viral particle. Yet the cells carried a COVID protein all over the body and caused inflammation. Number two most interesting thing is that the cells have a propensity to bind the blood vessels through a pathway called fractalkine. And number three, which is kind of the most directly applicable on a day-to-day basis, is the cells are mobilized by exercise and to a person long haulers have exercise intolerance.
Yes, to me, exertion feels like poison.
Dr. Patterson: And the good news is we are treating the two pathways that are involved. Number one, the mobilization of these cells for treating with what’s called CCR5 antagonists, which prevent the cells from moving to areas of inflammation and number two, using statins to block this fractalkine pathway that allows these cells to find the blood vessels and cause vascular inflammation. It’s like we’re there. And the response has been remarkable. And we’re even starting to treat post-Lyme, fibromyalgia and chronic fatigue. Post-Lyme patients said on this drug regimen, they’ve never felt better. So we really think this might have very, very broad implications for a lot of these unexplained post-infectious syndrome.
So how long does this treatment take? And will I ever be able to exert myself again?
Dr. Patterson: As we treat for, you know, four to six weeks, what we do when we restore the immune system and immune profile to normal, is then we start while they’re on medication, increasing their exercise and activity. So we perturb their system, knowing that we’re reducing a number of these COVID containing cells, and we’re keeping them from binding to blood vessels, which is causing the symptoms. So we’re increasing their activity, while on medication while we’re following them. They will get better, you will get better. You will get back to what you’re used to doing, and this is not something you’re going to have to deal with for a long time.
Are there any downsides to this treatment? Side effects?
Dr. Patterson: To tell you the truth, they’re, they’re relatively benign. I mean, one of the drugs we use there’s been this long, long discussion about potential liver toxicity from one of the original trials 12 years ago. And then there was subsequent papers, the NIH and the five-year safety profile of this drug, if you take it every day. But we’re talking about a four to six week course, you know? The other thing is this drug with supposedly liver toxicity has been shown to be safe in children. So, you know, what nothing says safety better than safety in children. So we monitor that don’t get me wrong, where we’re very conservative, but we’ve had more liver toxicity from people taking too much Tylenol than from anybody taking this drug.
So it’s six weeks and then the person does not have the COVID cells following them around?
Dr. Patterson: It goes down, the patients that we’ve followed that. And again, that’s still in the research realm. We haven’t launched that clinically, like we’ve launched our immune profile and, and that machine learning and AI algorithm that helps calculate how they’re doing—that’s all out in clear approved labs and run officially with approved reports. We’re setting up labs right now in the EU, the UK, Latin America, Mexico. We’re going global with this program.
So how can a Long Hauler out there get the treatment you’re talking about?
Dr. Patterson: So we designed our panels specifically for COVID and long COVID. So, our panel will generate a severity score, if you have acute COVID, to see who will become severe. It will then also generate what’s called a “long hauler index” for those who are, um, long haulers. And so this proprietary and patented panel that we developed is being offered through two reference labs in the United States. So what you would do is just, we have a website www.covidlonghaulers.com, and it’s very user-friendly: You register to get your blood tested. Your doctor next door can send the blood off to one of these two laboratories. The results come back, you arrange telemedicine with one of our telemedicine physicians, and you can make those appointments right on this website. And then the telemedicine group makes recommendations on therapy, which we then send to the primary care physicians to actually prescribe and follow the patients on therapy. And we have over a hundred physicians in our nationwide network, representing all 50 states, who have bought into the program, bought into the therapy, have seen the success in their patients, and have been really the linchpin in making this all work where we just act as the testing lab in interpreting the test results, as far as what therapies would be best. And then they’re the true leaders on the frontline implementing the therapies.
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You mentioned the post-exertional symptoms. Let’s go through a few more symptoms. How about brain fog?
Dr. Patterson: That’s a really important question. The bottom line is these cells that contain COVID protein, go through the blood-brain barrier and cause vascular inflammation in the brain. Okay? And when they, when these cells bind to the blood vessels, they liberate a compound called VEGF. VEGF we found is highly correlated with peripheral neuropathy, numbness and tingling weakness, neuropathic symptoms. The other thing that happens when you get this blood vessel inflammation is there’s vasodilatation. What does vasodilation cause? Headaches, migraines? Yeah. And the vascular information of course causes the brain fog and what we call tinnitus or ringing in the ears. The one drug agonist that we’ve been using has been amazing at reducing brain fog and 10 of this within three to five days. So we call it our brain fog killer. And then it also lowers the VEGF—the vascular endothelial growth factor—which is causing the peripheral neuropathic symptoms.
And some patients have mentioned a “cytokine storm”—like their immune system is buzzing?
Dr. Patterson: We’ve determined what symptoms are caused by what cytokine elevations. All we do is precision medicine using diagnostics to determine therapy. And what we can do is say, okay, here’s your immune profile while here are your abnormal lab results. This is what we need to use to target those abnormal lab results. And yes, it usually ends up being a combination of the two drug classes that I mentioned that address the vascular inflammation, but, we use other drugs—fluvoxamine is a good drug at lowering cytokine levels, as is ivermectin to some extent
Dr. Patterson: Usually when your inflammation goes down, the fatigue goes away, you start to have more energy.
And shortness of breath?
Dr. Patterson: Some people have this very interesting chest pain where there’s a perception of shortness of breath, but they’re not really short of breath. You do the oxygen and you’re normal. And what I think it’s caused by is the lining of the lungs, called the pleura, is inflamed. The diaphragm’s inflamed, the chest wall is inflamed because there’s a membranous lining on the big bone and the sternum or the chest bone, all the membranes are inflamed. And it’s the mechanical motion of taking a breath that makes you feel like you’re short of breath when in fact your oxygen exchange is perfectly normal. Vascular inflammation is something that is so universal that it really helps to explain all of these symptoms that seem unusual. To us, having studied it for now, 14 months, it’s not that unusual anymore.
As for yourself, to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.