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“Long-Hauler” COVID, Post-Acute Sequelae of COVID-19 (PASC, or “Chronic COVID”)

By Jeffery Roy, RPA-C


Acute COVID has varying degrees of severity from no symptoms to hospitalization and respiratory failure. The most common acute symptoms include fever, fatigue, diarrhea, cough, sore throat, and shortness of breath. Some patients will also develop neurological symptoms that include a lost sense of taste and smell, dizziness, and headache. This shows that acute COVID can infect a wide range of host systems.


In the acute infectious process, COVID-19 employs numerous mechanisms to dysregulate the host immune system. These include blocking the production of immune cells, causing inflammation, and interfering with the production or causing overproduction of chemicals that drive the immune response.


PASC, or chronic COVID, is when symptoms persist, or new symptoms develop after having Acute COVID. These can consist of fatigue, post-exertional malaise, brain fog, headaches, memory issues, insomnia, muscle aches, shortness of breath, joint pain, palpitations, diarrhea, dizziness, fever, rash, and mood changes.


One theory behind some of these symptoms is that an underlying previous infection that has been kept dormant by the immune system is reactivated. A good example of this is Epstein Bar Virus (EBV). Approximately 90 % of people have been exposed to EBV at some point in their life. For most people, the immune system can isolate it and keep it dormant, but some people with weakened immune systems can have a recurrence of EBV.


Another major contributor to PASC is inflammation. When the immune system is under attack it will release chemicals to help protect the body. These chemicals when secreted correctly will protect the body, but when the system is over-stimulated and there is an overproduction of them, they can damage the body. This inflammation cascade can then affect every system of the host contributing to the multisystem effects of PASC.


It is also thought that some individuals do not fully clear the COVID virus and that it persists in different tissues within the host, hiding from the immune system. This then can lead to chronic disease development.


These mechanisms are not new; they are seen with several other infectious states also. An example of this is when your immune system is challenged, and you have an outbreak of cold sores, herpes simplex, or shingles.


For Acute COVID it has been recommended to boost the immune system by taking Zinc, Vitamin C, and Vitamin D. For those who suffer from Chronic COVID, PASC we would look at decreasing inflammation, supporting the immune system, decreasing gut dysbiosis, and the use of nutraceutical to help the patient decrease symptoms and to heal.


We are now seeing patients at IM of CNY with “Long-Hauler” COVID symptoms, and are able to assist in their healing with integrative approaches. If this is something you would like to address or learn more about, please contact our office at 315-741-5774.



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