Covid Chronicles – Cytokine Storm to Chronic Fatigue

This is Joe Keenan, author of Covid Long Hauler. Welcome to the next edition of my Covid Chronicles.

As a follow up to my Blog, Covid Chronicles – Part 1, I promised some further information on Long Covid and the bodies autoimmune response. My mission statement for this blog is to try and tie together the research that I have been doing on linking Long Covid to an autoimmune response which ends in patients suffering from chronic fatigue.

Covid and the bodies autoimmune response

An autoimmune response to a virus like Covid 19 is not new. People that have been infected with Lyme disease, SARS, Epstein Barr and West Nile virus have been known to suffer protracted recoveries. The autoimmune response to these viruses can lead to Myalgic encephalomyelitis also known as chronic fatigue syndrome. The Center for disease control defines chronic fatigue as people with overwhelming fatigue that is not improved by rest. Fatigue that gets worse after any activity, whether it’s physical or mental. This symptom is known as post-exertional malaise. Other symptoms can include problems with sleep, thinking and concentrating, pain, and dizziness. People with chronic fatigue may not look ill, but;

  • Are not able to function the same way they did before they became ill.
  • Changes people’s ability to do daily tasks, like taking a shower or preparing a meal.
  • Makes it hard to keep a job, go to school, and take part in family and social life.
  • Can last for years and sometimes leads to serious disability.
  • One in four patients is bed- or house-bound for long periods during their illness.
  • Is most common in people between 40 and 60 years old.

In a recent article by the Autoimmune Institute in December of 2020, describes the common Long Covid Symptoms as;

“A person experiencing long COVID has persistent symptoms despite a negative coronavirus test after the normal recovery period from COVID-19. Symptoms can come and go, change over time, and affect any system in the body.

For many, despite fatigue, brain fog, shortness of breath, and other debilitating symptoms, routine lab work will show zero red flags. This makes the search for answers frustrating and confusing for both doctor and patient.

According to patient studies, the most common symptoms reported include:

  • Extreme fatigue
  • Body aches
  • Shortness of breath
  • Difficulty concentrating (brain fog)
  • Trouble sleeping
  • Headaches

The CDC includes joint pain and chest pain on their list, as well as other reported symptoms like depression, muscle pain, intermittent fever, and rapid heartbeat. “

All in all, the post infection symptoms of chronic fatigue syndrome and those defined by the Autoimmune Institute for Long Covid are a resounding match. This connection, could be the important to finding a cure of Covid Long Haulers.

What is cytokine storm?

When a healthy body is fighting an infection, there’s a natural immune system response that occurs that involves releasing cytokines, biological chemicals that stimulate cell pathways and allow for communication between cells. These cytokines, according to the American Cancer Society, essentially signal the immune system to start doing its job.

This response is normal, unless this outpouring of cytokines suddenly becomes accelerated. Cytokines are meant to be helpful to us in moderation, when engaged too much the immune system starts causing damage to the patient.

In a recent article by Health.com entitled, “What is a cytokine storm”, Dr. Fichtenbaum says that when most people hear the term “storm,” they think of a raining downpour, but that’s not the most accurate way to explain a cytokine storm. Clinically speaking, a cytokine storm means a cell pathway has been turned on, leading to the production of a number of biological mediators (which are kind of like signal transmitters) that cause changes to the body and interfere with normal cell function. Commonly, this means an excessive number of cytokines are released, which create high levels of inflammation in the area of the body being flooded—so much inflammation, even, that it can be fatal.

“Imagine that you put your foot on the accelerator and it gets glued to it,” Dr. Fichtenbaum says. “You can’t get your foot off the gas to slow down your car.” Essentially, these storms can be more deadly than the original virus the body is fighting.

Do Covid patients suffer from these storms?

In short. Yes. Cytokine storms can be detected after numerous types of infections, including Covid 19. But what is not fully understood is why these storms happen in only some of the people infected by Covid and not others. What makes people more vulnerable than others?

Many COVID patients experiencing cytokine storms are suffering with fevers and shortness of breath. If the patient is having too much difficulty breathing they may require ventilation within six or seven days after the infection.

My research has uncovered that the cure for a cytokine storm is not simple science. It appears that treatments range from anti-inflammatory drugs, to plasma transfusions, cancer treatments drugs, plus others are being tried by medical researchers. Some articles are trying to isolate genetic markers which indicate a patients propensity to suffering a cytokine storm. What is clear to me is that if your body is suffering a cytokine storm event, early detection and treatment could save your life.

Is there a relationship between chronic fatigue syndrome and cytokine storms?

Chronic fatigue syndrome is considered an immune disorder by many medical professionals. Chronic fatigue has long been considered a mystery illness but years of research have pointed to the key role that inflammation and autoimmune may play in the illness. A recent study published by Science Magazine titled, “More clues link immune system imbalance with chronic fatigue syndrome”, clearly points out that patients with chronic fatigue syndrome displayed much higher levels of cytokines than healthy patients.

In summary

As stated at the beginning of this blog, my mission statement for this blog was to try and tie together the research that I have been doing on linking Long Covid to an autoimmune response which ends in patients suffering from chronic fatigue. Factually, the evidence that I have uncovered and is illustrated in this blog says that, patients that contracted Covid 19 create an immune response from the body to fight the infection. In some Covid patients, this immune response malfunctions creating a cytokine storm. This storm then puts the body into an autoimmune response that depletes the bodies own immune capabilities. The newly created autoimmune state can manifests itself in the form of chronic fatigue syndrome. Thus, the potential treatment of Long Covid could come from several different but related outcomes, including;

-Avoid contracting the virus in the first place!

-Control or elimination of the cytokine storm with early detection

-Being able to calm down the bodies own immune response

When all of these preventative measures fail, it appears that patients prolong their recovery in what we are calling Long Covid. I hope that I have been successful in creating the link between the Covid infection, the bodies responses, autoimmune and chronic fatigue syndrome in such a way that the relationship is logical.

In an upcoming blog, I will look at potential treatments for chronic fatigue syndrome that might be useful for my fellow long haulers.

Until then, stay strong!

Joe Keenan

References

https://www.sciencemag.org/news/2017/07/more-clues-link-immune-system-imbalance-chronic-fatigue-syndrome

https://www.verywellhealth.com/inflammation-autoimmunity-in-chronic-fatigue-syndrome-716122

https://www.verywellhealth.com/what-is-post-exertional-malaise-716023

https://www.health.com/condition/infectious-diseases/coronavirus/cytokine-storm

https://www.cdc.gov/me-cfs/about/index.html

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