Aaron Hartman, MD (YouTube, Aug 19, 2020) explains and advocates recognition of post‑COVID inflammatory syndrome ("long haulers"): patients who continue to experience multi‑system symptoms after acute SARS‑CoV‑2 infection. He defines the syndrome as persistent innate immune activation causing ongoing inflammation, lists varied manifestations (fatigue/fibromyalgia‑like illness, cardiomyopathy, lung fibrosis or microclots, pain syndromes, mast cell activation, dysautonomia/POTS, neuropsychiatric and sleep disturbances, prolonged GI symptoms), and situates it among known post‑infectious conditions (post‑mono chronic fatigue, post‑Lyme, virally induced cardiomyopathy, PANDAS, rheumatic heart disease). Dr. Hartman recommends applying existing functional/integrative paradigms (identify predisposing factors such as hypermobility, mold exposure, vitamin D deficiency, SIBO/IBS, sleep apnea) alongside evolving SARS‑CoV‑2 research; he reports early clinical experience and community education efforts and urges patients to seek functional practitioners and practical self‑management resources.
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You. It's great to be with everybody once again. What I'd like to do briefly on this video is talk about a new concept that we're starting to see out there. They are called post Covid inflammatory syndrome. Now, if you do a Google search in the media, you'll probably most likely see this referred to as long haulers. What these long haulers are, or post Covid inflammatory syndrome. It's a group of people who get infected with the SARS CoV2 virus. After the virus is gone, they continue having symptoms, some for months. There are cases going back to this as far as February and March of people that are still ill as of today in August from their infection months and months ago. So what I'd like to do is briefly talk about that topic right now, talk about some ideas as far as what may cause it, why these people are lingering with the symptoms, ways we can address it, and also some hopefully plans forward with some educational materials that I like to put out in regards to this. So if that interests you, please continue to listen. Now. Why is this a big deal? One of the reasons this is a big deal is because millions and millions of people are going to get this virus. And of this group, there's a small percentage that are actually staying ill for a while afterwards. Now, if this was a rare illness, it wouldn't be that big of a thing. But the reality is there's tens of thousands of people that we're seeing across our country in the world who actually have this illness. So let's talk about that briefly. What is this? What is post inflammatory, Post Covid inflammatory syndrome? What it is is someone gets a viral infection and after the virus is gone, their innate immune system that was activated stays in an alert phase and so inflammation continues. And this can look like a bunch of different things. Some of the literature we're seeing is actually seeing a post Covid chronic fatigue and fibromyalgia syndrome. We already know about some of the people after Covid who have heart issues. About 30% of people that are hospitalized will still have some degree of cardiomyopathy or heart pump issues. Some people are getting lung issues, actually getting fibrosis of their lungs. Some people are getting small clots in their lungs and having some residual shortness of breath. Other people are getting pain syndromes, muscle aches, body burning. There's even a thing called mast cell activation syndrome, which is a fairly rare thing in conventional medicine. But in the functional integrative side, we see all the time where up to 25% of people who have a chronic illness have some degree of this mast cell activation syndrome. We're actually seeing that in some of these post Covid people. We're also seeing dysautonomia or a problem maintaining blood pressure, mood issues, sleep disturbances, a whole array of, for lack of a better word, bizarre syndromes. Now where does come from? Well, it's actually interesting because this concept is not new. The concept of a virus infecting someone and in a susceptible group causing residual inflammation is not new. We've known about mono induced chronic fatigue and fibro for decades, as well as CMV induced chronic fatigue and fibro. We've known about Coxsackie virus induced heart issues or cardiomyopathy for decades, as we always know about virally induced neurological conditions such as Guillain Barre. There's even a thing called pandas or pans, which is a bacterial infection that in kids can cause OCD and a bunch of other neurological issues. So the idea of a post infectious multisystem inflammatory syndrome actually is an old concept going back to the days of rheumatic heart disease in the 50s where you get a strep throat and and decades later get heart disease. The concept is not new. What is new is the SARS CoV2 virus, which has been around for 8, 10, 12 months, plus or minus. That's debatable. And people are getting ill. And the fact that this is the first time the whole world is susceptible to the thing and getting exposed to it, that's the new thing. So how do we address this? That's a great question. How do we address something we've never seen before? What we do is we go back and look at things we know about. We go back and look at things like mono. How do we deal with chronic fatigue and fibro and someone who's had recurrent mono, or someone who had tick bite and got chronic Lyme disease, now referred to as post Lyme disease, which is interesting. Post Lyme disease or post Lyme syndrome is another one of these post infectious things. We look at things like dysautonomia or pots, which we now know as an immune mediated neurological condition. Some people have their POTS related to underlying hypermobility, kind of double jointedness, related to underlying gut issues like sibo, dysbiosis, ibs, a whole host of things. Some people as well have it related to mold. And that's a big, big thing we see in our clinic here in Richmond. You know, about half of all buildings have some kind of mold or water damage and if you have a significant percentage of the population susceptible, that can lead into it. Well, we've seen infections in these group of people called post infectious inflammatory syndromes. And now I'm seeing that in my clinic where people who had mold issues or had dysautonomia or pots and these other things after the COVID they're having the symptoms return. So the good news is we actually have older paradigms. Even mast cell activation syndrome, which is a quote unquote newer paradigm that's been around for a while. A lot of these patients actually are developing mast cell activation syndrome. And I've been. And one of the listservs I've been on with doctors that deal with these patients around the world have actually had some decent therapies on some of these patients using mast cell activation syndrome therapies. So the idea that this is a new idea is correct in that it's a new virus causing it. But the idea of a post infectious inflammatory syndrome is actually not new. So how do we address this? We combine our old knowledge, our old learning with our new learning we're developing now in regards to this virus. And that's some of the things we've been posting on videos on Facebook, Instagram, as new things come up. And I feel pertinent putting them out there, but also putting those together for people I'm seeing in my clinic. How do I address someone who is getting better with their chronic illness? Got this. And now it's flaring. There's also a subset of the population who are quote unquote healthy, who had no health issues, got sick and now are having residual. There's one case of someone 12 to 13 weeks of diarrhea after their COVID 19. That's pretty impressive if you start talking to these people and start digging in. And I've been getting lots of messages on different listservs on our social media group as well as my own private patients that a lot of these people actually had something going on. They didn't realize. They didn't realize they had sleep apnea, they didn't realize they had crock vitamin D deficiency. They didn't realize their gas and bloating was more than just ibs. It was actually an autoimmune issue or SIBO S I, B O or some other immune inflammatory condition. They didn't realize that being double jointed, you know, having double jointed elbows, knees, hands would actually set them up for post infectious inflammation or even mast cell activation syndrome. So one of the ways we address this is finding out if someone had one of these predisposing factors and addressing that, also addressing underlying issues, that might be the nutritional environmental. If you are having some of these symptoms and you're currently in a moldy environment, potentially that low grade inflammation won't be able to be resolved while your body is being bombarded by aerosolized toxins. So looking for triggers, figuring out a person's triggers, figuring out what's mediating and keeping the fire going, but also learning more about SARS CoV2, which we're in the process of doing. To be honest with you, this is something I didn't know existed eight or nine months ago. And now I've been, I've learned a lot about it. We're continuing to learn more about this virus, but again, using old knowledge with new knowledge and applying to the people in front of us. And that ultimately is one of the aspects of integrative functional medicine or translational medicine, depending on which part of the country or the world you're in, what's called. So what I'd like to do is I like to educate people about this, talk about it, encourage people that there's hope that they can actually get better and empower people to take control of their health. One of the big issue is that there's not access to functional practitioners in every city and every town in the country. So hopefully some of the educational things I do will help people, you know, help start treating themselves. Now one of the things people ask me is like, why do I, why do I care about this? What's my scan, the game per se? Well, I've got three major things. One is my, my wife, my patience and my heart. Now first thing, my wife, my wife dealt with a lot of chronic illnesses from 2011 all the way through 2015 with chronic fatigue, weakness, a lot of adrenal kind of stuff. And about 2015 she kind of came out of her fog. When she got COVID 19 back in April time frame, we were a little concerned that she might go back into her illness. But fortunately she was sick for about a week, short of breath, lost her sense of taste and smell and actually got better. And that was very, very exciting to see that she was able to work through that. The other thing about it is patients, the people I work with on a daily base basis, I want them to get better. I truly, truly care for my patients and want them to get better. And as I see and talk to more people and gives me more tools, it puts more tools in my tool, toolkit, so to speak, to take care of people. The last of my heart is to give people access and support to care that they can't get otherwise. Which right now is a large swath of these long haulers. Where do you go? Who's the doctor? You see and the great question is, don't know. You gotta find a functional grave practitioner close to you. So if this seems interesting to you, please share some comments attached to this video. Share Share this with friends and family. I'm working with a couple of groups to kind of put some educational materials out there might even be doing a class. So stay tuned, continue to follow us. I'm excited to see where this goes. Not only just for my academic love of knowledge, but also just to be able to help people. So anyway, y' all take care, be well, be safe. The only way to share this information is if you like it, if you tag us, if you comment or follow. So please do those things the way the the numbers games works with social media. If you don't like it, you don't tag it, you don't comment, you don't share it. It actually does not become accessible. The only way this kind of information becomes accessible is if you share it. So please do that. Anyway, take care and we will talk to you soon.
