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Long COVID; Pathophysiology and Potential Treatment Options, by Dr David W Lescheid, BSC, PHD, ND

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a recently identified syndrome defined as the presence of one or more symptoms, in one or more organ systems, that persist for at least four weeks after an acute infection with the SARs-CoV-2 virus.

There is a high unmet medical need for Long COVID because: 1) it occurs in at least 10-30% of individuals following an acute episode of COVID-19, 2) it substantially reduces quality of life, 3) it increases the risk of mortality and 4) because there are currently no mainstream medical treatments. Long COVID is a complex syndrome, with multiple changing symptoms and multiple potential causes. The most common symptoms of long COVID are exertional fatigue, cognitive impairments (eg. brain fog, memory loss), anxiety and/or depression, cough, dyspnea, headache and altered sense of taste or smell.

These symptoms may wax and wane within the same person as well as show a high degree of variability between individuals. The pathophysiology of Long COVID is not yet fully understood. However, current evidence suggests an altered immune response, such as prolonged non-resolving inflammation and autoimmunity, mitochondrial dysfunction, a persistent viral infection or reactivation of latent viruses, impaired autonomic nervous system responses and leaky gut/ endotoxemia may play a role.

Due to the complexity and dynamic nature of Long COVID, reductionist, single target, mainstream medical drugs will likely provide limited benefit. Integrative medical approaches using holistic, systems science level thinking and multicomponent, multitarget medications are better suited to successfully treat the dynamic complexity of long COVID. This lecture will summarize current scientific knowledge of long COVID, including definitions, possible symptoms, epidemiology, proposed pathophysiology and potential treatments.

An increased understanding of the possible underlying causes of Long COVID provides Naturopathic doctors with treatment options that will improve quality of life and alleviate symptoms for their patients with this condition.

Learning Objectives

At the end of this lecture, participants will be aware of:

  • Long COVID as a complex, dynamic syndrome that is best treated using a systems level approach including natural health products and integrative medicine
  • The definition, prevalence and risk factors for developing Long COVID (also known as post-acute sequelae of SARs-Co-V2 (PASC) or Post-Covid-19 syndrome)
  • The underlying pathophysiology leading to the signs and symptoms of Long COVID and the potential associated integrative medical treatment approaches

CE Credits

CONO: Category A General – 1.0 credit 
British Columbia: Category C General – 1.0 credit
AANP:  General – 1.0 credit
OANP/OBNM: General – 1.0 credit

Dr David W Lescheid

Dr David W Lescheid, BSC, PHD, ND

David W Lescheid, BSc, PhD, ND works as freelance Medical Writer and consultant providing scientific material and delivering lectures that help support patient care using Integrative medical principles. He also works part-time teaching Leadership workshops to scientists as well as part-time as the MedicoScientific Manager of the International Academy of Bioregulatory Systems Medicine in Baden-Baden, Germany.

Prior to these current positions, Dr Lescheid was a Professor at the Canadian College of Naturopathic Medicine where he taught Physiology, Microbiology, and Infectious disease as well as Clinical Care. Additionally, he spent four years practicing full-time in a large multidisciplinary health clinic in Ottawa with specialized interests in the immune system and infectious disease, men’s health issues, obesity concerns, and sports medicine. He has been a member of several federal and international committees including the Expert Advisory Committee (EAC) to Health Canada, the Council for Naturopathic Medical Education (CNME), the Canadian Association of Naturopathic Doctors (CAND), and other government and media relations subcommittees.

Dr Lescheid graduated with honors from the Canadian College of Naturopathic Medicine (CCNM) in 2002. He earned his PhD in Molecular Biology and Protein Chemistry from the University of Victoria. He completed his B.Sc. in Biology, earned a Diploma in Health and Fitness studies from Simon Fraser University, and has additional training in IV therapies, homotoxicology, homeopathy, and different forms of bodywork. Dr Lescheid is a frequent guest speaker at various international medical and scientific seminars, and has published extensively on complementary and integrative medicine.