Experts explore long COVID-19 treatments as thousands of Albertans seek relief

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Thousands of Albertans are looking for relief from the long-term effects of COVID-19 but the condition, often called long or post-COVID, is still very much a mystery as medical experts explore a range of treatments.

Studies estimate that anywhere between 5 per cent to 50 per cent of people who contracted COVID-19 will experience lingering symptoms, such as debilitating fatigue, anxiety and cognitive difficulties, often called “brain fog.” The Public Health Agency of Canada said those who were hospitalized with COVID-19 appear to be at greater risk for long COVID, but it has been observed in people who had mild infections.

Neeja Bakshi, medical director of Park Integrative Health in Edmonton, described long COVID as a very debilitating condition, impacting work and home lives.

Dr. Bakshi launched a long COVID treatment program in January. So far, they have seen about 100 patients and are receiving nearly 20 referrals a week from people across Alberta and from neighbouring provinces that either have long wait times or different programs.

The high demand has led her team to be “more selective” to ensure access for locals. Currently, new patients aren’t able to book into the program until the fall.

“The sheer volume of people that are developing long COVID is just a numbers game,” she said. Not only will cases of long COVID increase as infections do, but Dr. Bakshi noted that more attention to the condition is raising awareness and encouraging people to seek help.

Treatment options through the specialized program can include acupuncture, massage therapy, mental-health services, nutritional counselling and referrals to rehabilitation services when needed. Dr. Bakshi said there is a range of medications and interventions to treat long COVID, but none are evidence-based yet, given its novelty.

“One of the big things that we’re seeing is what we call inappropriate sinus tachycardia, where [people’s] heart rates are going up really high for doing very menial things, such as brushing their teeth or going up and down a flight of stairs. Their heart rate is as though they ran a marathon,” she said.

Dr. Bakshi’s patients have described mental and physical fatigue, in addition to aches, pains and electric shock sensations to a lesser extent.

James Wood, a spokesperson with Alberta Health Services, said about 2,250 Albertans have been “referred to specialty medicine” as of May due to post-COVID symptoms lasting longer than three months.

This includes several outpatient clinics across the province, such as the pulmonary care clinic at the Kaye Edmonton Clinic and long COVID follow-up clinic at Calgary’s Peter Lougheed Centre, that provides targeted medical and rehabilitation services.

Mr. Wood said the agency’s Rehabilitation Advice Line, which provides free advice to people with persistent COVID-19 symptoms, has also connected with more than 8,700 people.

While most Albertans can safety manage mild COVID-19 symptoms at home with support from AHS self-care resources, Mr. Wood said they are planning clinical supports for a “small subset of long COVID patients” while supporting physicians with various approaches to long COVID.

“Estimates in the international literature suggest that 30 to 56 per cent of all COVID patients may have long-lasting symptoms post-infection. AHS internally uses 20 per cent as a general reference point,” he said.

“However, estimates vary with the population considered, and there is evidence that the incidence of long-lasting symptoms may be changing with high vaccination coverage, and also with changes in the virus.”

AHS did not provide cost estimates for existing long COVID services.

Satish Raj at the University of Calgary is researching the long-term effect of the virus on the body’s autonomic system. He said one of the biggest challenges with long COVID is that it’s not clear cut if someone has the condition, though there are overlapping symptoms between participants in his study.

“There’s undoubtedly a lot of frustration on the part of the patients. These are people that were performing at a high level with whatever they were doing … and all of a sudden something has come in their way and they aren’t able to do that,” he said. “We’re still at a stage where we don’t know what to do. I think everyone is sort of trying different things and some help a little, some more, some not at all.”

Dr. Raj said there are about 80 people enrolled in the study, which is more than originally anticipated, and other sites across Canada are expected to join. Patients are experiencing symptoms such as a rapid heartbeat, light-headedness, exercise intolerance, depression and fatigue.

He said those with persistent symptoms have highlighted difficulties in accessing specialized care and that more funding is needed to research and treat long COVID. But, beyond that, he said addressing this condition will require a coordinated approach across Canada considering “no one really has all the expertise.”

Government data show nearly 587,000 cases of COVID-19 have been confirmed in Alberta throughout the pandemic, but limited testing means the number is likely much higher. More than 27,000 people have been hospitalized.

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