Long COVID

Persistent symptoms of malaise, brain fog, dizziness, blurriness and anxiety are common following covid virus or immunization. The autonomic and vestibular systems are most vulnerable to dysfunction as a result of chronic neuroinflammation caused by this virus, and the immune system response to it.

Dysautonomia is a common condition experienced in individuals living with long COVID. POTS (postural orthostatic tachycardia syndrome) can occur and is defined as an increase in heart rate of more than 30 BPM in adults when transitioning from sitting to standing. This often leads to symptoms of dizziness, lightheadedness, fainting or near fainting, excessive fatigue, limited tolerance to activities, headache, and chest discomfort with sensation of rapid heart beating occurring in some individuals. Additional symptoms of dysautonomia may include nausea, blurry vision, GI disturbances, brain fog, poor regulation of blood pressure and heart rate, diarrhea or constipation, weakness, and poor temperature regulation with intolerance to heat or cold.

Vestibular dysfunction post covid is also very common. The mechanism for vestibular dysfunction after COVID is not yet well understood but is prevalent in both the central and peripheral nervous systems. Common symptoms may be experienced such as dizziness, imbalance, blurry vision with head movements, positional vertigo, sense of rocking, nausea, disorientation, and brain fog.

Many long COVID patients have both dysautonomia and vestibular dysfunction simultaneously.

Treatments vary based on the symptoms experienced by each person. Most utilized interventions include vagus nerve stimulation to regulate the autonomic nervous system, customized exercise program to address tolerance to activities in various positions, integrated dry needling techniques to reduce neurogenic inflammation and improve autonomic regulation, as well as comprehensive vestibular and balance rehabilitation.