There have been over 413 million cases of COVID-19 that have been reported and 5.8 million
deaths.
The world health organization has urgently requested that countries prioritize the research
and care of patients with long COVID.
Could it be that anti-histamines could help people with long COVID recover from their
symptoms and go on to live normal, healthy lives.
There's a new study out.
Let's have a look at it.
In the United States, two to three hospitalized patients have developed what is known as post
acute sequelae of COVID-19.
Among those who were not hospitalized about 10% have chronic symptoms that remain after
six months worldwide.
There are 54 million people with long COVID and no current treatments available.
In February 8th, 2022 routers reported that a quarter of British employers have cited
long COVID as a main cause of long-term sickness absences.
And this was in a survey done by a professional body.
This is having very serious implications throughout the world.
So the study that was published was published in the journal for nurse practitioners seen
here.
And what they looked at was the post-acute sequelae of SARS- cov two CoV-2 infection
as it is a public health crisis.
Currently there are no treatments.
So the study only looks at two patients, with long COVID, but they did report rapid symptom
resolution with antihistamine use.
Now, what they're saying is that anti-histamines may be a highly accessible therapy for post
acute sequelae of SARS-CoV-2.
Anti-histamines have been around for a very long time.
We know a lot about them and they're not very expensive.
You can just go into your pharmacy and grab them.
So if this is true, it's definitely worth looking into.
A quick look at anti-histamines when we speak of these anti-histamines, there are H1 receptor
antagonists and H2 receptor antagonists.
We hear us speaking of the H1 receptor antagonists that can be divided into first-generation
and second generation anti-histamines.
H2 receptor antagonists are largely used for, the reduction of gastric secretion.
And we won't be going into that.
So the first-generation anti-histamines are listed here.
And the problem with these is that they do have a lot of what we call anticholinergic
side effects, meaning that they do cause drowsiness.
And this is partly due to the fact that they do cross the blood brain barrier.
And for this reason, they're not usually used for a typical seasonal allergies, because
they can be quite bothersome.
Now, the second generation of anti-histamines is what we see used more commonly for seasonal
allergies because they do not have the side effect of causing drowsiness.
That's why most of them are marketed as being non-drowsy.
And many of them are actually shown to work for about 24 hours.
Whereas the first-generation anti-histamines, most of them don't work for quite as long.
So the study cases for this report are actually from a Facebook group called the Survivor
Corps.
This is a virtual COVID-19 research and advocacy organization.
It has over 170,000 members.
People who are reporting their experiences and their self-management.
And so in the timeframe of March 24th, 2020 until July 23rd, 2021 survivors mentioned
using anti-histamines on the Survivor Corps, Facebook page, more than 900 times anecdotally
I've also had viewers who have mentioned this to me and telling me that it has worked for
them
however, this is the first actual scientific report that I've seen of this.
So patient one is a white woman in her forties who works in healthcare.
her past medical history includes idiopathic Raynaud's disease.
That's a circulation disease, polycystic ovarian syndrome, uh, some other.
You know, more specific issues . She's a non-smoker she uses alcohol
occasionally.
She has a normal body mass index.
And before her illness, she engaged in moderate to intense physical activity for one to two
hours for four to five times a week.
So this is a fairly healthy woman at this point.
Now when she got sick, they believe she was infected with SARS-CoV-2 early in January,
20 20.
However, she was unable to get tested because testing was not, widely available at that
time.
Within 10 days she had a disseminated rash all over her anterior and posterior trunk.
I will mention that she did also have the typical symptoms of COVID-19.
She experienced inspiratory.
Chest pain, bilateral flank pain, dry cough fever, night sweats, disguesia.
That's an alteration in taste and alter ulcerations of the tongue, which is also quite common
soft palate end inside lower lip.
The acute illness phase lasted about 24 days for her.
Approximately two weeks after the acute illness in January, the patient developed Alopecia.
So she started losing her hair and noted petichiae of the arms, legs and trunk.
Several weeks later, she experienced multiple relapses of symptoms with varying degrees
of severity symptoms tended to occur in clusters.
We see this with long COVID
sometimes do come and go, it says she would first experience bruising, rash, oral ulcerations,
and then several days later she would develop fatigue and a uni- lateral headache, other
symptoms included nausea, chest pain, flank pain, bruising of the arms intermittent rashes.
And these were followed by longer lasting rashes that were distributed across the body.
And this is an actual photo of what was happening on her skin at the time.
In March of 2020, she reported cognitive impairment, otherwise known as brain frog.
And this also followed a relapsing and remitting pattern.
Uh, so she went on to see multiple specialists.
She had multiple tests and imaging.
If you go to the study, you'll see every single test that they did.
They did even look at her B12,
they looked at a lot of the different, uh, deficiencies that she could have in everything
came back.
Not abnormal six months later, by chance she ate some cheese and had a reaction and took
diphenhydramine, which is a first-generation antihistamine, 50 milligrams.
And she noted that her fatigue and concentration improved..
So she stopped the anti-histamine for three days and noted that her symptoms returned.
She restarted and her symptoms, disappeared.
So she took diphenhydramine for six months.
And I honestly can't imagine doing this because it does make you quite tired, but if you're
already tired from COVID-19 or from long COVID, maybe it helped overall.
The patient was then prescribed hydroxyzine 25 milligrams and told she could titrate up
to 150 milligrams a day, which was probably a much better option for her at 25 milligrams
a day.
She noted partial symptom resolution, and the pulmonologist also noted these effects.
And then at 50 milligrams of hydroxyzine a day, she noted that 90% of her functioning
was fully back.
She could return to work, exercise one to two hours for five to six times a week.
So this is quite impressive.
given that she's just taking this anti-histamine.
Patient number two is a middle aged white woman, works as a teacher, healthy, active
lifestyle.
Non-smoker she did have asthma and seasonal allergies, but no other medical conditions,
normal BMI, and her post COVID symptoms included fever, joint pain, shortness of breath.
She also had the typical COVID-19 toes.
She also had post exertion, fatigue, joint pain, insomnia, intermittent, anosmia, and
disguesia and difficulty concentrating.
So she did have disturbance of her, smell and taste.
So after nine months, she noted an intensification of fatigue, difficulty concentrating, ongoing
abdominal pain, bloating, and COVID-19 toes.
She also developed bilateral acrocyanosis in her hands, which I will show you in a moment.
She self administered five baby aspirin daily.
For two days, she actually researched this on the internet and she thought she could
be having some kind of microvascular complications.
So she did this herself and she did note that the acrocyanosis disappeared at this point.
So she was able to manage her symptoms with a daily regiment of one baby aspirin, vitamin
D zinc and a probiotic supplement.
This is a photo of the acrocyanosis of her hands.
So above you can see before she started her self management and then after, so he can
see the darkening, almost the bluish tinge there of the fingers.
And then in the lower photo, it's disappeared and she is back to normal.
So with 25 milligrams of diphenhydramine, she had a marked improvement in brain fog,
fatigue and abdominal pain.
After two doses of diphenhydramine 25 milligrams, she was able to resume her pre-illness exercise
regimen.
The patient has been taking 25 milligrams of diphenhydramine at night, and 180 milligrams
of fexofenadine which is a second generation antihistamine
that won't cause drowsiness and she reports that she has attained approximately 95% of
pre-illness functioning.
And that's been sustained now for more than 60 days.
Straight from the study here.
They say, similarly, previous studies have reported that patients hospitalized with COVID-19
demonstrated symptom improvement after administration of a histamine antagonist.
In critically ill patients, histamine antagonists were associated with increased survival and
halted COVID-19 symptom progression.
I have not seen that, but these studies are in the report.
Further in a study of 22,000 patients, the histamine agonist promoting was associated
with lower levels of immune markers of severe COVID-19 disease.
Suggesting that anti-histamine antagonists may mitigate the excessive cytokine release
typical of COVID-19.
So in conclusion, they say that SARS-CoV-2, we know binds to the ACE two receptor, which
is abundantly expressed throughout the body.
Resulting in cellular infection with inflammation and activation of the endothelium as a result,
SARS-CoV-2 may affect any organ system.
And in fact, we have seen in studies that this virus has been found in almost every
single tissue of the body.
This may be a critical factor in the heterogeneity of post-acute sequelae signs and symptoms.
It makes sense that these patients are experiencing widespread symptomsin all different areas
of the body, because we know that the virus can not only go to these areas, but also cause
widespread inflammation.
So it does make sense what these people are experiencing..
And I just thought it was really important here, to say this, if you know someone who's
suffering from long COVID, or any chronic illness like myalgic encephalomyelitis, or
a rare illness, something that has not been diagnosed or been able to be diagnosed.
Some patients with PAC or long COVID have been dismissed or ignored by medical providers,
especially those who had COVID-19 early on and were unable to get a test.
And they still might not know that maybe this is why they're still suffering.
This can leave such patients feeling disempowered and devalued, adversely affecting both their
wellbeing and willingness to attend future medical appointments.
And this could lead them not to seek medical help when needed.
Providers should therefore familiarize themselves with the emerging spectrum of these symptoms
and provide nonjudgmental and supportive care.
So that concludes the study.
I hope that that was helpful if you know someone with long COVID or if you yourself are suffering,
maybe he's talk to their prescriber and see if an anti-histamine might be right for them.
Anti-histamines do come with some side effects and they're not always indicated for every
person
so please do not start or stop taking any medication without the help of a healthcare
provider.
Thank you so much.
Take care and stay healthy.
Bye bye.