Long Covid: I'm a Covid doctor and this is how best to protect yourself against long Covid

I am a Covid scientist and research conducted at the height of the pandemic has uncovered three practical lifestyle and nutritional strategies which help us speed up recovery from Covid and prevent progression to long Covid.

If, like myself, you have caught Covid recently, you will be aware of the steep rise in incidence. Fortunately, most people are recovering and hospital admission rates continue to fall, but this rise in cases is triggering a resurgence of long Covid in those who thought they were out of the woods. A recent study reported that people who were recovering from long Covid or had fully recovered are being plunged back into the depths of their illness. This phenomenon is called viral resurrection and is also being brought on by other viruses such as a common cold or flu.

About 10% of people go onto develop Long Covid, officially called Post-Acute Sequelae of Covid-19 (PASC). Latest consensus figures estimate that there currently are over 2 million people with significant long Covid which is affecting their jobs, social life and relationships.

The most common complaint is chronic fatigue which causes brain fog, demotivation and depression. It stops people from exercising, as even slight exertion leads to exhaustion. Other symptoms, familiar to a lot of sufferers, include muscle and joint aches, headaches, high blood pressure, palpitations, pins and needles in their hands and feet, indigestion and bloating all of which can last many months after the early symptoms resolve.

Lead author of this recent study, Professor Christina van der Feltz-Cornelis was struck by the figures showing how many are now being affected by long Covid, this debilitating condition. She went on to say: “There is a tendency in the UK to think Covid is over, but long Covid is having a profound and lasting effect on individuals and society as a whole, with many people leaving the workplace due to the condition. This is placing a heavy burden on the economy.” 

The exact cause of long Covid remains unresolved and there are likely to be a number of contributory factors. These include a persistent grumbling virus which never adequately cleared after the acute infection and a chronic abnormal immune response which starts attacking the hosts own body cells – a form of autoimmune disease.

Having led the UK’s National Covid nutritional intervention study, my colleagues and I have spent a lot of time listening to the devastating effect long Covid has had on many people’s lives. It must be emphasised that nobody is to blame for the suffering that Covid-19 has caused to innocent people across the world. However, the chance of progressing to long Covid is influenced by a number of modifiable factors. It’s higher amoung anti-vaxxers, people who are overweight, diabetic, have low vitamin D levels, lead a sedentary lifestyle, had previous autoimmune issues such as rheumatoid arthritis and have chronic poor gut health.

The best way to prevent more severe and longer Covid is to be physically fit but this takes years of eating well, sleeping well, not smoking and exercising. The big question during the pandemic was whether a change in nutrition and lifestyle could act quickly enough to prevent the development of long Covid after an acute infection or help people currently suffering from long Covid.

To answer this question, we set up a scientific committee to look at the data emerging from Covid research centres across the world. It soon became very clear that three of the biggest lifestyle factors we are able control right now are:

• Improving gut health
• Raising vitamin D levels
• Boosting the intake of phytochemical-rich foods:

Poor gut health

The data from published studies has revealed that healthy strains of gut bacteria such as Lactobacillus become depleted in the majority of patients with Covid, especially those with chronic gastrointestinal symptoms. Individuals with a history of symptoms of suggested poor gut health also do significantly worse.

The authors postulated that an imbalance of gut bacteria (microfloral dysbiosis) contributed to worse Covid damage via increased gut inflammation, impaired gut wall integrity - which correspondingly leads to systemic inflammatory dysfunction - and reduced immune surveillance. This excess inflammation damages the joints, heart, muscles and lung causing pulmonary exudates (sludge), both features of Acute Respiratory Distress Syndrome (ARDS).

About this time, research generated from the UK Zoe app team also reported that people taking probiotics, which aimed to improve gut health, had fewer Covid symptoms.

Vitamin D Deficiency

The Zoe app team also reported that people taking regular vitamin D had less severe Covid. Other studies from China and the USA found that people with below normal levels of vitamin D3 had higher risks. This relationship was confirmed by the massive prospective UK Biobank study, which found a strong association between low serum vitamin D with Covid-19 severity, even considering and adjusting for obesity and ethnicity.

This information led to official management guidelines, eventually changing to include the correction of vitamin D deficiency.

Phytochemical-rich foods

Phytochemicals provide the colour, aroma and taste of plants but also have enormous health benefits. They are abundant in vegetables, salads, herbs, spices, teas, nuts, fruits, mushrooms, seeds and legumes. The typical western diet, is often deficient in phytochemicals and ongoing studies are investigating whether boosting intake could enhance exercise performance, help fatigue, improve mood, mental agility and a reduce risk of cancer and other chronic diseases.

We know they direct anti-inflammatory properties and laboratory research shows they also have direct antiviral properties by slowing replication and blocking the spreading of the virus, especially turmeric; resveratrol and citrus flavonoids (grapes, polygonum cuspidatum root); ellagic acid and quercetin (pomegranate) and apigenin in chamomile.

With this data, the scientific committee, together with colleagues from Cambridge University-linked hospitals, designed and conducted a national randomised controlled trial (RCT) to answer that dilemma.

The study turned out to be the first and largest nutritional intervention for people suffering from acute and Long Covid in the world. It was conducted in the height of the pandemic and the results were published in 2023 but the findings are just as relevant now as they were then.

Male and females were all given a specifically made capsule containing five blends of Lactobacillus probiotics together with a prebiotic called inulin and vitamin D, which after the trial became known as Yourgutplus. On top of this, half the participants were randomised to either take a placebo or a bespoke broad-spectrum phytochemical-rich supplement containing concentrated pomegranate, chamomile, citrus ioflavonoids from oranges, purified turmeric and resveratrol from polygonum cuspidatum root, which after the trial became known as Phyto-V.

The final analysis revealed that the intervention resulted in a two-fold improvement in fatigue, cough, breathlessness, and overall quality of life after taking the Yourgutplus capsule. This was certainly welcomed, especially among those who had suffered for over 100 days and especially those with gut problems in whom the overall effect was greater. For those randomised to the additional Phyto-V capsules, the benefit was even greater, with a further three to four-fold improvement in symptoms compared to the placebo group. There was particularly good improvement in insomnia.

The final research papers were published in the international journal COVID and received widespread media attention and the supplement is now used in many long Covid clinics across the world.

In conclusion, long Covid is a major burden of illness for a great deal of people around the world and the incidence is increasing again. It can affect anyone, but is more likely to affect people with pre-existing conditions, so, the best way to avoid it is to stay as fit as possible by stopping smoking, exercising three hours a week, maintaining a normal weight, eating lots of fruit, vegetables, and healthy fats. If you recently caught Covid, especially if symptoms are lingering or already have long Covid, these measures still apply, but the latest research shows a particular benefit for nutritional interventions which improve gut health, vitamin D levels, and boost phytochemical-rich food intake.