Lengthy COVID, also called post-acute sequelae of SARS-CoV-2 an infection (PASC), refers to a variety of signs that persist or develop lengthy after the acute COVID-19 sickness. Estimates counsel that between 5% and 30% of COVID-19 survivors develop lengthy COVID, representing tens of thousands and thousands of individuals worldwide.
Now, clear patterns are rising suggesting that COVID-19 could set off or worsen autonomic and multisystem problems in a subset of sufferers.
On this information, we discover the hyperlinks between lengthy COVID and circumstances reminiscent of POTS, mast cell activation syndrome, Ehlers-Danlos syndrome, and a number of chemical sensitivity syndrome. Our targets is to supply sensible recommendation to assist sufferers navigate the advanced path to incapacity insurance coverage advantages.
Medical Research & Statistical Information
Lengthy COVID and Dysautonomia (POTS)
Viral infections have lengthy been acknowledged as triggers for POTS, and SARS-CoV-2 is not any exception. A rising physique of analysis signifies that lengthy COVID is usually related to dysautonomia, particularly postural orthostatic tachycardia syndrome (POTS).
A number of case studies and research have documented beforehand wholesome sufferers who developed POTS after COVID-19:
And clinicians are seeing the identical development within the subject:
This proof strongly helps an affiliation between lengthy COVID and POTS and is in keeping with studies that many long-haulers expertise tachycardia, dizziness, palpitations, and train intolerance as a consequence of autonomic nervous system impairment.
Lengthy COVID and Mast Cell Activation Syndrome (MCAS)
Mast cell activation syndrome – a situation by which mast cells inappropriately launch inflammatory mediators – has additionally been related to lengthy COVID.
- Some researchers counsel that hyperactive mast cells could drive the hyper-inflammation seen in acute and lengthy COVID.
- In a single research, a survey of 136 lengthy COVID sufferers confirmed that their post-COVID symptom profile (rash, hives, flushing, GI misery, tachycardia, mind fog, and so forth.) so intently mimicked MCAS that the authors concluded that aberrant mast cell activation could underlie among the pathophysiology of lengthy COVID. This implies that COVID-19 could set off mast cells, resulting in MCAS-like signs in inclined people.
- In keeping with Dr. Lawrence Afrin, a number one mast cell dysfunction specialist, many lengthy COVID sufferers have proven enchancment with MCAS remedies, lending additional assist to the idea that mast cell dysregulation could play a major position in lengthy COVID.
- An Asia-Pacific immunology overview additionally famous an “activated situation of mast cells in lengthy COVID.” Such findings are in keeping with anecdotal studies of long-haulers growing new allergic sensitivities – for instance, sudden perfume and chemical intolerances and recurrent hives – that are hallmark signs of MCAS.
Total, the prevalence of MCAS-like signs in lengthy COVID is excessive. Ongoing analysis is exploring this relationship, and specialists are calling for focused trials of mast cell stabilizers in lengthy COVID sufferers who match the MCAS profile.
Lengthy COVID and Ehlers-Danlos Syndrome (EDS)
Ehlers-Danlos syndromes are inherited connective tissue problems characterised by joint hypermobility, pores and skin elasticity, and tissue fragility. Though EDS is genetic, lengthy COVID has been noticed to disclose or worsen hypermobility spectrum problems in some sufferers:
- An evaluation by physicians on the Mayo Clinic discovered that 30–57% of sufferers with lengthy COVID meet standards for joint hypermobility (or hypermobile EDS) – a a lot larger fee than within the common inhabitants. In essence, persistent irritation may cause or exacerbate hypermobile EDS/HSD, inflicting joints to change into extra lax.
- A research in BMJ Public Well being (2023) discovered that individuals with pre-existing joint hypermobility had been 30% extra more likely to expertise extended signs (particularly long-term fatigue) after COVID than these with out hypermobility, suggesting that hypermobile people could also be at larger threat for lengthy COVID or have “unmasked” signs after an infection.
- Knowledgeable opinion helps this affiliation: Dr. Jessica Eccles, a clinician and researcher, famous that POTS is intently related to hypermobility, and COVID-19 could “unmask” underlying connective tissue abnormalities in at-risk folks.
Whereas COVID-19 doesn’t trigger genetic EDS, it seems to contribute to a rise in EDS diagnoses or symptom flares. Many long-haul sufferers have been subsequently recognized with hypermobile EDS/HSD that they didn’t know they’d.
Lengthy COVID and Chemical Sensitivity Syndrome
A number of chemical sensitivity (MCS), also called idiopathic environmental intolerance, is a situation by which people change into sick from low-level publicity to chemical compounds reminiscent of fragrances and solvents. New or worsened chemical sensitivities have been famous in some lengthy COVID sufferers, suggesting one other side of post-viral immune dysfunction:
- Clinicians have reported instances of long-haulers growing extreme perfume “allergy symptoms” or hyperosmia (heightened sense of scent) leading to complications, rashes, and respiratory signs when uncovered to perfumes or chemical compounds. One speculation is that the immune results of SARS-CoV-2’s could set off mast cell activation or different immune pathways that overlap with MCS.
- Lengthy COVID affected person surveys have famous elevated charges of meals and chemical intolerance, and these usually coexist with circumstances reminiscent of MCAS and dysautonomia in long-haulers. Alternatively, preliminary knowledge suggests that people with pre-pandemic chemical intolerance could also be disproportionately affected by lengthy COVID.
Chemical sensitivity seems to be one other situation on the rise within the lengthy COVID inhabitants, and it’s probably intertwined with the mast cell and autonomic disturbances described above. This connection underscores the advanced multi-system influence of lengthy COVID, blurring the traces between what had been as soon as thought-about distinct syndromes.
Anecdotal Proof & Affected person Experiences
Quite a few affected person tales have put a human face on these statistics, describing how lengthy COVID has triggered circumstances reminiscent of POTS, MCAS, and others in beforehand wholesome people. Many long-haulers really feel “forgotten, unheard, disbelieved, [and] remoted” when their post-COVID circumstances aren’t initially acknowledged.
For instance, a affected person named Mike shared, “I haven’t labored since October 2020. I’ve had three failed makes an attempt to get again to work… however I simply couldn’t do the job,” illustrating the debilitating nature of extended COVID signs.
Sufferers usually describe a sudden change in well being: in the future they had been lively and employed, and weeks after COVID they discovered themselves dizzy upon standing, breaking out in hives, or unable to tolerate regular gentle and smells. One well being care employee reported: “I’m a nurse myself and particularly introduced up that I believed I had POTS after COVID an infection… I used to be handled like a hypochondriac and advised I had anxiousness, which was ludicrous as I had bodily signs.”
This testimony, echoed by many in social media assist teams, highlights each the event of POTS and the preliminary dismissal sufferers face when looking for look after these novel post-viral circumstances.
Equally, lengthy COVID survivors who’ve developed MCAS signs have shared tales of frustration. Two younger sufferers described how their lengthy COVID-triggered MCAS was not believed at first – one affected person mentioned a physician was “so unreceptive to the purpose the place they had been truly offended” concerning the MCAS analysis, and one other had her unintentional weight reduction mistakenly questioned as an consuming dysfunction.
On-line boards and lengthy COVID assist teams are crammed with comparable accounts: folks reporting that “COVID made me notice I’ve EDS/POTS/MCAS”, or {that a} minor an infection “flipped a change” of their our bodies, resulting in power sickness. The overlap of circumstances is a typical theme – sufferers with newfound hypermobility usually even have POTS and MCAS signs, which is in keeping with medical observations of those comorbid syndromes
This anecdotal proof from sufferers factors towards the fact that lengthy COVID can set off advanced syndromes that had been usually beforehand under-recognized.
Rising Incapacity Claims As a consequence of Lengthy COVID
The rise in lengthy COVID instances has resulted in a major enhance in incapacity claims and long-term absences. The truth is, lengthy COVID has been referred to as “the biggest inflow of latest members to the incapacity group in a era.”
A patient-led survey of three,782 COVID long-haulers in 2021 discovered that greater than two-thirds needed to cut back their work hours or had been unable to work in any respect seven months after an infection– indicating a major want for incapacity assist.
Navigating Incapacity Claims for Lengthy COVID and Different Complicated Sicknesses
Lengthy-Time period Incapacity (LTD) Insurance coverage Claims
Many non-public incapacity insurers supply long-term incapacity (LTD) advantages for these unable to work as a consequence of power circumstances. Nevertheless, LTD claims for lengthy COVID and associated problems usually face:
Proceed to advocate for your self, and know that with thorough documentation and assist, many sufferers are in a position to safe the advantages they want to deal with these life-altering post-COVID circumstances.
Social Safety Incapacity Claims (SSDI)
As a result of the Social Safety Administration (SSA) doesn’t have a particular itemizing for lengthy COVID, claimants should display that their signs meet or equal one other listed impairment, reminiscent of cardiovascular, neurological, or immune system problems.
For instance, one technique is to check with Itemizing 14.06 (Autoimmune Issues) for MCAS instances – if two or extra physique programs are reasonably concerned and there are frequent extreme signs reminiscent of fatigue or malaise, you possibly can argue that your situation parallels this itemizing.
Equally, extreme orthostatic intolerance will be in comparison with power coronary heart failure listings (as a consequence of lowered capability) or neurological problems. It may be invaluable to have a incapacity lawyer or educated advocate assist body these arguments within the language the evaluators anticipate.
Steering for Incapacity Claims
Pursuing incapacity advantages will be daunting. Listed here are suggestions and greatest practices to enhance the possibilities of a profitable incapacity declare:
- Accumulate Complete Medical Information: Collect all related medical information and take a look at outcomes that display your situation and its purposeful results. This could embody formal diagnoses (e.g., tilt desk take a look at report confirming POTS, and tryptase or mediator stage exams and allergy workups for MCAS). Ensure the information cowl the period of your sickness and observe any development or relapse.
- Get hold of a Practical Capability Analysis (FCE): In the end, incapacity determinations hinge on purposeful capability – what you possibly can or can’t do constantly. A medical skilled can doc work-related impairments reminiscent of the shortcoming to face, sit, or focus for lengthy intervals of time.
- Spotlight Failed Work Makes an attempt: When you have tried to proceed working however failed (as many sufferers have), describe these makes an attempt and why they weren’t sustainable (e.g. symptom recurrence, issues of safety, frequent absences). This real-world proof can strengthen your case.
- Use Residual Practical Capability (RFC) Varieties: A residual purposeful capability (RFC) analysis from a doctor will be helpful – this kind quantifies your limitations (how a lot you possibly can elevate, how lengthy you possibly can stroll/stand, and so forth.) and sometimes determines whether or not you possibly can work in any respect. Physicians ought to present RFC evaluations that explicitly state how signs have an effect on the power to carry out work-related duties.
- Embody Comorbid Situations: Lengthy COVID usually entails a number of overlapping circumstances (e.g., dysautonomia, fibromyalgia, and cognitive impairment collectively). Don’t restrict your incapacity declare to only one analysis – checklist all related diagnoses and signs. The mixed results could meet incapacity standards even when every situation alone wouldn’t. When you have anxiousness or melancholy on account of your situation, embody that as nicely (as psychological well being points can add to the general severity).
- Be Persistent and Contemplate Authorized Assist: It’s necessary to set expectations – preliminary claims are sometimes denied (even in well-documented instances). Don’t be discouraged by an preliminary denial; many lengthy COVID and POTS sufferers win on reconsideration or attraction. The method will be prolonged (months or years), so think about consulting a incapacity lawyer early on. Attorneys who specialise in incapacity claims often work on a contingency payment and might enormously enhance your probabilities by dealing with paperwork, assembly deadlines, and making ready authorized arguments.
Proceed to advocate for your self, and know that with thorough documentation and assist, many sufferers are in a position to safe the advantages they want to deal with these life-altering post-COVID circumstances.
Schedule a Free Case Analysis
For a lot of, lengthy COVID is greater than a lingering sickness — it’s a life-changing transition that brings with it new medical realities and monetary uncertainties. When you’re battling circumstances like POTS, MCAS, or EDS, know that you just’re not alone and that you could be be eligible for advantages.
With persistence, documentation, and the proper advocacy, incapacity advantages are inside attain. Contact us on-line or name (888) 321-8131 to schedule a free case analysis with nationwide incapacity lawyer Nick Ortiz.
