Case Study #4: Day 26 Update from a Long COVID Patient

Case Study #4: Day 26 Update from a Long COVID Patient

A case study from a patient with Long Haulers who was recommended Tollovid by their physician Dr. Lee Morgentaler.

Post-Acute Sequelae of SARS-CoV-2 (PASC), as known as "Long Haulers", is a major public health problem. Todos Medical reported a Day 26 update from an ongoing 60-day case study by Dr. Lee Morgentaler of a 3CL protease cleanse with Tollovid, a 3CL protease inhibitor dietary supplement, in a patient who originally contracted COVID in March 2021 and experienced symptoms of Long COVID.

SUMMARIZED CASE REPORT:
The subject is a 33-year-old male, 6’1” and weighed 195 lbs prior to onset of symptoms.  The subject considered himself to be in excellent physical condition.  He states prior to his bout with PASC, he played team sports such as hockey and soccer at least twice a week. By report, subject tested COVID-19 positive on March 29, 2021 via nasal pharyngeal PCR test.  The subject denies underlying medical conditions or any concerning family history of disease prior to testing COVID-19 positive. Within 3 days of known exposure to COVID-19 the subject began to exhibit symptoms, including loss of taste and sense of smell, extreme fatigue, profuse sweating, chills, and nausea.  The subject states the majority of symptoms subsided within 17 days of onset and was followed by a subsequent regression including shortness of breath, heart palpitations, insomnia, blurred vision, and light sensitivity.  The subject sought treatment at an urgent care facility. A chest x-ray ruled out pneumonia. He was housebound for 2 months during which time his weight decreased by 25 lbs, had a resting heart rate above 90 BPM which increased to 120 BPM with minimal exertion. By report, pre-COVID resting heart rate was 75 BPM.  His poor condition necessitated a move back into his parent’s house where his mother provided assistance with activities of daily living. 
In mid-June 2021 his level of fatigue significantly decreased and again worsened. This was followed by a series of improvements and regressions which cycled numerous times over the next 3 months.  Although his fatigue eventually resolved, he continued to note a heart rate which was above what was noted in the pre-COVID baseline, blurred vision, nausea, and his head felt concussed.  He described feeling like he had “brain inflammation.”  The subject was COVID-19 vaccinated on August 24, 2021 with the Pfizer vaccine and received the second of a series of 2 vaccinations on September 22, 2021.  There were no adverse side effects reported at the time of vaccination.

The subject states he was prepared to live with these symptoms for 7-8 months, but then sought out the assistance of a Long COVID clinic in February 2022.   By report, the clinic performed a complete cytokine panel which revealed elevated SCD40L which may be indicative of trauma-induced endothelial damage and coagulopathy.

The treating physician prescribed pravastatin (10mg daily), LD aspirin daily, and fluvoxamine (25mg daily).  The regimen brought relief to the subject in the form of significantly reducing the head concussed feeling in 2 weeks. At the completion date of the medication regimen, the balance of symptoms subsided. Following the discontinuation of the medications, symptoms returned within 24 – 48 hours. Subject restarted medications and once again achieved symptom relief within 72 hours.   After 2-3 months, the subject considered himself as back to a point where he could somewhat perform his usual routine despite continuing to experience symptoms including elevated heart rate, fatigue, nausea, and insomnia.  

On May 5, 2022 the subject started a regimen of Tollovid Maximum Strength.  He took 12 Tollovid capsules daily for 5 days. Symptoms significantly improved in 3 – 4 days and the patient discontinued use of Tollovid. After the 5 days of Tollovid use, the biggest improvement for the patient was digestion, which returned to his pre-COVID baseline.  He reported sleeping better and longer, however, his Garmin monitor showed that he was getting less deep sleep.  The head concussed feeling was minimal and his resting heart rate returned to pre-COVID values.  The subject noted a blood pressure of 110/65 which was better than his pre-COVID baseline of 120/80.  Weight was 200 lbs.  The subject noted he had always experienced heat intolerance which was no longer manifested after taking Tollovid. The subject states, overall, he feels physically better and now has excess energy.  The subject decided to stop Tollovid use to see if the gains would hold with additional Tollovid use.


On May 31st, 2022 follow-up, subject states subsequent to an interruption in continuing with Tollovid, and in an effort to stave off symptoms, he has started another round of treatment with Prevastatin 10 mg per day, Fluvoxamine 25 mg per day and daily low dose aspirin. In describing his ongoing symptoms, subject states he experiences “flare-ups” from time to time. “Prior to taking Tollovid, my flare-ups were an 8 out of 10” on the severity of symptoms scale, with 0 being no symptoms at all and 10 being the worst possible symptoms. “After taking Tollovid, [3 capsules, 4 times per day for 5 days,] my flare-ups are less intense with a rating of only 3 out of 10. Because of Tollovid, I am suffering less now.” The subject intends to restart the use of Tollovid for a 10-day period in the near future and to re-evaluate the patient’s Tollovid experience thereafter.

DISCUSSION:
This case study shows Tollovid had a beneficial effect. The subject’s symptoms resolved with return to better than the pre-COVID baseline. This indicates the possibility there is an additional mechanism at work that may have been undiagnosed before the subject contracted Long COVID. The subject was diligent in eliminating any medicines before taking the Tollovid regimen. This strengthens the efficacy evaluation of the case study as it eliminates a number of potential variables.  Although the subject was not naïve to treatment, he states he was not taking any medications or other supplements that could explain the sudden change in health. The other significant observation was the normalization of resting heart rate.  Treatments, prior to Tollovid, alleviated some symptoms and provided relief, but didn’t address the elevated heart rate which underpins other symptoms such as the head concussed feeling.  Whatever mechanism was addressed by inhibiting 3CL protease was likely responsible for the reduction in heart rate to baseline levels.  The elimination of digestion issues further enhances the theory of viral persistence in reservoirs located in the gastrointestinal tract.  The lack of deep sleep measured by the Garmin sleep monitor should be noted.

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