Case Study #6: Day 45 Update with Long COVID Patient

Case Study #6: Day 45 Update with Long COVID Patient

Symptoms Include: Fatigue, Headache, Anxiety, Insomnia, Breathing Issues, and Heart Palpitations

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 45 update from an ongoing 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 February 2021 and experienced symptoms of Long COVID.

SUMMARIZED CASE REPORT:
The subject is a 46-year-old, 6’0”, 210 pounds, unvaccinated male who describes his premorbid condition as healthy with 5 days per week of vigorous exercise and held a physically demanding job. By report, his blood pressure was 120/75 with a resting heart rate of 60 bpm. He tested positive for COVID-19 on 2 occasions, separated by 15 months. The subject reports exhibiting Long COVID symptoms because of his initial infection and failure of Paxlovid treatment due to adverse side effects with his second infection.

On February 14, 2021, the subject tested PCR positive with a nasal pharyngeal swab following exposure to a known COVID-19 positive person.  His symptoms included fever peaking at 103 degrees Fahrenheit, runny nose, loss of taste and smell, cough, shortness of breath, fatigue, muscle pain, and severe headaches.  He was experiencing shortness of breath noting a home use pulse oximeter reading of 94%. Five days later, the subject sought treatment in the local emergency department due to complaints of shortness of breath. Radiographic studies indicated the presence of pneumonia for which he was prescribed Azithromycin and home rest.  Ten days after onset, the subject’s symptoms resolved with the notable exception of shortness of breath which he describes as being of such severity so as to significantly restrict his activities of daily living. The subject states, “I felt winded just walking to the mailbox. I couldn’t do my job or much of anything else.”

In April 2021, the subject consulted with a cardiologist and a pulmonologist. There were no significant findings reported. This prompted the subject to attempt returning to his exercise regimen.  In June 2021, the shortness of breath persisted but the subject was determined to get back into his routine of working out.  The subject continued to improve over the next 5 months noting he had returned to 80% of pre-COVID capacity.

In mid-September, the subject experienced a new onset of symptoms including feeling dizzy, pressure in his head, sleep disturbance, tachycardia, pain in his throat, and difficulty swallowing stating, “I felt as if my throat was closing.” He was able to tolerate only soft solid foods. There was a weight loss of 40 pounds over 8 weeks. An emergency department doctor diagnosed the tachycardia symptoms as a manifestation of anxiety. An ENT performed a nasopharyngoscopy and prescribed a proton pump inhibitor to treat GERD. The subject discontinued the medication after 2 weeks due to a lack of improvement in symptoms. The subject tested negative for COVID-19 with PCR.

During the next 4 months, the subject sought treatment and diagnostic testing from several medical specialists. A cardiologist diagnosed Post COVID POTS. The neurologist could find no evidence of POTS with autonomic testing. A tilt table test ruled out POTS. The subject was fitted with a cardiac halter monitor for 30 days. There were no significant findings. A rheumatologist ordered extensive serological testing which returned normal values with the notable exception of an elevated IL-10 biomarker. An anti-inflammatory cytokine, IL-10 can both impede pathogen clearance and ameliorate immunopathology. The rheumatologist made a diagnosis of Long COVID. The subject initiated treatment with a Long Hauler researcher who prescribed dexamethasone which was discontinued in 14 days due to the adverse side effect of crawling skin sensation. The subject stated, “This period of my life was a living hell.”

Between March and April 2022, the subject underwent 42 sessions in a hyperbaric oxygen chamber at 1.5 atmospheres which the subject found helpful in that he had more energy.

On April 28, 2022, the subject began supplementation with Tollovid. There were no concurrent therapeutic modalities. He took 3 capsules 4 times a day for 10 days. The subject states, “Within the first five days of taking Tollovid I felt 90 – 95 percent better.” Sleep improved from 4 to 7 hours per night.  The sensation of head fullness resolved by the 3rd day.  The feeling of dizziness when standing abated by the 8th day.

On day 11 (May 8th), the subject decreased the Tollovid dose to 6 capsules per day.  The throat pain and flu-like symptoms returned.  The subject tested PCR positive on May 20, 2022.  He stopped Tollovid and began Paxlovid on May 23, 2022. The next morning, the subject felt everything was spinning and called the ambulance for transport to the hospital per the warning label on Paxlovid.  A CT scan of the brain was unremarkable. On May 25th, the subject started Tollovid, 3 pills, 3 times per day for 5 days.  All symptoms resolved. The subject states, “After five days of restarting Tollovid, I have recovered to 85 percent [of the premorbid condition].  I can run for 30 minutes, and my resting heart rate is back down to 60 [beats per minute].”

DISCUSSION:
The subject was inoculated with a very large dose of COVID-19 from three children, and this was the key factor in a prolonged recovery.  The lingering shortness of breath could have been a sign of viral persistence in the lungs that eventually overtook his immune system with a flare-up in his throat.  The symptom of tachycardia seems to stem from viral persistence that was likely located in his lungs. He quickly resolved a number of his Long COVID symptoms after taking the 3CL protease inhibitor.  The secondary COVID-19 infection allowed him to take Paxlovid but the side effects prevented any extended benefit.  Tollovid immediately resolved the subject’s COVID-19 and Long COVID symptoms.  Evidence of the heart rate returning to the pre-COVID baseline could lead to a complete resolution of the subject’s Long COVID symptoms and have him wean off the use of Tollovid.

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