Lengthy COVID, often known as 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 tens of millions 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 corresponding to POTS, mast cell activation syndrome, Ehlers-Danlos syndrome, and a number of chemical sensitivity syndrome. Our objectives is to offer sensible recommendation to assist sufferers navigate the advanced path to incapacity insurance coverage advantages.
Medical Research & Statistical Knowledge
Lengthy COVID and Dysautonomia (POTS)
Viral infections have lengthy been acknowledged as triggers for POTS, and SARS-CoV-2 isn’t 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 stories and research have documented beforehand wholesome sufferers who developed POTS after COVID-19:
And clinicians are seeing the identical development within the area:
This proof strongly helps an affiliation between lengthy COVID and POTS and is per stories 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 wherein 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 examine, a survey of 136 lengthy COVID sufferers confirmed that their post-COVID symptom profile (rash, hives, flushing, GI misery, tachycardia, mind fog, and so on.) so intently mimicked MCAS that the authors concluded that aberrant mast cell activation could underlie a number of the pathophysiology of lengthy COVID. This implies that COVID-19 could set off mast cells, resulting in MCAS-like signs in vulnerable people.
- In response to 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 function in lengthy COVID.
- An Asia-Pacific immunology assessment additionally famous an “activated situation of mast cells in lengthy COVID.” Such findings are per anecdotal stories of long-haulers creating new allergic sensitivities – for instance, sudden perfume and chemical intolerances and recurrent hives – that are hallmark signs of MCAS.
General, 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 normal inhabitants. In essence, persistent irritation may cause or exacerbate hypermobile EDS/HSD, inflicting joints to grow to be extra lax.
- A examine in BMJ Public Well being (2023) discovered that folks with pre-existing joint hypermobility have been 30% extra prone 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.
- Skilled 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 that they had.
Lengthy COVID and Chemical Sensitivity Syndrome
A number of chemical sensitivity (MCS), often known as idiopathic environmental intolerance, is a situation wherein people grow to be unwell from low-level publicity to chemical substances corresponding to fragrances and solvents. New or worsened chemical sensitivities have been famous in some lengthy COVID sufferers, suggesting one other aspect of post-viral immune dysfunction:
- Clinicians have reported instances of long-haulers creating extreme perfume “allergy symptoms” or hyperosmia (heightened sense of odor) leading to complications, rashes, and respiratory signs when uncovered to perfumes or chemical substances. 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 typically coexist with circumstances corresponding to MCAS and dysautonomia in long-haulers. Then again, preliminary information 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 affect of lengthy COVID, blurring the strains between what have 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 corresponding to POTS, MCAS, and others in beforehand wholesome people. Many long-haulers really feel “forgotten, unheard, disbelieved, [and] remoted” when their post-COVID circumstances are usually not 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 typically describe a sudden change in well being: at some point they have been energetic and employed, and weeks after COVID they discovered themselves dizzy upon standing, breaking out in hives, or unable to tolerate regular mild 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 informed 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 searching for take care of 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 health care provider was “so unreceptive to the purpose the place they have been really 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 related accounts: folks reporting that “COVID made me notice I’ve EDS/POTS/MCAS”, or {that a} minor an infection “flipped a swap” of their our bodies, resulting in persistent sickness. The overlap of circumstances is a typical theme – sufferers with newfound hypermobility typically even have POTS and MCAS signs, which is per medical observations of those comorbid syndromes
This anecdotal proof from sufferers factors towards the fact that lengthy COVID can set off advanced syndromes that have been typically beforehand under-recognized.
Rising Incapacity Claims As a result of Lengthy COVID
The rise in lengthy COVID instances has resulted in a major improve in incapacity claims and long-term absences. In actual fact, lengthy COVID has been referred to as “the biggest inflow of latest members to the incapacity neighborhood in a technology.”
A patient-led survey of three,782 COVID long-haulers in 2021 discovered that greater than two-thirds needed to scale back their work hours or have 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 Advanced Sicknesses
Lengthy-Time period Incapacity (LTD) Insurance coverage Claims
Many personal incapacity insurers provide long-term incapacity (LTD) advantages for these unable to work as a consequence of persistent circumstances. Nonetheless, LTD claims for lengthy COVID and associated problems typically face:
Proceed to advocate for your self, and know that with thorough documentation and assist, many sufferers are capable of 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 reveal that their signs meet or equal one other listed impairment, corresponding to cardiovascular, neurological, or immune system problems.
For instance, one technique is to seek advice from Itemizing 14.06 (Autoimmune Issues) for MCAS instances – if two or extra physique methods are reasonably concerned and there are frequent extreme signs corresponding to fatigue or malaise, you may argue that your situation parallels this itemizing.
Equally, extreme orthostatic intolerance might be in comparison with persistent coronary heart failure listings (as a consequence of diminished 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.
Steerage for Incapacity Claims
Pursuing incapacity advantages might be daunting. Listed below are suggestions and finest practices to enhance the possibilities of a profitable incapacity declare:
- Acquire Complete Medical Data: Collect all related medical information and take a look at outcomes that reveal your situation and its useful results. This could embody formal diagnoses (e.g., tilt desk take a look at report confirming POTS, and tryptase or mediator stage checks and allergy workups for MCAS). Make certain the information cowl the period of your sickness and notice any development or relapse.
- Acquire a Practical Capability Analysis (FCE): In the end, incapacity determinations hinge on useful capability – what you may or can not do constantly. A medical skilled can doc work-related impairments corresponding to the lack to face, sit, or focus for lengthy durations of time.
- Spotlight Failed Work Makes an attempt: In case 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, questions of safety, frequent absences). This real-world proof can strengthen your case.
- Use Residual Practical Capability (RFC) Kinds: A residual useful capability (RFC) analysis from a doctor might be helpful – this kind quantifies your limitations (how a lot you may elevate, how lengthy you may stroll/stand, and so on.) and sometimes determines whether or not you may work in any respect. Physicians ought to present RFC evaluations that explicitly state how signs have an effect on the flexibility to carry out work-related duties.
- Embrace Comorbid Situations: Lengthy COVID typically entails a number of overlapping circumstances (e.g., dysautonomia, fibromyalgia, and cognitive impairment collectively). Don’t restrict your incapacity declare to only one analysis – listing all related diagnoses and signs. The mixed results could meet incapacity standards even when every situation alone wouldn’t. In case you have anxiousness or despair on account of your situation, embody that as effectively (as psychological well being points can add to the general severity).
- Be Persistent and Take into account 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 might be prolonged (months or years), so take into account consulting a incapacity lawyer early on. Attorneys who concentrate on incapacity claims normally work on a contingency price and might drastically enhance your possibilities 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 capable of 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. Should you’re battling circumstances like POTS, MCAS, or EDS, know that you simply’re not alone and that you could be be eligible for advantages.
With persistence, documentation, and the suitable 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.
