Montreal study looks for ways to treat COVID-19 long-haulers crippled by lingering symptoms

When Louise Brire caught COVID-19 back in December2020, she had the usual symptoms like losing her sense of taste and smellbut overall it was tolerable.

Then February 2021 rolled around and Brire, a 59-year-old woman who lives in Repentigny, Que., started feeling exceptionally fatigued and wasn't able to think clearly at times. To this day, some mornings it feels like she is waking up after a hard night of drinking, and that's only the beginning, she said.

"It started with chest pain, and I have pain all over the body," she said.

The retired life coach has gone from an active lifestyle, walking five or six kilometres per day, to being practically immobilized. Now with a grandchild on the way, she's extra worried.

"Will I be able to babysit that child safely? It's the biggest joy in my life, having this child in the family. It's the first. So this is my main concern. I wish I could be like before," she said.

She has turned to the Montreal General Hospital for help, hoping Dr. Thao Huynh can uncover the cause of and find a solution for the brain fog, pain and fatigue.

Huynh is a researcher and epidemiologist-cardiologist with the McGill University Health Centre (MUHC) and she is conducting a study on the long-haul impacts of COVID-19 with the aim of better understanding the disease and treating itssymptoms.

At the same time, she is looking to raise awareness about the disease and how it is affecting what she believes to be as many as one million Canadians including a third of people infected in 2020.

Her estimate is higher than the federal government's, which says nearly 3.9 million people have contracted the virus and about 390,000 people suffer from long COVID.

Long-COVID symptomsinclude fatigue, chest pain, trouble speaking and problems with breathing, memory and concentration, the World Health Organization (WHO) says.

The WHOestimates that at least 10 per cent of people infected with COVID-19 will experience post-COVID condition.

Uncovering heart and brain damage

Huynh said her research has so far uncovered clear indicators of heart damage in patients who have these long-COVID symptoms.

Her study is uncovering active heart inflammation or heart scarring. There are also heart palpitations and other abnormalities, she said. In fact, a third of patients have heart problems, she said. The brain is also affected, she added, and the brain and heart are closely related.

She said about 80 per cent of long-COVID patients are women and she believes it is an autoimmune issue. However, she admits, not everybody agrees with her on that. What is clear is that many people, including doctors and nurses, are crippled by the symptoms, she said.

Huynh'sImpact QuebecCOVID-19 Long Haul Study launched a year ago after the project won an international competition and a grant from Pfizer. It includes the MUHC,Universit de Sherbrookeand the Montreal Clinical Research Institute.

She has 25 patients who have severe cases of long COVID. Some, she said, were healthy and young in their 20s when they got infected and now rely on a wheelchair to get around.

She said those who were infected before the vaccines are particularly difficult cases with less hope for a complete recovery, but those who caught COVID while vaccinated are more likely to recover.

"The good news, if there is good news, is most of the cardiac problems, I can treat them," Huynh said. "The brain unfortunately there's not much to do. There's just time."

Huynh said she already has enough data to complete the study, but will continue it at least until the end of the year before publishing, just because of the sheer demand from patients.

She said she also hopes the data from this study will allow for the creation of a broaderstudy down the road, involving a much larger group of patients, and she would like to see moreinvestedin studying and treating long-COVID.

Huynh said she has been inundated with patients seeking help, and while Quebec has announced it is opening 15 long-COVID clinics and investing millions, she said it's not enough.

"I hope to find a medication to help my patients," she said. "I have some ideas and I wish for the government's support to do so."

Other treatments on horizon

Treating symptoms such as breathlessness, fatigue and brain fog in those who suffer from long-COVID is now possible thanks to research led by Western University.

Using a functional MRI where patients inhale xenon gas, researchers there can see in real time what is happening inside the lungs.

Preliminary results show symptoms are related to microscopic abnormalities that affect how oxygen is exchanged from the lungs to red blood cells.

The research, which was published late last month, found the transition of oxygen was depressed in long-COVID patients compared to healthy volunteers.

The research also shows that there doesn't seem to be a difference in the severity of the abnormality between patients who required hospitalization for COVID-19 and those who recovered from the illness at home.

Meanwhile, Canadian provinces are struggling to keep up with the demand from long-COVID sufferers.

Dr. Neeja Bakshi, an internal medicine physician based in Edmonton, Alta., runs a post-COVID clinic out of her private practice. She gets about five patient referrals a day, some from out of province, and they have to wait months before getting their first appointment, she said.

"It feels great that I'm providing a service that can help so many people," said Bakshi. "But it's also an incredible pressure because I know that I can't see everybody and I know that I'm not going to be able to provide the care that I want if I'm burnt out."