#Long #COVID SYMPTOMS

Some people who get COVID have ongoing symptoms, new symptoms, or symptoms that go away but return. This condition is commonly called Long COVID.

It has been challenging to know whether symptoms are really due to the ongoing effect of COVID infection or is due to a different cause.

The NIH has developed a research study, named RECOVER, that is intended to identify symptoms after COVID infection that can reasonably identify people with Long COVID.

People who had COVID were compared to people with similar characteristics such as age, sex, race, and the like Both groups were questioned about the presence of symptoms that may be associated with Long COVID.

Those symptoms that were more common 6 months after an initial infection in people who had COVID compared to the control group were considered to be a result of COVID rather than some other coincidental cause.

There were 12 symptoms that were significantly more common among people who had COVID. In order of frequency they are: postexertional malaise (after physical exertion having a feeling of being unwell and often lacking interest in things that used to interest them), fatigue, brain fog, dizziness, GI symptoms, palpitations (unusual awareness of heart beats), change in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements.

Six of these symptoms were the most common; in order of frequency they were: postexertional malaise (87%), fatigue (85%), brain fog (64%), dizziness (62%), GI symptoms (59%), and palpitations (57%).

While these findings are not yet definitive, they are able to be used to determine if a person has Long COVID. Your odds of having Long COVID, increases the more of these symptoms you have.

My suggestion is for you to see your doctor if you have one or more of these symptoms several weeks after an acute episode of COVID.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

#Weight Loss Medication

Wanting to lose weight is a common concern for many people. Unfortunately, it is not often an easy thing to do. That’s why many people hope for a medication that can make the process work faster and more effectively.

Recently, certain medications developed to treat diabetes have been shown to aid weight loss. There are at least 8 different ones with a similar mechanism of action.

One of them is semaglutide (brand names include Ozemoic, Rybelsus, and Wegovy). The last brand is the only one intended for use for weight management for a person who does not have diabetes.

Semaglutide is a GLP-1 agonist, which stimulates insulin secretion when glucose enters the blood stream. It also stimulates brain receptors involved in regulating appetite so that its use reduces hunger. There are currently 8 different GLP-1 medications available.

Semaglutide is given by subcutaneous injection once a week. The dose is gradually increased over time.

The NIH published a review article indicating that semaglutide produces an average weight loss of 9.6% of the starting weight after 68 weeks of use.

It should not be used by pregnant women or people with serious GI illnesses. The most common side effects are nausea, vomiting, and diarrhea. Other less common ones include dizziness, increased heart rate, infections, headache, and upset stomach.

Recently, Reuters (5/19 Rigby) reported on a study by the Mayo Clinic that showed that semaglutide not only produced weight loss but also reduced the risk of heart attacks and strokes.

The researchers used a risk assessment tool from the American College of Cardiology and found that the risk for these two conditions dropped from 7.6% to 6.3%. The study primarily involved white women with no history of heart disease and who had a starting BMI averaging 39.8.

A more detailed study is underway, the 5-year SELECT TRIAL. It is expected to provide more precise information about the benefits and potential harms of using semaglutide.

It is also important to keep in mind that most people will regain some of the weight they lost when they stop the medication.

Also, although the GLP-1 medications can be an aid in weight management for select patients, it is not intended to be the sole means of weight loss. Diet, exercise and other “lifestyle” measures remain a critical part of weight management.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

The #Brain #Diet

The Harvard School of Public Health published a wonderful online article titled, “MIND diet targets brain health,” especially for the aging brain.

MRI of Brain

The MIND diet combines two health-promoting diets, the Mediterranean and the DASH diets. Both of them had already been shown to benefit brain health.

The MIND diet “highlights plant-based foods and limits the intake of animal and high saturated fat foods.” The article gives specific guidelines on what foods to eat and which ones to limit.

The foods recommended by the MIND diet are “foods rich in certain vitamins, carotenoids, and flavonoids that are believed to protect the brain by reducing oxidative stress and inflammation.”

Research on the MIND diet in older people, who adhered to the diet to the greatest extent, showed a 53% lower rate of Alzheimer’s disease compared with people who followed the diet to a minimal degree. Even moderate adherence to the diet led to a 35% reduction compared to those who followed the diet to the least extent.

The MIND diet added to the benefits from other helpful factors such as “leading a healthy lifestyle, limiting cardiovascular risk factors (e.g., high blood pressure, diabetes, depression, and obesity”).

The article also notes that the MIND diet “may also benefit heart health, diabetes, and certain cancers …”. The authors point out that people who want to adopt this diet will “need to create their own meal plans and recipes based on foods recommended on the MIND diet.”

This blog is based on the review article by the Harvard T.H. chan School of Public Health. It would be worth your while to look it up online.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

OTC #Birth #Control Pill

An advisory group to the FDA has recommended that an over-the-counter pill, Opill (norgestrel) be approved. This would mean that women could purchase oral birth control pills without a prescription and a visit with their doctor.

Some people have raised concerns that some women will begin taking these pills when they are contraindicated, e.g., have breast cancer or abnormal vaginal bleeding.

However, this concern may be dealt with by providing clear instructions on the correct use of the pills. The instructions should include contraindications for their use.

The pills are not available at this time because they must first be approved by the FDA. If they are in the future, it will be a real convenience for women desiring oral contraception.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

Clouds at Sunset

What is #CRT? Does it help? What is an alternative? The answers are in this book from Amazon.

Amazon: $5.50 for the paperback.

#Dating # Violence in #Teens

A recent study published in Pediatrics on May 2, 2023 summarized 38 studies on the long term effects of dating violence among teens.

Teen dating violence (TDV) was defined as “a variety of harmful partner-directed behavior (including physical, sexual, psychological, and cyber violence) that occurs within adolescent romantic relationships.”

TDV was linked to “substance use and poor conflict and anger management skills.” Physical violence was present in 20% of cases, sexual violence in 9%, and psychological violence in 17-88%, depending on the population.

Females are negatively affected more than males, but both can be victims of dating violence. Other studies have shown that teen boys and girls are equally likely to engage in one or more of these forms of “violence,” however, boys are much more likely to commit sexual violence.

Some of the long-term effects of TDV include problems with “mental and physical health, recurrence of violence in intimate relationships, and high-risk behaviors (i.e., marijuana and sexual behaviors).”

Mental health problems from TDV included “depression and anxiety” (both boys and girls but especially in girls), suicidal thoughts, “post-traumatic stress disorder, and binge eating disorders.” Sexual risk behavior (unprotected sex) increased in victims of physical and psychological abuse.

The bottom line is that teen dating violence is common and carries risks including in the long run. Teens deserve education about this problem and be provided with counseling when needed.

Peter M. Hartmann, MD

Family Medicine & Psychiatry