Calgary researchers explore association between COVID-19 long-haulers, autonomic disorders

Dani Pohn, 37, caught COVID-19 in June 2020. Close to a year-and-a-half later, she is free of the virus, but still suffers long-term effects of the disease. She is what most people refer to as a "long-hauler."

"It's frustrating. I''ve lost a lot of the ability to live my day-to-day life the way I used to," said Pohn, a respiratory therapist. "The fatigue really limits how much I can do on a day-to-day basis. Activity wise, I'm unable to stand up as long as I used to and so that's really limiting."

The lingering symptoms of COVID-19 have kept her from her work at the Peter Lougheed Centre in northeast Calgary, where she would likely be treating COVID-19 patients.

"It's precluded my ability to go back to work, I find I have about two good hours on a daily basis, where I can focus and maybe do an errand or two. After that, I start to get quite fatigued. If I'm not laying down by 1 (p.m.), I feel absolutely sick. My heart is pounding, I'm flushed, I feel nauseous. I feel like it's difficult to get a breath in."

Pohn was part of the outbreak at a condo in Calgary's East Village.  She describes her bout with the virus as mild to moderate and her symptoms included extreme fatigue, headaches and a loss of smell. The initial symptoms lasted less than a month. At that point, she was officially listed as "recovered" but though she was free of the virus, she was not free of its effects on her body.

"In about October (2020), my recovery plateaued and there was no more increase of the improvement at that time," said Pohn. "So it was around that time when I thought this might be longer lasting than I originally thought it would be.

“I reached a plateau and realized nothing was changing. I continued to feel exhausted, have shortness of breath and tachycardia that just hasn’t gone away."

Pohn is now seeking treatment at a Calgary long-haul COVID-19 clinic, the Calgary Autonomic Investigation & Management Clinic in the Cumming School of Medicine, which treats individuals suffering with autonomic problems like tachycardia (rapid heartbeat), unregulated blood pressure and fainting.

Pohn is now a patient advisor for a study led by Cumming School of Medicine researcher Dr. Satish Raj, who is investigating how individuals suffering with long COVID-19 seem to develop problems with their autonomic nervous system.

"The autonomic nervous system takes care of background functions in the body," explained Raj. "One of the challenges with saying 'Is it working or not?', is it affects almost everything. So things like heart rate regulation, blood vessel tone, breathing, sweating, sleeping, to some extent, bowel function, bladder function, all the things that we need to work for ourselves to function properly, but things that we don't want to think about."

Raj, who is also a clinician at the Libin Cardiovascular Institute, has seen a noticeable increase in patients seeking treatment at the Calgary Autonomic Investigation & Management Clinic since the pandemic began. He is hopeful his research will lead to treatments for long-haul COVID-19 sufferers.

"The challenge is there are no evidence-based treatments for long-COVID or late COVID POTS (Postural Orthostatic Tachycardia Syndrome) because it's so new. There hasn't been time to do studies. But at the same time, from a patient point of view, it's not reasonable to say 'sit tight' or 'we'll get back to you in 10 years'  because the patients are suffering right now.

"These are people in the prime of their life, highly functioning members of society who may no longer be able to contribute to the full extent of their training and prior ability."

The study is currently recruiting. If you have long-haul COVID-19 symptoms and are interested in participating in the study, you can find out more by emailing autonomic.research@ucalgary.ca.