ATUNE Long COVID Clinic
What is Long-COVID?
The Post COVID condition, also known as "Long-COVID," is a phenomenon that has affected many individuals who have recovered from the initial COVID-19 infection. This condition is characterised by the persistence of new or unexplained symptoms that last for more than 12 weeks after the initial infection.
Long-COVID is not just a mild extension of the acute disease. The symptoms of Long COVID can be incredibly diverse and affect multiple parts of the body. They can range from hardly noticeable to debilitating, making it difficult for those affected to carry out the simplest daily activities. Symptoms may also fluctuate unpredictably leaving people frustrated and confused.
Long-COVID can affect anyone, regardless of the severity of their initial COVID-19 infection or whether they have been vaccinated against the disease. Unfortunately, there is no one specific test for Long COVID, and a definite diagnosis requires an expert assessment from a health care professional, such as a physician or general practitioner.
At ATUNE Long COVID Clinic, we don't require a definitive diagnosis. You can be referred from your doctor, or you can contact us yourself if you have symptoms that are still present more than 12 weeks after your COVID-19 infection, and the symptoms are severe enough to affect your daily life.
If you have significant symptoms 4 weeks after a COVID-19 infection, so-called "medium COVID" treatment may prevent Long COVID developing. You are welcome to contact us to consider your options even if you have not reached 12 weeks post infection.
We will have you complete a thorough assessment of the severity of your symptoms, and if they are not improving reasonably quickly, we will request your doctor to run some tests to make sure you don't have other conditions that are causing these symptoms.
For more information on Long COVID, please read the WHO Coronavirus disease (COVID-19): Post COVID 19 condition page and watch the short "What are common Long COVID symptoms" video.
What are the symptoms of Long COVID?
Common symptoms can include:
- Shortness of breath
- Chest pain or discomfort
- "Brain fog" or difficulty thinking clearly
- Loss of smell or taste
- Hair loss
- Poor concentration
- Sleep disturbance
- Heart palpitations (racing heartbeat)
- Reduced exercise tolerance
Symptoms of Long COVID
Long COVID, also known as post-COVID syndrome, is a condition that can affect individuals who have recovered from a confirmed or probable case of COVID-19. According to the World Health Organization (WHO), Long COVID is characterized by symptoms that last for at least two months and impact everyday functioning, and may occur either as a new onset following initial recovery from COVID-19 or as a persistence of symptoms from the initial illness. These symptoms may also fluctuate or relapse over time.
Long COVID can manifest with a wide range of symptoms, with around 15% of individuals experiencing mental health and cognitive symptoms such as depression, anxiety, and brain fog, and another 5% experiencing respiratory symptoms like breathlessness and coughing. However, the majority (80%) of people with Long COVID have a broad range of symptoms that are not easily classified, including fatigue, hair loss, low libido, headaches, and pain.
In total, over 200 different symptoms have been identified and grouped into 10 categories based on the body system affected.
Systemic (affecting the whole body) Most common symptoms: Fatigue, Chills/Flushing/Sweats
Reproductive / Genitourinary / Endocrine Common symptoms: Extreme thirst, Sexual or Menstrual dysfunction
Cardiovascular (heart and blood vessels) Common symptoms: Palpitations, Heart rate changes, Pain in chest
Musculoskeletal (muscles and joints) Common symptoms: Tight chest, Muscle/Joint/Neck/Bone aches or pains
Immunologic / Autoimmune Common symptoms: Allergies, Shingles
HEENT (head, ears, eyes, nose, and throat) Common symptoms: Pain, Vision problems, Sensitivity, Ringing in ears
Pulmonary / Respiratory (breathing and airways) Common symptoms: Short of breath, Cough, difficulty breathing
Gastrointestinal (stomach and digestion) Common symptoms: Diarrhoea, Nausea, Loss of Appetite
Dermatologic (skin) Common symptoms: Itchy, Rash, Peeling
Neuropsychiatric (brain and nerves) divided into 9 areas:
- Cognitive Dysfunction - Brain fog, difficulty thinking,
- Speech and Language Difficulties and communicating with difficulty
- Memory loss
- Smell and Taste changes
- Poor Sleep - Insomnia, vivid dreams, Restless leg
- Emotion and Mood - Anxiety, Irritability, Depression
- Sensorimotor - Dizziness, Pins and needles, tremors
Causes of Long COVID
The causes of Long COVID are not yet fully understood, but some possible explanations include:
- raised levels of inflammatory chemicals,
- damage to blood vessel walls in the lungs and the brain caused by the immune system attacking special cells called endothelial cells,
- an overactive immune response,
- chronic low-grade inflammation,
- autoimmune reactions in which the immune system attacks the body's own cells.
- higher levels of immune cells in the blood and lower levels of cortisol (the stress hormone).
- Dysfunction in the immune system, and in the central and autonomic nervous systems feature in these suggested causes of Long COVID symptoms. In the next post, we will delve into how to address these dysfunctions and potentially relieve your symptoms.
We recommend that you first visit your GP for an initial assessment. Based on their findings, they may request further investigations to help determine the cause of your symptoms.
While a doctor's referral is not required for you to join our clinic, it's important to note that your symptoms may be indicative of other conditions besides Long COVID. To ensure an accurate diagnosis, we recommend consulting with your GP.
If you do visit your doctor, please share this link with them for Information for referring physicians.
The ATUNE Long COVID clinic is an integrated, multi-disciplinary team of allied health professionals providing an outpatient service to address the symptoms of Long COVID for patients living in Newcastle and Lake Macquarie.
The service includes:
- General Practitioner/Health Coach
- Physiotherapists (manual and respiratory approaches)
- Exercise Physiologist
- Osteopath (Perrin technique)
- Breathing Therapist
Weekly Support Group
These facilitated meetings are to provide you with social support and appropriate education for your clinical needs while you recover.
Our approach has two stages:
First, we provide three to six weeks of therapy focused on relieving symptoms, increasing energy and reducing debility. Once this "pre-rehabilitation" stage is complete, and you are ready, we move on to rehabilitation towards getting your life back to normal.
Our approach during the pre-hab stage:
- We believe in starting treatment as early as possible for the quickest and smoother recovery.
- Our treatment plans are tailored to you, as no two people have the same needs or responses to treatment.
- We use a combination of therapies, as no single therapy can effectively relieve this complex condition. Even therapies that may not work alone, can be effective when combined.
For more on the prehab stage see information under the '4 Principles For Recovering From Long COVID' and 'Unlock the Power of Naturopathy, Breathing Therapy & Thermotherapy' headings.
Rehabilitation may include providing information, education, supported self-management, peer support, symptom management strategies, and physical rehabilitation. Our Long COVID clinic uses a multi-disciplinary approach to guide the rehabilitation process, which includes both physical and psychological aspects of management. This includes:
- Setting goals for your rehabilitation based on an initial assessment, which may lead to further investigations.
- Assisting you and providing guidance throughout the recovery process.
- Helping you and giving guidance when your symptoms fluctuate.
Get Your Life Back
If you've been struggling with the aftermath of COVID-19 for months, you're not alone. Long COVID, also known as post-acute COVID-19 syndrome, affects a significant portion of people who have had the virus. The good news is that there are steps you can take to improve your chances of recovery.
The ATUNE Long COVID Clinic has developed a four-principle approach to helping people like you get back to their former selves.
Limited time for action
The longer you wait to address long COVID, the harder it can be to recover. Your immune system and metabolism can become accustomed to being out of balance, making it difficult to get back on track. That's why it's important to start treatment as soon as possible. Initial treatments are designed to require minimal effort on your part but still get you on the path to recovery.
Everyone's symptoms are different, so a one-size-fits-all approach won't work for everyone. At ATUNE, we use the Symptom Burden Questionnaire to create an individualised treatment plan that takes into account your specific issues and tracks your progress. This allows us to adjust the plan if progress is slow.
Long COVID affects multiple body systems, so it's likely you'll need a combination of treatment modalities to recover. ATUNE's long COVID rehabilitation team includes physiotherapists, exercise physiologists, psychologists, a dietitian, and practitioners of the Perrin Technique (an osteopathy technique used for chronic fatigue). These therapies can take months to show improvement, but when used in an integrated way, they can be effective in helping you recover.
ATUNE also offers therapies that are less commonly used in long COVID clinics but have been shown to have quick, system-wide effects. These include naturopathy, breathing therapy, and thermotherapy. By starting with these therapies, you can create a foundation for your rehabilitation and conserve your energy.
By following these four principles in an integrated approach, you can increase your chances of a quick recovery from long COVID. If you're struggling with the aftermath of COVID-19, don't hesitate to seek help. The sooner you start treatment, the better your chances of getting back to your normal self.
Are you struggling with the symptoms of Long COVID? You're not alone. Many people are experiencing fatigue, brain fog, impaired memory and concentration, headaches, ringing in the ears, and breathing difficulties as a result of the virus. But, at ATUNE, we believe that there is hope for recovery.
Naturopathy, Breathing Therapy, and Thermotherapy are three powerful therapies that address the underlying causes of Long COVID symptoms. By targeting dysfunction of the immune and nervous systems, these therapies can make a quick impact on your symptoms and help you regain your health.
Addressing Central Nervous System Dysfunction (CNS)
Naturopathy uses diet, nutrients, and herbal medicines to reduce inflammation and improve brain function. Thermotherapy improves the health of blood vessels and reduces inflammation in the brain. And Breathing Therapy reduces stress hormone production and improves the balance of the autonomic nervous system.
Additionally, the Perrin technique which uses osteopathic techniques to stimulate motion of the fluid around the brain and spinal cord, can also be beneficial in reducing symptoms of fatigue.
Addressing Autonomic Nervous System Dysfunction (ANS)
This system regulates automatic body functions such as breathing rate, heart rate, blood pressure and digestion. Naturopaths can recommend herbal medicines and help you make changes to your sleep and lifestyle to improve ANS health. Breathing Therapy helps balance the two parts of the ANS: the sympathetic system, which reacts to stress, and the parasympathetic system, which helps conserve energy when you have chronic fatigue. Breathing therapy for chronic fatigue is called “autonomic conditioning” and has been showing success in treating long COVID.
Addressing the Immune System Disorders
Thermotherapy also helps to address immune system disorders, by kickstarting a normal inflammatory response, which is followed quickly by a strong anti-inflammatory phase, assisting the immune system return to its normal, everyday function of repair and regeneration. Naturopathy also provides herbal medicines and nutritional supplements that can help in both the inflammatory and anti-inflammatory phases of the immune response. Additionally, changes in diet, sleep, and other lifestyle patterns can strongly affect the immune system and help return it to health. Breathing therapy can also strengthen the immune system by relieving stress, reducing air intake and increasing filtration, reducing ongoing exposure to air contaminants reducing pressure on the immune system.
When used together (ATUNE's Pre-hab stage), these therapies can have a synergistic effect, helping relieve your symptoms, allowing you to begin rehabilitation earlier and make progress more quickly. Don't let Long COVID symptoms control your life. Unlock the power of naturopathy, breathing therapy, and thermotherapy and start on the road to recovery.
We are focused on finding the best treatment for Long COVID, so we use diagnostic tools to assess your degree of disability. These tools also assist us in determining the best treatment course.
Our process includes the following steps:
1 . A free Group Information Session with staff from the clinic. Both online and in-person. We will assist you to complete the PASC Score – a quick scale assessing your symptoms. More information about the services offered will be provided and your questions answered. If you choose to join the clinic, or the study, the staff member will:
- Help you schedule an Intake Interview and an appointment with the clinic GP.
2 . At the Intake Assessment Interview (at the cost of a physiotherapy consult) one of our therapists will:
- Review your SBQ with you and answer any questions you have.
- Complete the intake form with more details about your COVID infection and other health issues that may be affecting your long COVID
- Conduct objective tests, appropriate to your condition and symptoms.
- The results will be sent to the GP.
3 . At a doctor’s visit the General Practitioner will:
- Review the results of the questionnaires and objective tests with you.
- Conduct the Yorkshire Rehabilitation Survey
- Ensure your assessment is complete and gather any additional information that is needed.
- Discuss your preferences, needs and options.
- Together, you will plan the best pathway of treatment.
4 . You will have the opportunity to join a GP-facilitated, long COVID support group. Current meetings are fortnightly on Friday mornings.
5 . After the GP appointment, the clinic will assist you to schedule appointments that meet your treatment goals and suit your condition and personal situation. Care pathways can involve several practitioners seeing you on the same clinic visit. Long COVID is a complex condition requiring an individualised, carefully integrated, multi-disciplinary approach.
6 . We will give you follow-up questionnaires at appropriate intervals to measure your response to treatment and adjust your pathway.
7 . If you choose to join the pilot study, you will be given more details and the information from your initial questionnaires and the follow-up measurements will be used to design a Long COVID clinical trial. All the information we will collect your de-identified data and compare it with others to understand the symptom burden of people with Long COVID and track your progress over time.
Medicare (referral required), health fund
NDIS and other please ask for more information.
A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
Hair loss and lower libido among long COVID symptoms – new research https://theconversation.com/hair-loss-and-lower-libido-among-long-covid-symptoms-new-research-187504
Characterizing long COVID in an international cohort: 7 months of symptoms and their impact https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/fulltext
When does COVID become long COVID? And what’s happening in the body when symptoms persist? Here’s what we’ve learnt so far https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976
Long COVID-19 and other chronic respiratory conditions after viral infections may stem from an overactive immune response in the lungs https://theconversation.com/long-covid-19-and-other-chronic-respiratory-conditions-after-viral-infections-may-stem-from-an-overactive-immune-response-in-the-lungs-186970
Being stressed out before you get COVID increases your chances of long COVID. Here’s why https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649
Long COVID: How researchers are zeroing in on the self-targeted immune attacks that may lurk behind it https://theconversation.com/long-covid-how-researchers-are-zeroing-in-on-the-self-targeted-immune-attacks-that-may-lurk-behind-it-169911
Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010124/
What is Long-Haul COVID? How Naturopathic Medicine Can Help Relieve the Suffering https://nhcmed.com/further-reading/topic-immune-resilience/what-is-long-haul-covid-how-naturopathic-medicine-can-help-relieve-the-suffering.html
Autonomic conditioning therapy reduces fatigue and improves global impression of change in individuals with post-acute COVID-19 syndrome https://assets.researchsquare.com/files/rs-440909/v1/2d114b41-2789-41d2-8ce5-68097594b3a9.pdf?c=1631881293
Thermotherapy - Key Points - an overview https://docs.google.com/document/d/1JuDZH6DlCFPVPobUWUutna1ZAfBv2A33uW_gEkzkaK8/edit?usp=share_link
Repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure https://www.sciencedirect.com/science/article/pii/S0735109701018241
H., Heald, A., Perrin, R., Walther, A., Stedman, M., Hann, M., Mukherjee, A., & Riste, L. (2022). Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention. Cardiovascular endocrinology & metabolism, 11(2), e0261. https://doi.org/10.1097/XCE.0000000000000261
Long Covid And The Perrin Technique https://goodhealthcentre.co.uk/long-covid-perrin-technique/
Autonomic conditioning therapy reduces fatigue and improves global impression of change in individuals with post-acute COVID-19 syndrome https://www.researchsquare.com/article/rs-440909/v1
The effect of repetitive mild hyperthermia on body temperature, the autonomic nervous system, and innate and adaptive immunity https://www.jstage.jst.go.jp/article/biomedres/36/2/36_135/_article
Breathing exercises to help reduce stress and improve immune system https://www.candi.nhs.uk/news/breathing-exercises-help-reduce-stress-and-improve-immune-system