In contrast to other chronic infectious diseases, where many people go through a true odyssey until the diagnosis is finally made, the suspicion of a long-covid syndrome is usually made much earlier. Often it is easier to establish a temporal connection with an infection that has been passed through and there is a broader knowledge in the general population regarding the clinical picture.
A comprehensive diagnosis should clarify the following questions:
- Is there a secondary condition of a chronic infection at all?
- If so, is this infection active or inactive?
- What consequences are detectable (immune system disorders, metabolic changes, systemic inflammation, regulatory disorders, etc.)?
- Are there any accompanying factors (co-infections, heavy metal contamination, vital substance deficiency)?
The medical history already provides initial indications of the presence of a corona-related multisystem disease. Mainly the symptom pattern and its previous development as well as a temporal relationship between the first symptoms and a corona infection provide corresponding clues.
However, a corona infection rarely occurs alone. In most cases, the immune system must also deal with a whole series of other infectious agents. These include pathogens that have been present in the body for years as persistent pathogens. The immune system normally copes well with these. However, in concert with a misdirected immune system response cascade resulting from a corona infection, the pathogens can become active again. The occasional occurrence of shingles (herpes zoster virus) after a corona infection or corona vaccination is a clinical example of this. Other so-called co-infections can be:
- Bacterial pathogens: Borrelia, Anaplasma, Bartonella, Chlamydia, Mycoplasma, Yersinia and others.
- Viruses: Epstein-Barr, herpes, cytomegalovirus and others
- Parasites: Babesia, Toxoplasma, Worms and others.
- Fungi: candida, molds (aspergillos) and others
Here, a choice must be made with regard to diagnostics based on the clinical probability of the presence of such co-infection, the therapeutic consequence, and the cost.
In addition, the following examinations should ideally be performed in every patient with a Long Covid Syndrome:
- Cellular immune status (provides information about immune competence, immune activation and immune tolerance).
- Autoimmunity diagnostics (as a result of "confusion" of pathogen structures with the body's own tissues, the immune system may attack its own body = autoimmunity). For example, autoantibodies against receptors of brain messenger substances are a frequent finding in chronic fatigue syndrome as a result of a Corona, Borrelia or Epstein-Barr virus infection.
- Heavy metal screening (mercury, lead, cadmium or aluminum are not only harmful to the organism on their own, they also induce biofilm formation in the pathogens, a resistance mechanism which protects the pathogens from the heavy metals, from the immune system and unfortunately also from antibiotics)
- Vital substance diagnostics (serious chronic diseases lead to an increased need for vitamins, minerals and enzymes)
- Regulation diagnostics (disturbances in the vegetative nervous system, the control center of all internal processes in the organism, represent an obstacle to therapy and must be recognized and treated accordingly)
- Detection of metabolic changes typical of multisystem diseases, such as functional disorders of the mitochondria (the energy power plants of the cells), systemic inflammation, oxidative and nitrosative stresses (free radicals) or specific hormonal and enzymatic metabolic disorders
Overall, the diagnosis of suspected long covid syndrome or another infection-related multisystem disease is very complex and therefore belongs in the hands of a specialist. In principle, the following applies: As much diagnostics as necessary to find a holistic and promising therapeutic approach. However, no diagnosis should be made without a therapeutic consequence resulting from it. The final scope of the examinations to be performed will be determined during the initial appointment in the consultation.