Long-haul COVID-19 has proven one of the most troubling mysteries in a virus that’s caused no shortage of bafflement. Why do some people hospitalized with the virus develop symptoms that linger for months after infection? And, perhaps more bewilderingly, why do some patients who recover from mild COVID cases also end up saddled with lingering difficulties, including fatigue, shortness of breath and difficulty concentrating?
Dr. Leonard Weinstock, a gastroenterologist at Missouri Baptist Medical Center, believes the answer lies in the body’s mast cells. Those cells are activated in response to allergens or toxins. But for some patients, they seem to run amok. Even when there’s seemingly nothing to aggravate them, they go into attack mode, setting off symptoms like hives, swelling and difficulty breathing.
For Weinstock, who’s become an expert in what’s known as mast cell activation syndrome, long COVID had a familiar ring — one now confirmed by research. In a recent study published in the International Journal of Infectious Diseases, Weinstock and his colleagues found patients suffering from long COVID had “symptoms almost identical and similar in severity to those of mast cell activation patients.”
With some long COVID patients, Weinstock has begun treatments recommended for mast cell activation syndrome. One of them is Larissa McPherson, a St. Louis speech pathologist who suffered from a host of debilitating symptoms long after contracting COVID-19. McPherson’s tinnitus had gotten so bad, she couldn’t sleep.
Today, McPherson said she continues to struggle with hearing issues, which is a big problem for her career. But overall, she feels much better, and she credits Weinstock.
“I’ve had significant improvements in my life,” she said.
Weinstock noted that in many cases, the treatment for mast cell activation doesn’t involve expensive prescription drugs. “Many of the treatments are over the counter,” he said.
He said he’s been pleased to see how those treatments are working for people like McPherson, although he cautioned that further research is needed. He noted that mass cell activation syndrome is something that was only discovered in 2006 and even today frequently falls through the cracks between disciplines.
“It's unusual for a doctor to learn about it,” he acknowledged. In his case, it took a patient to educate him just a few years ago — but once they did, he began to realize just how many seemingly inexplicable symptoms in his patients traced back to it.
In that way, it has something in common with long COVID, which some physicians initially discounted. Today that’s changing, as the medical establishment increasingly acknowledges the toll it takes and the need for early intervention.
McPherson, for one, is grateful for that.
“I would just like to let people out there know that if they are dealing with symptoms similar to mine that they're not alone, that there are medical professionals out there that can help them and are understanding,” she said. “And they’ll listen and hear them and respect their wishes and help them to navigate the long-term consequences of this disease.”
Weinstock is hopeful for further advances. In the meantime, he’s also hopeful that many patients can benefit from what he’s learned.
“I think that many people are going to find some degree of relief with simple things,” he said. “And once the virus is truly out of the body, which is the hope, then the body's immune system will get back to normal.”
“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Kayla Drake. Jane Mather-Glass is our production assistant. The audio engineer is Aaron Doerr.
