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Management of Long-COVID Postural Orthostatic Tachycardia Syndrome With Enhanced External Counterpulsation, 2021, Varanasi

Discussion in 'Epidemics (including Covid-19)' started by ola_cohn, Nov 25, 2021 at 12:35 AM.

  1. ola_cohn

    ola_cohn Established Member (Voting Rights)

    Messages:
    35
    Location:
    Australia
    Abstract

    A growing number of patients diagnosed with COVID-19 disease have been reported to have postural orthostatic tachycardia syndrome (POTS) after the acute phase.

    A 57-year-old female was diagnosed with COVID-19 in December 2020. As a result of her acute illness, she was hospitalized for COVID pneumonia and respiratory failure, followed by stays at an acute care facility and home rehabilitation center.

    After the acute phase, the patient was diagnosed with long-COVID-19-associated POTS with symptoms such as fatigue, “brain fog,” and dyspnea. The patient was referred to an enhanced external counterpulsation (EECP) treatment center and underwent 15, one-hour sessions over three weeks.

    Upon completion of therapy, the patient reported improvements with “brain fog” and the ability to perform activities of daily living. Her Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue score was reduced by three points, six-minute walk distance increased by 85 feet, and Duke Activity Status Index (DASI) improved by over 15 points. EECP therapy was chosen due to the overlap in underlying pathology driving POTS and the mechanisms of action of EECP.

    This report is the first case of using EECP for the successful management of COVID-19-associated POTS and warrants further trials.

    Full text, open access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555928/
     
    Last edited by a moderator: Nov 25, 2021 at 2:02 AM
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    17,394
    Location:
    New Zealand
    EECP:
    A case study of 1, a potentially profitable treatment with multiple sessions required, the treatment is supposed to help with a whole lot of illnesses.
    She had had a pretty bad Covid-19 infection, having been hospitalised for a long time. So she may well have still been recovering.
    It's all consistent with a placebo effect.

    Enhanced circulation and prevention of fluid build-up would probably help with POTS in the short term, but it's hard to see how the treatment could have a lasting effect.

    So, I'm not rushing out for EECP just yet.
     
    alktipping, Lilas, Mij and 8 others like this.
  3. Milo

    Milo Senior Member (Voting Rights)

    Messages:
    1,594
    Nailed it.

    Doctors with the dollar sign in mind will be more than happy to provide this treatment to whoever is desperate enough to believe that this study provides objective evidence that it works.

    85m more on a 6 minutes walking test? Wowwwwie! I reminds me of our beloved friend with his GET videos, @Graham (RIP)

    Edit to add:
     
    Last edited: Nov 25, 2021 at 4:36 AM
    alktipping, Lilas, Mij and 2 others like this.
  4. 5vforest

    5vforest Senior Member (Voting Rights)

    Messages:
    158
    Location:
    San Francisco, CA
    Not 85 meters, 85 feet. "910 ft at baseline to 995 ft post-EECP". Are you serious?

    Also, 3 points on the PROMIS score... is this the scale that goes from 0-40?

    I don't even know why I am commenting...
     
    alktipping, Lilas, Mij and 5 others like this.
  5. Trish

    Trish Moderator Staff Member

    Messages:
    37,449
    Location:
    UK
    Looks like advertising masquerading as science. I wonder whether it's a real journal.
     
  6. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    7,646
    Location:
    Canada
    N=1 with a highly fluctuating illness makes this uninterpretable, adding to that the high % of natural recoveries making any attribution basically reaching.

    If the "placebo" effect were anything but errors of measurement (or more commonly the error of not being able to measure accurately but pretending that it's OK), this would do nicely:
    So basically a dynamic compression garment, commonly used with POTS. But unlikely to add anything to it.
     
    alktipping and Hutan like this.

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