Research Team May Have Found A Way To Reduce Effects of Long COVID-19 Symptoms

FORT WORTH – A study involving patients experiencing Long COVID-19 symptoms that have coronary artery disease (CAD), and those without it, has shown improvement in a variety of long COVID-19 symptoms using enhanced external counterpulsation (EECP) therapy.  

Mohanakrishnan Sathyamoorthy, M.D., FACS, Chair of Internal Medicine at the Anne Burnett Marion School of Medicine at Texas Christian University, is a part of a research group studying ways to reduce the effects of Long COVID-19 symptoms in patients. 

Dr. Sathyamoorthy helped formulate the hypothesis for the study with Sachin A. Shah, PharmD, the senior author on the study and chief scientific officer at Flow Therapy, a nationwide EECP provider headquartered in Fort Worth.  

Dr. Sathyamoorthy’s hypothesis aimed to demonstrate the effectiveness of EECP to treat Long COVID patients in either subgroup with or without CAD.  

“But we did it with the greater aim to generate preliminary data in the non-CAD group,” Dr. Sathyamoorthy said. “Having confirmed positive findings in this group we are designing a larger randomized trial to confirm this finding. If so it would strengthen EECP therapy as a potential standard of care treatment for Long COVID in any patient not just those with CAD.” 

Globally, it is estimated that about 50% of patients who get infected with COVID-19 experience symptoms after the virus is gone. Those symptoms include fatigue, breathing difficulties and chest discomfort can linger six months after the acute phase of a COVID-19 infection, with the long-term symptoms varying in severity. 

That is why it is important we keep searching for solutions to fight COVID before and after infection occurs, Dr. Sathyamoorthy added. 

“I am on record stating that the acute infection and illness phase is the tip of a chronic disease state iceberg that COVID-19 will unfortunately leave us with in global society,” Dr. Sathyamoorthy said. “Long COVID is one long term concern for us in the clinical community.” 

EECP therapy is a non-invasive technique shown to improve cardiac and cerebral perfusion. Perfusion is the passage of fluid, or blood, through blood vessels to an organ or a tissue. EECP therapy has demonstrated in numerous peer-reviewed and published studies to have a machine-like basis of impact through the enhancement of the Endothelial NOS (eNOS) and nitric oxide pathway, which is a part of cardiovascular health maintenance in the human body.   

The patients in the study presented with a variety of Long COVID-19 symptoms, including fatigue, breathing difficulties and chest discomfort. After undergoing 15-35 hours of EECP therapy, that included the patients undergoing a treatment session for one hour up to 35 times over the course of seven weeks, the patients showed improvement in several areas. 

The research group’s analysis found statistically significant improvements across all validated testing tools: 

• Health Status using the SAQ7 tool improved by 25 points (Range 0-100) 
• Functional capacity using the DASI assessment improved by 20 points (range 0-58.2) 

• Fatigue levels using the PROMIS score decreased by 6 points (Range 4-20) 
• Shortness of Breath using the RDS decreased in 50% of patients 
• Walking capacity (6MWT) in 6 minutes increased by 178 feet 

Researchers found the change from baseline for patients with long COVID only was significant for all endpoints and no difference was evident between patients with long COVID without CAD compared to those with CAD. 

“We both believed that a very important part of Long COVID pathophysiology is driven by SARS-CoV2 induced endothelial inflammation and subsequent dysregulation of vasoreactive function through alterations in eNOS driven nitric oxide availability in patients,” Dr. Sathyamoorthy said. “Thus we had a hunch that this approach of EECP to treat Long COVID may work and all of our initial studies and publications in this area seem to support it.” 

The research group presented their findings at the American College of Cardiology’s Cardiovascular Summit virtual conference back in February. Dr. Sathyamoorthy will help design and secure funding for the group to begin a larger randomized trial with a sham-control group to better test the findings in their initial study.   

“Randomization studies have been done with EECP and have an accepted methodology in the literature which we will use to ensure validity of results,” Dr. Sathyamoorthy said.