UPDATE: August 16, 2021
We are not involved in the direct management of Covid positive patients. While certain therapeutic modalities are available for outpatient management, such as monoclonal antibody therapy, its use is restricted and limited to certain patient populations based on CDC and FDA recommendations. Other therapeutics may also have restrictions. Please contact your PCP, local urgent care, or ED or hospital system for information on management of your Covid related symptoms. For those patients with long Covid syndrome, there are emerging clinics and programs around the country to manage your ongoing problems. In the metro Atlanta area, Piedmont Hospital has such a program.
Booster Statement: Please see the CDC website for updates to this evolving process. Up to today, it was ONLY available for certain immunocompromised patients to include those with HIV or cancer. Today it changed to recommending that people receive a booster after 8 months from their original vaccine. Please see the CDC, the NIH, or your local community health department for ongoing and the most current recommendations.
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Many are asking questions about the vaccine. An excellent source of information is from the CDC, the White House Coronavirus Task Force, the NIH, or your local community health department.
From our perspective on December 14th, 2020 and as a general rule, the mitochondrial and other chronic complex disease patients we personally follow who have contracted COVID are getting sicker and requiring more intervention than their age matched controls. This finding is consistent with a study looking at Down syndrome patients who similarly developed more severe problems at younger ages. Of note, one of my adult patients has developed long COVID syndrome with fatigue, concentration and focusing issues and worsening autonomic problems following his recovery from active infection.
In regards to the reaction to the vaccine, one of our patients who participated in the Moderna trial developed 103F fever, was sick for days, but fully recovered within a week. As is consistent with other reports, these patients are developing a mild COVID phenotype. That is the extend of the data I have to date from our patients.
Those patients who are critically ill or very unstable baseline (intractable seizures that worsen with illness, for example) may wish to defer the vaccine in initial phases to prevent decompensation from the onset of a COVID phenotype post immunization. Other more stable patients may consider their general exposure risk (i.e. are they in health care or work in the critical supply chain) in the context of their health issues, the mental and physical fatigue of isolation, their age, and previous response to immunizations and illness. Unfortunately, we are unable to decide individual risks for any one person due to a lack of adequate data surrounding the various COVID-19 vaccinations. Such data will likely take months or years to obtain and is, therefore, unavailable at this time to assist with decision making. As such, ultimately the decision to receive the vaccination is up to you, the patient and the family. We, the medical community, are here only to provide you with the information as we know and understand the information at any given time.
Fran D. Kendall, M.D.
