Young Adult admissions for Long Covid & ME/CFS open in my center!

People from all over the world can be admitted, as needed

Long Covid and ME/CFS are mostly neglected or labelled as functional disorders around the world, with the exception of a few centers.

While this is generally true for everyone, this is particularly true for children, adolescents and young adults.

About children and adolescents up to 18 years of age, I have been able (and lucky, but also good) to convince my Institution about the importance of this field, therefore I can easily follow and admit these patients in my pediatric ward. Italian patients are admitted for free within the national health system.

However, I have understood (by talking with hundreeds of affected people) that young adults up to 30-35 years old with Long Covid or ME/CFS are literally abandoned from a health care perspective. They are literally patients of no one.

Some colleagues told me “Hey, Danilo, a 30yro man is more similar to a 17yro guy than a 70yro patient”, also referring to comorbidities and so on. “Why don’t you also try to help these patients?”.

Honestly, they were not wrong. As I work in one if not the best Italian Academic Hospital (not only pediatric, but general hospital), I have all the expertise I need for these patients. Actually, even my pediatric patients are cared in collaboration with other adult experts. Their experience with more severe cases of covid and long covid helped me translating my care to younger adolescents.

“Well, let’s do that, I thought”. However, from an administrative perspective, my hospital does not have a Long Covid-ME/CFS unit, and I cannot admit adults in the pediatric ward. As such, the Institution has allowed me to create a team that can check patients within the private sector of the hospital. Hopefully, this might work at least for the growing and growing number of people that have a health insurance.

People from all over the world can be potentially admitted. There are no restrictions on this regard.

I have already started with first adults.

HOW DOES IT WORK?

Step 1 - first contact

If you are a young adult up to 35 yro, or even a bit older if you have no previous major comorbities exept Long Covid or ME/CFS, you first have an online consultation with me. This consultation is free for my paid subscribers (it is only a symbolic 30 euros per year, the platform does not allow lower prices). This step is important to understand the diagnosis, what has been already done so far (in terms of diagnostics and treatments) and to agree a plan

Step 2 - first admission

Usually, the first admission, is mostly diagnostic. This is what I usually do:

• my assessment

• Cardiopulmonary exercise testing to measure a baseline fatigue and undertand how much the fatigue is due to muscle, hearth, metabolic, respiratory, or a mix

• stand test and 24hours ECG with heart rate variability to see if POTS or inappropriate tachicardia syndrome are there. These are usually treatable

• neurologic assessments with tests including for small fiber neuropathy and skin biopsy for mytochondrial function

• if severe neurocognitve symptoms, brain PET and SPECT can be done

• In those infected during initial variants and still with severe symptoms, lung SPECT

• neuropsychiatric assessment; with our ped NPIs, we have great experience in managing severe pain and headache with gabapentin

• psychiatric assessment. Many patients have also mood issues (either as a consequence or as part of long covid - ME/CFS). Important to have care from this perspective

• blood specialist to assess endothelitis and utility of anticoagulation

In older adolescents and young adults with severe symptoms, my first proposal is to start with intraveous immunoglobulin (IVIG) infusions, once a month for a minimum of three times, up to 6-8 if effects on symptoms. The reasons are written in a next dedicated post on IVIG, as well as recent studies on transfer of antibodies from long covid patients to mice, which I’ll discuss in future.

IVIGs do not substitute ivabradin, gabapenting, anticoagulation (prophilactic dose) if needed.

Also, I usually advice to treat reinfections, mostly with metformin, for the reasons I said in a previous post.

Feel free to contact me for further info

Thank you

(hope to not see you, as this would mean you are fine and don’t need my support)