Long-COVID aus Sicht der Anthroposophischen Medizin – Symptome und Behandlungsmöglichkeiten. Empfehlungen einer internationalen Expertenkommission für medizinische Fachkräfte

Henrik Szőke, Markus Sommer, Eva Streit, Christian Grah, Madeleen Winkler, Philipp Busche, Severin Pöchtrager, Jan Mergelsberg, Carla Wullschleger, Katharina Gerlach, Rolf Heine, Robert Fitger, Harald Matthes, Georg Soldner
Article-ID: DMS-21451-DE
DOI: https://doi.org/10.14271/DMS-21451-DE

  • Login
  • Get Access
  • Export Citation

Eine wachsende Anzahl von Menschen ist von einem Long-COVID-Syndrom mit oft langanhaltender erheblicher Beeinträchtigung ihrer Gesundheit betroffen. Dabei treten unterschiedliche Bilder mit prolongierter Hyperinflammation, Schädigungen und funktioneller Einschränkung der Muskulatur, des Herzens, des Nervensystems und der Sinnesorgane auf. Eine größere Gruppe eher jüngerer Patienten und Patientinnen weist die Symptomatik eines postviralen Chronic-Fatigue-Syndroms/Myalgischen Enzephalomyelitis-Syndroms (CFS/MES) auf. Diese Patienten hatten öfter einen eher milden COVID-19-Verlauf und können danach eine langanhaltende CF-/ME-Symptomatik entwickeln. In diesem Beitrag werden Aspekte zum Verständnis der Störung sowie ein multimodales Therapiekonzept der Anthroposophischen Medizin dargestellt.

Long COVID from the perspective of Anthroposophic Medicine – symptoms and treatment options. Recommendations of an international expert commission for health professionals

A growing number of people are affected by a Long COVID syndrome with often long-lasting, significant impairment of their health. Different pictures with prolonged hyperinflammation, damage and functional restriction of the musculature, the heart, the nervous system and the sensory organs occur. A relatively large group of rather younger patients shows symptoms of post-viral chronic fatigue syndrome/myalgic encephalomyelitis syndrome (CFS/MES). These patients more often had a rather mild COVID-19 course and may subsequently develop long-lasting CF/ME symptoms. This article presents aspects for an understanding the disorder as well as a multimodal treatment concept of Anthroposophic Medicine.

1 Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nature Medicine 2021;27:601–615. DOI: https://doi.org/10.1038/s41591-021-01283-z. [Crossref]

2 Oronsky B, Larson C, Hammond TC, et al. A review of persistent post-COVID syndrome (PPCS). Clinical Reviews in Allergy & Immunology 2021. DOI: https://doi.org/10.1007/s12016-021-08848-3. [Crossref]

3 Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of Long-COVID: Analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App. medRxiv preprint 19.12.2020. DOI: https://doi.org/10.1101/2020.10.19.20214494. [Crossref]

4 Greenhalgh T, Knight M, Acourt C, et al. Management of post-acute covid-19 in primary care BMJ 2020;370:m3026. DOI: https://doi.org/10.1136/bmj.m3026. [Crossref]

5 Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact, EClinicalMedicine 2021;38:101019. DOI: https://doi.org/10.1016/j.eclinm.2021.101019. [Crossref]

6 Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI). Aktuelle Ergebnisse der Datensammlung von Pediatric Inflammatory Multisystem Syndrome (PIMS) Fällen bei Kindern und Jugendlichen in Deutschland. PIMS Survey Update: 2021. Verfügbar unter https://dgpi.de/pims-survey-update (29.07.2021).

7 Robert-Koch-Institut (RKI). COVID-19 und Impfen: Antworten auf häufig gestellte Fragen (FAQ). Verfügbar unter https://www.rki.de/SharedDocs/FAQ/COVID-Impfen/gesamt.html (29.07.2021).

8 Jaffri A, Jaffri UA. Post-Intensive Care Syndrome and COVID-19: crisis after a crisis? Heart & Lung 2020. DOI: https://doi.org/10.1016/j.hrtlng.2020.06.006. [Crossref]

9 Al-Aly Z, Xie Y, Bowe B. Highdimensional characterization of post-acute sequelae of COVID-19. 2021;594(7862):259–264. DOI: https://doi.org/10.1038/s41586-021-03553-9. [Crossref]

10 Mayo Clinic Staff. COVID-19 (coronavirus): Long-term effects. Verfügbar unter https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351 (29.07.2021).

11 Milovancev A, Avakumovic J, Lakicevic N, et al. Cardiorespiratory fitness in volleyball athletes following a COVID-19 infection: a cross-sectional study. International Journal of Environmental Research and Public Health 2021;18(8):4059. DOI: https://doi.org/10.3390/ijerph18084059. [Crossref]

12 Renk H, Dulovic A, Becker M, et al. Typically asymptomatic but with robust antibody formation: Children’s unique humoral immune response to SARS-CoV-2. medRxiv Preprint 2021, July 22. DOI: https://doi.org/10.1101/2021.07.20.21260863. [Crossref]

13 Molteni E, Sudre CH, Canas LS, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. The Lancet Child & Adolescent Health 2021. DOI: https://doi.org/10.1016/S2352-4642(21)00198-X. [Crossref]

14 Giacomelli A, Pezzati L, Conti F, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study. Clinical Infectious Diseases 2020;71(15):889–890. DOI: https://doi.org/10.1093/cid/ciaa330. [Crossref]

15 Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, Behavior, and Immunity 2020;87:34–39. DOI: https://doi.org/10.1016/j.bbi.2020.04.027. [Crossref]

16 Taylor S. COVID Stress Syndrome: clinical and nosological considerations. Current Psychiatry Reports 2021;23(4):19. DOI: https://doi.org/10.1007/s11920-021-01226-y. [Crossref]

17 Tucker P, Czapla CS. Post-COVID Stress Disorder: another emerging consequence of the global pandemic. Psychiatr Times 2021;38(91):9–11.

18 Taquet M, Luciano S, Geddes JR, et al. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry 2021;8(2):130–140. DOI: https://doi.org/10.1016/S2215-0366(20)30462-4. [Crossref]

19 Tsamakis K, Tsiptsios D, Ouranidis A, et al. COVID-19 and its consequences on mental health. Experimental and Therapeutic Medicine 2021;21(3):244. DOI: https://doi.org/10.3892/etm.2021.9675. [Crossref]

20 Kola L, Kohrt BA, Hanlon C, et al. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry 2021;8(6):535–550. DOI: https://doi.org/10.1016/S2215-0366(21)00025-0. [Crossref]

21 Luo Y, Chua CR, Xiong Z, et al. A systematic review of the impact of viral respiratory epidemics on mental health: an implication on the coronavirus disease 2019 pandemic. Frontiers in Psychiatry 2020;11:565098. DOI: https://doi.org/10.3389/fpsyt.2020.565098. [Crossref]

22 Bansal M. Cardiovascular disease and COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020;14(3):247–250. DOI: https://doi.org/10.1016/j.dsx.2020.03.013. [Crossref]

23 Sahanic S, Sonnweber T, Pizzini A, et al. Persisting pulmonary impairment following severe SARS-CoV-2 infection, preliminary results from the CovILD study. European Respiratory Journal 2020;56:4143. DOI: https://doi.org/10.1183/13993003.congress-2020.4143. [Crossref]

24 Severin R, Arena R, Lavie CJ, et al. Respiratory muscle performance screening for infectious disease management following COVID-19: a highly pressurized situation. American Journal of Medicine 2020;133(9):1025–1032. DOI: https://doi.org/10.1016/j.amjmed.2020.04.003. [Crossref]

25 van der Bie GH, Scheffers T, van Tellingen CW. The Healing Process: Organ of Repair. Driebergen: Louis Bolk Instituut; 2008.

26 National Institute for Health and Care Excellence (NICE). COVID-19 rapid guideline: managing the long-term effects of COVID-19. NG 188. London: National Institute for Health and Care Excellence; 2020. Verfügbar unter https://www.ncbi.nlm.nih.gov/books/NBK567264 (29.07.2021).

27 Koczulla AR, Ankermann T, Behrends U, et al. S1-Leitlinie Post-COVID/Long-COVID (Stand 12.07.2021). AWMF-Register Nr. 020/027. Verfügbar unter https://www.awmf.org/uploads/tx_szleitlinien/020-027l_S1_Post_ COVID_Long_COVID_2021-07.pdf (21.07.2021).

28 Abreu RM, Rehder-Santos P, Minatel V, et al. Effects of inspiratory muscle training on cardiovascular autonomic control: A systematic review. Autonomic Neuroscience: Basic and Clinical 2017;208:29–35. DOI: https://doi.org/10.1016/j.autneu.2017.09.002. [Crossref]

29 Adamopoulos S, Schmid JP, Dendale P, et al. Combined aerobic/inspiratory muscle training vs. aerobic training in patients with chronic heart failure: The Vent-HeFT trial: a European prospective multicentre randomized trial. European Journal of Heart Failure 2014;16(5):574–582. DOI: https://doi.org/10.1002/ejhf.70. [Crossref]

30 Kunzler AM, Stoffers-Winterling J, Stoll M, et al. Mental health and psychosocial support strategies in highly contagious emerging disease outbreaks of substantial public concern: A systematic scoping review. PLoS One 2021;16(2):e0244748. DOI: https://doi.org/10.1371/journal.pone.0244748. [Crossref]

31 Internationales Forum für Anthroposophische Pflege. Äußere Anwendungen in der Anthroposophischen Pflege. Verfügbar unter https://www.pflege-vademecum.de (15.09.2021).

32 Ihlow C, Lamminger S. Modellprojekt: Waldmedizin zur Prävention und Therapie bei Burn-out. Zeitschrift für Komplementärmedizin 2020;12(2):18–22. DOI: https://doi.org/10.1055/a-1125-4317. [Crossref]

33 Girke M. Nichtonkologische Misteltherapie. Der Merkurstab 2021;74(3):242–250. DOI: https://doi.org/10.14271/DMS-21360-DE.

34 Vagedes J, Kuderer S, Helmert E, et al. Warm footbaths with Sinapis nigra or Zingiber officinale enhance self-reported vitality in healthy adults more than footbaths with warm water only: A randomized, controlled trial. Evidenced-Based Complementary and Alternative Medicine 2021;2021:9981183. DOI: https://doi.org/10.1155/2021/9981183. [Crossref]

35 Lorenz C. Rhythmische Massage bei Angst. Verfügbar unter https://www.anthromedics.org/PRA-0603-DE (02.09.2019).

36 Gerlach K, Recchia DR, Büssing A. Development of a documentation instrument for movement-orientated Mind-Body-Therapies taking the example of Eurythmy-Therapy. Complementary Therapies in Medicine 2019;44:91–93. DOI: https://doi.org/10.1016/j.ctim.2019.04.004. [Crossref]

37 Büssing A, Edelhäuser F, Weisskircher A, et al. Inner correspondence and peacefulness with practices among participants in eurythmy therapy and yoga: a validation study. Evidence-Based Complementary and Alternative Medicine 2011;2011:329023. DOI: https://doi.org/10.1155/2011/329023. [Crossref]

38 Kienle G, Werthmann P, Grotejohann B, et al. Addressing COVID-19 challenges in a randomized controlled trial on exercise interventions in a high-risk population. Preprint Research Square 2020 Oct. DOI: https://doi.org/10.21203/rs.3.rs-100074/v1. [Crossref]

39 Mokhtari T, Hassani F, Ghaffari N, et al. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. Journal of Molecular Histology 2020;51(6):613–28. DOI: https://doi.org/10.1007/s10735-020-09915-3. [Crossref]

40 Verfügbar unter www.youtube.com/watch?v=doafemel9Es und www.youtube.com/watch?v=wEMpB7nz7J0 (12.08.2021).

41 Verfügbar unter www.youtube.com/watch?v=clwZ6cZEk8U und www.youtube.com/watch?v=GaUqe3cxpWI (12.08.2021).

42 Verfügbar unter https://www.youtube.com/watch?v=8sXH-S344OM, www.youtube. com/watch?v=DVgF-7blPkE (12.08.2021).

43 Verfügbar unter https://www.youtube.com/watch?v=S_ypOaKKGVM (12.08.2021).

44 Riva G, Bernardelli L, Browning MHEM, et al. COVID feel good – An easy self-help virtual reality protocol to overcome the psychological burden of coronavirus. Frontiers in Psychiatry 2020;11:563319. DOI: https://doi.org/10.3389/fpsyt.2020.563319. [Crossref]

45 Cheshire A, Ridge D, Clark L, et al. Guided graded exercise self-help for chronic fatigue syndrome: patient experiences and perceptions. Disability and Rehabilitation 2020;42(3):368–377. DOI: https://doi.org/10.1080/09638288.2018.1499822. [Crossref]

46 Gerlach K, Adamcova H, Hermansen I. Treatment with Eurythmy Therapy after COVID-19 disease – An expert consultation. Conference paper; 2021. DOI: https://doi.org/10.13140/RG.2.2.32615.98723.

47 Steiner R. Heileurythmie. GA 315. 6. Aufl. Basel: Rudolf Steiner Verlag; 2021.

48 Kirchner-Bockholt M. Grundelemente der Heileurythmie. 5. Aufl. Dornach: Verlag am Goetheanum; 2010.

49 Gul MH, Htun ZM, Inayat A. Role of fever and ambient temperature in COVID-19. Expert Review of Respiratory Medicine 2021;15(2):171–173. DOI: https://doi.org/10.1080/17476348.2020.1816172. [Crossref]

50 Ihlow C, Lamminger S. Modellprojekt: Waldmedizin zur Prävention und Therapie bei Burn-out. Zeitschrift für Komplementärmedizin 2020;12(2):18–22. [Crossref]

51 Ihlow C, et al. Salutogenetische Faktoren therapeutisch begleiteten Waldbadens – Eine Kooperationsstudie der Dr. Becker Klinik Möhnesee mit dem Landesbetrieb Wald und Holz Nordrhein-Westfalen. In: 29. Rehabilitationswissenschaftliches Kolloquium; 2020: 428.

52 Arnold DT, Milne A, Samms E, et al. Are vaccines safe in patients with Long COVID? A prospective observational study. Preprint medRxiv 2021 Mar 14. DOI: https://doi.org/10.1101/2021.03.11.21253225. [Crossref]

53 Dorigatti I, Lavezzo E, Manuto L, et al. SARS-CoV-2 antibody dynamics and transmission from community-wide serological testing in the Italian municipality of Vorsquo. Nature Communications 2021. Verfügbar unter https://spiral.imperial.ac.uk/bitstream/10044/1/89915/9/s41467-021-24622-7.pdf (29.07.2021).

54 Turner JS, Kim W, Kalaidina E, et al. SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans. Nature 2021;595:421–425. DOI: https://doi.org/10.1038/s41586-021-03647-4. [Crossref]

Merkurstab Newsletter
Latest content with links to all articles.
Free of charge. Without obligation.
Open access to selected articles.
Sign up

J O B   M A R K E T

Ärztliche Leitung (m/w/d)
Psychologe (m/w/d)

More details

Leitung Herstellung
More details

Projektleitung Online-Veranstaltungen
More details

Therapeut (m/w/d) für Anthrop. Therapeutische Sprachgestaltung
More details

Praxisnachfolge (m/w/d)
More details

Oberarzt Leitender Arzt Geriatrie (m/w/d)
More details

Anthroposophischer Arzt (m/w/d)
More details