Dr. Bruce Patterson, M.D., announced in early 2021 that he knew what was causing long COVID and how to treat it without the need to develop new drugs. His early studies have yielded significant results, and plans for clinical trials are underway. 

Similarities Between Long COVID and ME/CFS

Patterson, the former Medical Director of Diagnostic Virology at Stanford University Hospitals and Clinics and current CEO of IncelDX, believes that long COVID and other post-viral conditions, such as ME/CFS (chronic fatigue syndrome), post-vaccination syndrome, post-Lyme disease, and fibromyalgia, involve similar processes. In all these conditions, there is a clear overlap of symptoms that include:

• Fatigue
• Aches and pains
• Post-exertional malaise
• Brain fog and difficulty concentrating
• Sleep disturbance and insomnia 

In each condition, even when the pathogen has left the body, proteins remain behind that cause dramatic changes to the immune system.

How Do These Proteins Affect the Immune System? 

Patterson thinks that long-COVID patients can be reliably diagnosed by analyzing patterns in their cytokines, proteins produced by the immune system to guide immune cells to infection sites. Identifying a pattern specific to long COVID could help scientists better understand–and doctors better treat–this condition and address its underlying causes.

Data from his team’s research suggests that post-COVID syndrome is vascular inflammation resulting from the continued presence of the S1 protein in patients’ white blood cells. S1 is ​​the SARS-CoV-2 protein that binds to cell receptors during the initial infection. Certain monocytes (a type of white blood cell) appear to carry the S1 protein. 

Monocytes do not generally last long. At just a few hours old, classical monocytes travel through the bloodstream and attach to various tissues and organs and become macrophages, specialized soldiers ready to defend their territory. 

Monocytes classified as “intermediate” and “non-classical” have been associated with spreading inflammation. In long COVID, Patterson believes, these monocytes hang around longer than normal and are steered by the CCR5 cytokine to attack endothelial cells, cells that make up the delicate membrane lining the inside of the heart and blood vessels.

How is Dr. Patterson Treating Long COVID and ME/CFS?

Patterson uses a core set of 12-14 drugs in his treatment regimens. In his studies, he has been treating post-infectious illnesses with statins (cholesterol-lowering drugs) and CCR5 antagonists (developed to treat HIV), which reduce vascular inflammation by preventing the monocytes from being driven to the endothelial cells and binding to them. 

His research really took off in July 2020 when he noticed so many COVID patients leaving hospitals, allegedly “cured” but going on to suffer symptoms that, in some cases, were worse than their acute illnesses. The explanation, he says, is that though they recovered from the acute illness, their immune systems were far from normal. Unfortunately, due to the overwhelming strain on resources, follow-up with those who had been hospitalized was scarce.

Patterson says he has already treated more than 13,000 patients with similar pathology (long COVID, ME/CFS, post-vaccination, post-Lyme, fibromyalgia), and his regimen of statins and CCR5 antagonists has resulted in “disruption of these mechanisms” in more than 80% of patients treated. His approach has been “very, very effective,” he said because the combination of the two drugs “attacks the underlying cause of inflammation, clotting, etc.”

What Does This Mean for Other Conditions Like ME/CFS?

Patterson has been giving his post-infectious disease patients the same immune system tests and has made some interesting finds:

• Post-vaccination patients seem to have some markers that differ from COVID long-haulers, and they also respond more quickly to treatments.
• ME/CFS patients don’t exhibit the vascular inflammation he sees in COVID long-haulers, though they respond well to CCR5 antagonists.
• ME/CFS patients resemble post-vaccination patients more closely than they do long-haulers.

If ME/CFS patients have underlying chronic viral infections, which Patterson suspects is the case, then they should be given antivirals, he says. He also wants to test a herpesvirus assay (that he developed at Stanford) on these patients.

Forward Movement

In general, Patterson rejects a one-size-fits-all approach to treatment and wonders if perhaps the current widespread dexamethasone use and blanket immunosuppressive approach will wind up producing reservoirs of the virus in the body. It would be much better to individualize treatment to the immune system of each patient. 

While Patterson only has anecdotal reports at this time, the evidence overwhelmingly shows improvement as a result of his treatments, though he admits that results are variable from patient to patient. The next step in his long-COVID research is a large-scale randomized, placebo-controlled clinical trial using Maraviroc (a CCR5 antagonist) and atorvastatin (a statin) to evaluate symptoms and immunological changes.

Patterson adds that clinical trials for the use of his treatment regimen for ME/CFS, fibromyalgia,  post-coronavirus vaccine illness, and post-Lyme disease are planned for 2022, as well.

*Johnson, C. (2021, Dec. 12). Getting at the Heart of Post-Infectious Illnesses? Bruce Patterson Talks on Long COVID and ME/CFS/FM. Health Rising. https://www.healthrising.org/blog/2021/12/12/post-infectious-illness-patterson-long-covid-chronic-fatigue-fibromyalgia/