第2季，第3集：“为什么莱姆病可能会为Covid-19-19的长途旅行者提供线索''

在第2季，《盒装》第3集：新冠肺炎和您的心理健康，主编莫琳·康诺利（Maureen Connolly）交谈Brian Fallon, MD, the director of the Center for Neuroinflammatory Disorders and Biobehavioral Medicine and director of the Lyme and Tick-Borne Diseases Research Center at Columbia University in New York City. A leading expert in illness anxiety and somatoform disorders, Dr. Fallon is currently leading a national study to examine how yoga and meditation might play a role in treating heightened anxiety around COVID-19. The study is currently enrolling, and you can find registration details atProuckpilot.com。

在接下来的访谈中，Connolly和Fallon讨论了Covid-19与其他多系统疾病之间的重叠。COVID-19-the-19'longhaulers''可能会受到病毒的持久影响；以及为什么医疗保健提供者和患者可能想考虑一种基于大流行的生活焦虑的更全面，基于正念的方法。

The following are some highlights from an edited transcript of the interview:

莫琳·康诺利（Maureen Connolly）：法伦博士，您是世界知名的专家莱姆病。And you've noted some similarities with Lyme and COVID-19. Both, as you described, are multisystem disorders that affect everything from the brain and joints to peripheral nerves. Can you explain to me a little bit more about that?

布莱恩·法伦：Absolutely. I mean, what's been most interesting to me and striking to me is the overlap between Lyme disease and COVID-19. And one of the significant overlaps of course is that many different systems of the body are affected. So with Lyme disease, it starts with a皮疹通常在您的皮肤上，然后进入组织，然后进入血液，然后进入不同的器官。因此，它可能会引起您的心脏，引起心脏炎，炎症。它可能会引起您的大脑，并引起认知问题或情绪变化。它可能是您的周围神经，引起灼热的感觉或尖锐的刺痛或射击痛。它伸向您的肌肉，导致肌肉疼痛。它可以转到您的关节，导致关节或关节疼痛肿胀。因此，这些是莱姆病的多系统表现。

当然，我们正在学习有关Covid-19的知识，它主要是一种影响肺部的感染，但随后它也会影响体内许多不同的器官，包括胃肠道，大脑和心脏 -神经系统以其他方式，外周神经系统。因此，在Covid-19和莱姆病之间有很多相似之处。我认为它们与以下事实有关，两者都是系统地影响身体的感染。

[…]因此，有很多相似之处，然后问题就变成了您感染后会发生什么？在获得Covid-19之后，会发生什么？你治愈了吗？您没有症状，还是他们都消失了？你恢复正常吗？莱姆病后会发生什么？病人被告知他们已经治愈了。您已经获得了正确量的抗生素。如果您有持续的症状，那一定是由于其他症状。也许您出于某种原因发展了慢性疲劳综合征，或者纤维肌痛or depression or anxiety has emerged. It has nothing to do with the fact that you previously had Lyme disease. And the same thing seems to be happening with COVID-19. So we have this phenomenon now called the "COVID-19 long haulers." And these are people who have persistent symptoms or recurring symptoms after getting COVID-19. Some of those patients have well-defined COVID-19, where they had positiveblood testsand they know for sure that they had it. Other people had classic COVID-19 symptoms but never tested positive. And so they're included in the long haulers.

MC：您知道，要对我们所知道的事情负责，例如自我保健，饮食，睡眠，消除压力，我想所有这些事情都会非常支持并发挥帮助您从病毒中康复的吧？

BF：That's exactly right. And we have a study right now […] looking at three different approaches to treating the heightened anxiety and arousal that patients worrying about COVID-19 might have, and they can be hypervigilant. They can be fearful. They can be worrying all the time, having either lost their jobs or lost loved ones, or [having] their own personal fears of infection or illness, or having to stay home from work because their children are at home and trying to struggle with, “How are you going to survive?” [That] creates a lot of understandable, natural, normal anxiety. But you as an individual can help reduce that through things like meditation, yoga, and cognitive therapy, as well. So in the study that we're doing, everybody gets cognitive therapy online at home, no cost. If you go toProuckpilot.com，您可以注册。

MC：告诉我，当人们降低炎症反应[…]以及如何增强其免疫力时会发生什么。

BF：We need inflammation to fight infection, but if you have too much inflammation, that causes problems in the body: joint swelling, joint pain, muscle pain. It basically causes the release of cytokines in the body, which can cause slowness of thinking and profound fatigue. So just think about what happens when you get a cold or when you get a minor flu, for example. You're out. You want to sleep, you want to rest, you don't want to do anything for two or three days, and then you come out of it and you're back to normal.

但是，如果持续时间太长，那可能是因为您的炎症标记升高了。所以有自身免疫性疾病，有psoriatic arthritis例如，它们具有这些真正升高的炎症标记，并且可能会损害身体的心脏和其他部位。因此，患有炎症对您的身体不利。只要您不太降低炎症，您可以采取的措施降低炎症可能会有所帮助。我们需要发炎才能最初与感染作斗争，但我们希望它停止。我们不希望它继续。

MC：回到您处理莱姆研究的经验，您想让长途跋涉知道如何赋予自己能够获得所需的治疗类型的知识？这是非常令人沮丧的，[体验]整个症状，他们不知道该转向谁，对吗？[…]那么，一个人从哪里开始？

BF：这是一个很好的问题。我认为部分取决于您的症状特征是什么。如果这是情绪症状的特征，那么当然可以与社区中的心理健康提供者联系。如果这是一个与心脏有关的问题，您的呼吸急促，您在楼梯上行走，并且比平常更困难，然后去看看心脏病专家。If your glucose is getting out of control, if diabetes that was previously well controlled is problematic, see your endocrinologist. […] So basically, take advantage of both the regular, standard, Western, evidence-based medicine, but also take advantage of the mind-body therapies that can be enormously helpful.