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This episode is on Mast Cell Activation Syndrome (MCAS) and Long Covid. In this first part, I talk about the symptoms, diagnosis, investigations and causes of Long Covid MCAS. In the second part, I will talk about the treatments, management and outcomes.

I am Dr Tim Robinson, formerly a GP for 30 years, retired as planned at the start of the Covid pandemic. Since then I have become involved in the world of Long Covid. Currently I am GP clinical lead for Long Covid NHS in  South West England, as well as GP lead for three NHS Long Covid Services - Dorset, Bristol and South Devon. I am also Clinical Lead for Hope for the Community CIC. I have research involvement as co-investigator in a study on breathlessness in Long Covid, University of Bristol.

Long Covid Doctor is an educational series for Long Covid sufferers; each talk covers the many aspects of Long Covid, the symptoms, causes, treatments, management and expected outcomes.

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Disclaimer: Long Covid Doctor is an educational series. Any advice, diagnosis, treatments mentioned should only be considered after discussion with your own GP or qualified professional health provider.

References, links, resources:
NICE Covid-19 rapid guideline:
https://www.nice.org.uk/guidance/ng188

 General resources for Long Covid recovery:
Your Covid Recovery: NHS England website self-help patient resource for symptoms information and self-management. www.yourcovidrecovery.com

Royal College of Occupational Therapists: How to manage post viral fatigue after Covid-19. www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0

NICE Covid-19 rapid guideline: https://www.nice.org.uk/guidance/ng188

 Douaud G 2022: https://doi.org/10.1038/s41586-022-04569-5

Proal AD 2021: https://doi.org/10.3389/fmicb.2021.698169

Weinstock, L. B. et al. Mast cell activation symptoms are prevalent in Long-COVID. Int. J. Infect. Dis. 112, 217–226 (2021).

Nurek M, Rayner C, Freyer A, Taylor S, Järte L, MacDermott N, Delaney BC. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. British Journal of General Practice 2021;  71 (712): e815-e825.

Glynne, P., Tahmasebi, N., Gant, V. & Gupta, R. Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. J. Investig. Med. 70, 61–67 (2022).

 Bruttmann, G., Pedrali P. Loratadine (SCH29851) 40 mg Once Daily versus Terfenadine 60 mg Twice Daily in the Treatment of Seasonal Allergic Rhinitis. J Int Med Res. Mar-Apr 1987;15(2):63-70.

https://www.ucl.ac.uk/health-informatics/research/stimulate-icp

Sale ME et al 1994. Clinical Pharmacology and Therapeutics (1994) 56, 295–301; doi:10.1038/clpt.1994.140

www.NHS.uk ‘Dangers of buying medicines online’