Novel Oronasal Drainage for Long COVID: Proposed Mechanisms-Case Report

Abstract

Long COVID, potentially emerging post COVID-19 infection, involves extreme health challenges. Based on current literature in the field, we propose a novel approach to Long COVID treatment based on epipharyngeal abrasive therapy targeting ostia of the oral and nasal mucosa, having been identified for the first time. The presented case report documents the application of innovative oronasal drainage (OND), a novel treatment integrating physiological, biochemical, and fluid mechanical components simultaneously. OND led to remarkable improvements and even remissions of various symptoms, along with enhanced hand blood circulation. While the case suggests potential efficacy in Long COVID therapy, acknowledging inherent limitations is essential and its impact needs further validation through clinical trials.

Keywords: Long COVID; case report; myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); nose; oral; oronasal drainage (OND); ostia.

Figure A1

Proposed mechanism of Oronasal Drainage (OND) for Long COVID treatment. Cycle chart outlining the hypothesized treatment cycle for OND. The proposed mechanism involves OND sessions lasting less than 20 min, followed by phases of exhaustion, thirst, and initial regeneration. Subsequently, hunger and food intake lead to a brief convalescence, succeeded by extended regeneration and prolonged convalescence.

Figure 1

Proposed site of action of Oronasal Drainage (OND) for Long COVID treatment. (a) Schematic depiction of the human oral and nasal cavity, where the white arrow signifies the region for epipharyngeal abrasive therapy, and the red-black dots indicate ostia as the site of action for OND. (b) Schematic representation of the human oral cavity highlights numerous ostia near the tonsilla palatina, with hidden plicae unfolding through mechanical stimulation using cotton swabs. The illustration shows an enlargement of (a), highlighted with a blue dashed outline. (c) Schematic representation of the human oral cavity illustrates the arrangement of ostia within the oropharynx. Our hypothesis posits that the opening of obstructed ostia is facilitated by biochemical stimulation using 0.5% zinc chloride (ZnCl₂) solution.

Figure 2

Oronasal Drainage (OND): Procedure for a Long COVID patient. (a) Elongated, thread-like salivary secretion observed (white arrow). (b) OND in the oral cavity targeting ostia on the right palatine gland. Adhesion between tongue secretions and the swab shown by the black arrow. (c) OND on the nasal mucosa, focusing on the epipharyngeal mucosa. Visible onset of herpes simplex virus 1 (HSV-1) reactivation on the lower lip on the fourth day of OND (black arrow).

Figure 3

Removed nasal mucosa secretion during Oronasal Drainage (OND). (a) Stringy, transparent mucus measuring several centimeters. (b) Patient expelled long, stringy, transparent secretions through snorting (white triangle). On the fourth day of OND, a few green nasal secretions were observed (black triangle). (c) Nasal-mouth secretions. No S proteins were detected; the content, especially within brackets, remains unclear.

Figure 4

Impact of Oronasal Drainage (OND) on Long COVID Symptom Severity. (a) Weighted symptom severity score before, during (red bar) and after OND. Black data points represent symptoms (0 to 100, left y-axis) with mean displayed. Blue data points represent exercise intolerance, identified as post-exertional malaise (PEM) (0.0 to 1.0, right y-axis) with mean displayed. (b) The data encompass the complete symptom score. A thick horizontal bar within the boxplot represents the mean of symptom (0 to 250) with error bars denoting the standard error of the mean. (c) Symptom severity for dyspnea. A thick horizontal bar within the boxplot represents the mean of symptom (0 to 8) with error bars denoting the standard error of the mean; (b,c) reflect data collected before (−3 days), during (1–5 days), immediately after (6–10 days), and during follow-up (>10 days; n = 35) OND sessions.

Figure 5

Impact of Oronasal Drainage (OND) on Long COVID skin. (a) The upper panel illustrates the patient’s hands before OND, while the lower panel shows the patient’s hands on the fourth day of OND. (b) The upper panel illustrates the patient’s tongue before OND, while the lower panel shows the patient’s tongue on the fifth day of OND.