Hi Everyone!
Welcome to this edition of the Long Covid Weekly! In this issue, we explore the staggering economic burden of long COVID on Australia and the growing consensus that it can no longer be overlooked. We also examine the challenges faced by the National Institutes of Health (NIH) in its quest to understand this enigmatic condition, despite a substantial $1 billion investment in research. Additionally, we investigate the turmoil within disability claims systems as they grapple with the influx of long COVID cases. Lastly, we present findings from Scientific Reports on the concerning cognitive impairment experienced by young adults with post COVID-19 syndrome.
Media
Article: Long COVID’s soaring cost to the Australian economy means it ‘cannot be ignored’
DEFINITIONS:
Gross Domestic Product (GDP): an economic measure of the total value of goods and services produced within Australia.
SUMMARY:
Long COVID is costing the Australian economy at least $5.7 billion a year as tens of thousands are left unable to work by the debilitating disease.
If the highest estimates for long COVID absenteeism are used, the cost to GDP rises to $880 million a week, or $46 billion a year.
The federal parliament’s inquiry into long COVID, which received almost 600 submissions, is due to report its findings shortly.
Long COVID can affect relatively young people, and potentially keep them out of the labour force for an extended period during prime working years, which has the potential to affect the long-term earning capacity of many sufferers.
Article: The NIH poured $1 billion into long Covid research, with little to show for it
DEFINITIONS:
RECOVER: an NIH initiative aimed at studying long Covid.
Observational research: a type of research that involves observing and recording participants' behaviors and experiences without intervening.
SUMMARY:
The National Institutes of Health (NIH) has spent $1 billion on long Covid research but has little to show for it.
The government-funded study, dubbed RECOVER, was designed to help millions of Americans who experience symptoms such as brain fog and fatigue after recovering from coronavirus infection.
However, RECOVER has yet to enrol any patients for clinical trials of potential treatments, despite a clear mandate to do so from Congress.
The NIH has instead conducted broader, observational research that will not directly help patients.
My Take: I think constructive criticism here is valid but it is important to remember most illnesses do not see major progress from $1 billion dollars. The Federal Government absolutely needs to give Long Covid an annual research budget.
Article: Long COVID crisis exposes disability claims system in disarray
SUMMARY:
COVID long haulers are facing issues when applying for disability coverage through Social Security.
There is no clear guidance on how to prove their disability, and the lack of a single test to identify long COVID is making it even harder.
Long COVID has created a “mass disabling event” affecting a growing pool of sufferers.
Long haulers must deal with medical records to show they have a condition, while also facing a disability claims system with long wait times.
Episode 54: Dr Bhupesh Prusty – Molecular Virologist
Did a twitter thread on this one!
My Take: Definitely check out my thread... I think this theory is very well thought out and is very plausible.
Research
Article: Association of COVID-19 Infection With Incident Diabetes
SUMMARY:
In this cohort study, SARS-CoV-2 infection was associated with a higher risk of diabetes and may have contributed to a 3% to 5% excess burden of diabetes at a population level.
The risk of diabetes was higher among people with severe disease vs those without COVID-19, including individuals admitted to the intensive care unit
Article: The ME/CFS and Long-COVID PEM Studies: Exercise, Recovery and Symptoms
DEFINITIONS:
Post-Exertional Malaise (PEM): an extreme worsening of ME/CFS symptoms occurring after even mild exertion.
SUMMARY:
Post-exertional malaise (PEM) is a key symptom that makes ME/CFS so different from other diseases.
The recovery after exercise study indicated that ME/CFS patients, on average, took two weeks to recover.
The incidence and symptoms associated with PEM in long-COVID patients appear to be nearly identical to those found in ME/CFS patients.
The symptoms of fatigue, reduced functioning, gut problems, sleep issues, and muscle/joint pain were provoked among ME/CFS patients in response to two short but intense physical exercise stressors.
PEM symptoms appear to be more severe in long COVID than in ME/CFS patients, although it is important to document that PEM is a key symptom in long COVID.
Article: Cognitive impairment in young adults with post COVID-19 syndrome | Scientific Reports
DEFINITIONS:
Cognitive Dysfunction: A impairment of cognitive function typically associated with injury or disease of the brain.
SUMMARY:
Headache, fatigue, respiratory difficulties and cognitive dysfunction are some of the most common symptoms of the more than 200 reported by the patients.
More interestingly, both the presence and severity of impairments seem to have a relationship with age in the opposite direction to that expected
Younger patients show impairment in some cognitive domain more frequently than older ones, and the severity of this impairment is greater in these younger patients.
Finally, although several studies point to the determinant role of cognitive reserve in the deterioration of abilities, it seems to have little impact on the cognitive performance of our patients, although a relationship was found with some tasks (the higher the cognitive reserve, the better the scores in the TAVEC-A, in the reasoning task, and in phonological and semantic verbal fluency).
My Take: I got sick when I was 22 so this research definitely hits close to home...
Article: Causal effects of COVID-19 on cancer risk: A Mendelian randomization study
SUMMARY:
Together, our study indicated that COVID-19 had causal effects on cancer risk.
The genetic liabilities of critically ill COVID-19 were linked with the increased risk for five cancers (HER2-positive breast cancer, esophageal cancer, colorectal cancer, stomach cancer, and colon cancer).
The genetic liabilities of hospitalized COVID-19 were linked with the increased risk for three cancers (HER2-positive breast cancer, esophageal cancer, and stomach cancer).
The genetic liabilities of SARS-CoV-2 infection were linked with the increased risk of stomach cancer but decreased risk of head and neck cancer.
My Take: Causality is always extremely difficult to prove but this is a super interesting study, nontheless. It definitely warrants a further look.
DEFINITIONS:
Extracellular: situated or taking place outside a cell or cells.
SUMMARY:
Intracellular SARS-CoV-2 proteins S1(RBD) and nucleoprotein (N) were detectable in blood extracellular vesicles in acute COVID-19 and long-COVID.
Significantly abnormal levels of several functional mitochondrial proteins were observed in blood extracellular vesicles of acute COVID-19 patients who developed long-COVID.
Mitochondria are targeted for damage when cells are invaded by SARS-CoV-2 that results in decreased normal functions and disordered mitophagy, and leads to abnormal levels of constituent proteins in extracellular vesicles
Persistence of intracellular SARS-CoV-2 in long-COVID suggests that their treatment should include cell-permeant agents, such as anti-viral drugs and anti-SARS-CoV-2 nanobodies.
Hope
SUMMARY:
it was later discovered that naltrexone and naloxone also inhibit the toll-like receptor 4 (TLR4).
Stimulation of TLR4 results in the activation of microglia, the resident immune cell of the central nervous system.
microglia may become “primed” to over-react to subsequent immune system challenges. This phenomenon, called neuroinflammation, is thought to play a role in many conditions including multiple sclerosis, Alzheimer’s disease, and ischemic injury.
The drug we use clinically is called (-)-naltrexone, and antagonizes both opioid receptors and TLR4 receptors. This could explain why low doses exhibit anti-inflammatory processes that may become disguised by the opioid receptor blockade induced at higher doses.
A new antibody therapy is in development that may be able to reduce microglial activation by preventing the activation of T cells, which would disrupt the viscous cycle between chronically activated microglia and functional T cell exhaustion.
Article: The Latest Promising Long COVID Treatment? Psychedelic Drugs
SUMMARY:
Some patients have reported significant improvements in symptoms such as fatigue,after using psychedelics
There are research barries given that psychedelic drugs are currently federally illegal and categorized as substances with a high potential for abuse and no accepted medical use
Some researchers are looking to understand therapeutic potential of psilocybin, for Long COVID
Immediate action is necessary to ensure that COVID long haulers do not encounter difficulties when seeking disability coverage through Social Security!