Long Covid Weekly: 10/9-10/16
Photo by National Cancer Institute on Unsplash
Hi everyone,
Some interesting news this week. It seems like the a lot of interesting literature is continuously being released on the pro-thrombotic state that covid induces. Interested to see where this leads..
Wanted to highlight that The Guardian is looking to talk with people with Long Covid. I highlighted a couple of articles below from their new series centered around Long Covid.
Research
TL:DR:
‘We have previously determined that various inflammatory molecules are entrapped inside fibrinolysis-resistant microclots in individuals with Long COVID (10, 19). We undertook proteomics analysis and with a double digestion method to liberate these molecules.‘
‘All six inflammatory molecules were significantly upregulated in the soluble part of the blood that was measured‘
‘These molecules and similar such molecules are also well-known to activate platelets, by binding to their receptors (58, 59). Both microclots and hyperactivated platelets, may interact with damaged endothelial cells and further perpetuate widespread vascular damage.‘
!NOTE: Could not get access to the full article. Only the abstract
TL:DR:
‘We first demonstrate persistence of these NETs (Neutrophil extracellular traps) markers in PAP patients and consequently of sustained innate immune response imbalance, and a prolonged low-level pro-thrombotic potential activity highlighting the need to monitor these markers in all COVID-19 PAP individuals, to investigate post-acute COVID-19 pathogenesis following intensive care, and to better identify which medical resources will ensure complete patient recovery.‘
TL:DR:
‘Sixteen vascular transformation blood biomarkers were measured using multiplex immunoassay technology (Additional file 1: Tables S2 and S3), with fourteen being significantly different between cohorts‘
‘Although the biomarker profile of all Long-COVID patients is not homogenous, there was a distinct difference between the biomarker profile of Long-COVID patients and that of the other patient cohorts.‘
‘The concentrations of the leading 2 biomarkers, ANG-1 and P-SEL, were compared between the demographics and clinical presentations of the Long-COVID outpatients. Only ANG-1 was significant between females and males (P = 0.028), with females having a higher median ANG-1 blood concentration (Fig. 4A).‘
The Neurobiology of Long COVID
!This is a really insightful piece, highly recommend it.
TL:DR:
‘We highlight a number of possible underlying disease mechanisms that could contribute to CNS dysfunction, including neuroinflammatory effects of distal inflammation, autoimmunity, direct CNS infection, herpesvirus reactivation, neurovascular injury, and hypoxia. What accounts for the persistent nature of cognitive dysfunction in neuro-COVID remains to be fully elucidated. Continuing neuro-inflammation could reflect a lasting state change in CNS immune and glial cells that perpetuates neural pathophysiology, ongoing endotheliopathy with microvascular disruption and blood-brain-barrier breakdown, autoimmunity, response to ongoing peripheral inflammation - attributable to latent herpesvirus reactivation (Su et al., 2022), possible persistent reservoirs of SARS-CoV2 infection outside of the nervous system (Gaebler et al., 2021; Tejerina et al., 2022), or persistent circulating spike protein (Swank et al., 2022) - or a combination of these possibilities.’
Long COVID Risk and Pre-COVID Vaccination: An EHR-Based Cohort Study from the RECOVER Program
TL:DR:
‘We see protective associations of vaccination with long COVID onset in both logistic and time-to-event models, and in both clinic-based and model-based cohorts. While these findings are similar to those of other large observational studies,8–10 previous sources have only looked for evidence of COVID-associated symptoms as evidence of long COVID‘
‘Several features that are associated with a higher likelihood of long COVID (coefficients in eTables 3–6) are also associated with a higher likelihood of vaccination (coefficients in eTables 1–2). The most significant is age: eTable 7 shows how older adults are both more likely to be vaccinated and more likely to contract long COVID in comparison to younger adults‘
Media
A young life, interrupted: finding hope – and an identity – while suffering from long Covid
!Ravi is on Twitter, you can find him @RaviHVJ
TL:DR:
‘One question dominates Ravi’s thoughts: who will he be after his illness?‘
‘Martin saw Ravi’s illness through the prism of his own – perhaps Covid had triggered a chronic disease that Ravi was predisposed to – which had its benefits. Chronic illnesses have the stigma of being psychosomatic, but Martin knew from his own episodes of fatigue that what Ravi was going through wasn’t in his head.‘
‘Since the diagnosis, Ravi’s physical health has plateaued, despite moderate improvement at the end of the year. He’s still learning to live with the condition and manage the psychological consequences of losing his former life.‘
How will long Covid play out over the coming years? Eight experts weigh in
TL:DR:
‘My worry is that we’re going to be left with waves and waves of people with chronic disease and that’s not only going to affect the lives and livelihood of these people, but it’s going to affect the economy, it’s going to affect education attainment, it’s going to affect their ability to maintain economic productivity and maintain a job and continue to be productive members of society.‘
‘This is going to be one of the grand challenges of our time. The Office for National Statistics from the UK estimate that there’s around 2 million people in the UK with long Covid, which is just a staggering number.‘
‘So it is a struggle. I am lost, to be honest. A lot of people who have been living with these symptoms for a long time have often been looking on the internet, talking with various people, and they come with ideas of what might work. What I’ve often been doing is actually talking through those ideas and seeing which ones might make sense to explore.‘