Long Covid Weekly #125: LC & cognitive performance, AI + Precision Medicine & ME/CFS?

Hi everyone!

Really a lot of interesting research this edition! From the application of machine learning and multi-omics in precision medicine for me/cfs, to intriguing investigations into neurocognitive changes and cardiovascular implications in previous covid-19 patients.

` Our article of the week is "Machine learning and multi-omics in precision medicine for ME/CFS," published in the Journal of Translational Medicine. This review discusses how advanced technologies like machine learning and multi-omics approaches can pave the way for better understanding and treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a complex and heterogeneous disorder.

Key insights from the article include:

• The authors emphasize the potential of precision medicine by stating, "The heterogeneous nature and healthcare burden of ME/CFS present a timely opportunity for precision medicine, which aims to understand the molecular and biological factors that initiate and progress human diseases at the individual level."

• Additionally, they highlight the importance of robust computational tools, asserting that "without high-quality, relevant input data and defining specific training endpoints to be modeled, even the most advanced algorithms may struggle to produce actionable insights."

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Article: Machine learning and multi-omics in precision medicine for ME/CFS | Journal of Translational Medicine | Full Text

DEFINITIONS:

• Machine learning: A branch of artificial intelligence enabling computers to learn patterns from data and make predictions without explicit programming.

• Multi-omics: An integrative approach combining multiple omic data types (genomics, transcriptomics, proteomics, metabolomics) for comprehensive biological insights.

• Precision medicine: A medical model that customizes healthcare, tailoring medical decisions to individual patients for more effective treatment regimens.

SUMMARY:

• Traditional diagnostic and treatment approaches fail to account for the vast heterogeneity of ME/CFS, impacting patient care and contributing to an estimated economic loss of $14.5 billion in Australia.

• The integration of machine learning and multi-omics can advance precision medicine, improving our understanding of ME/CFS's biological and molecular foundations.

• Utilizing sophisticated computational tools and collaborative data-sharing can help researchers unravel the intricate biological pathways involved in ME/CFS.

• Advances in "big data" analytics may generate hypotheses leading to targeted therapeutic strategies for ME/CFS.

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Article: Choroid plexus volume is enlarged in long COVID and associated with cognitive and brain changes | Molecular Psychiatry

DEFINITIONS:

• Choroid plexus (ChP): A network of cells in the brain that produces cerebrospinal fluid (CSF) and maintains the brain's homeostasis and immune responses.

• Neuroinflammation: Inflammation of nervous tissue that can contribute to cognitive deficits and other neurological symptoms.

• Grey matter: Tissue in the brain and spinal cord composed mainly of neuronal cell bodies, involved in functions such as muscle control, sensory perception, and decision-making.

• White matter: Tissue in the brain composed of myelinated axons that facilitates communication between different brain regions.

SUMMARY:

• The study demonstrates that patients with post-COVID condition (PCC) show significant enlargement of the choroid plexus (ChP) volume, which negatively correlates with cognitive performance—larger ChP is associated with poorer cognitive function.

• ChP enlargement is linked to reductions in grey matter volume, especially in frontal and subcortical regions, and alterations in white matter integrity, indicating potential neuroinflammatory mechanisms stemming from SARS-CoV-2's impact on the brain.

• The findings suggest that ChP volume could serve as a biomarker for cognitive deficits and a target for interventions in patients with long COVID.

• The study emphasizes the ChP's role in maintaining brain homeostasis and regulating immune cell entry.

My Take:

• Brain studies like this seem quite uncommon in the LC-verse, however I think they shine a light on something that plagues many with LC

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Article: Attributes and factors associated with long covid in patients hospitalized for acute COVID-19: A retrospective cohort study | PLOS ONE

DEFINITIONS:

• Dyslipidemia: An abnormal amount of lipids (fats) in the blood, increasing the risk of cardiovascular disease.

SUMMARY:

• A study at Hallelujah General Hospital in Ethiopia found that 72.1% of patients hospitalized for acute COVID-19 reported at least one ongoing symptom four weeks after symptom onset.

• Common symptoms included fatigue (41.7%), shortness of breath (31.2%), and cough (27.1%), indicating a significant impact on patients' quality of life.

• The research identified that a longer duration of symptoms before hospitalization and a prolonged hospital stay were associated with a higher risk of developing Long COVID.

• Notably, there were no significant associations between Long COVID and factors such as age, sex, or obesity, despite the prevalence of fatigue and respiratory issues.

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Article: Tracking Persistent Symptoms in Scotland (TraPSS): a longitudinal prospective cohort study of COVID-19 recovery after mild acute infection | BMJ Open

DEFINITIONS:

• Cognitive Function Tests: Assessments designed to evaluate memory, attention, and problem-solving skills, which can be affected by conditions like Long COVID.

• Mobile Health (mHealth): Health services and information delivered via mobile devices, facilitating remote patient engagement and symptom tracking.

SUMMARY:

• The TraPSS study tracked persistent symptoms in individuals with mild COVID-19 infections over nine months.

• The proportion of participants reporting full recovery rose from 31.7% at baseline to 96.9% by month nine.

• Fatigue was the most prevalent symptom, affecting over 64% of respondents at baseline.

• While many reported partial recovery within three months, a notable minority continued to experience long-lasting symptoms, indicating the complexity of post-COVID recovery.

• The study highlighted gender differences, with males showing distinct recovery trajectories in symptoms like headache and fatigue.

My Take:

• This underscores the urgent need for tailored healthcare solutions and reinforces the importance of leveraging mobile health technology to track symptoms effectively.

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Article: Full article: Long-term cognitive and autonomic effects of COVID-19 in young adults: a cross-sectional study at 28 months

DEFINITIONS:

• Cognitive function: The mental processes involved in knowledge and comprehension, including thinking, memory, and judgment.

• Autonomic nervous system (ANS): A part of the peripheral nervous system that regulates involuntary bodily functions, including heart rate and digestion.

• Heart rate variability (HRV): The variation in time between successive heartbeats, often used as a measure of autonomic nervous system health.

SUMMARY:

• The study investigates the long-term cognitive and autonomic effects of COVID-19 in young adults approximately 28 months post-infection.

• While young adults demonstrate resilience, subtle cognitive inefficiencies persist, particularly in memory and executive function tasks.

• The COVID-19 group showed increased reaction times in the 2-item absent condition of a working memory task, suggesting lingering cognitive effects.

• The findings suggest a generally favorable long-term prognosis for young adults following mild to moderate COVID-19, although further investigation into specific cognitive subtleties is needed.

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Article: Post‐COVID Hypertension With Hyperreninemic Hyperaldosteronism in a Pediatric Patient - Shi - 2025 - Clinical Case Reports - Wiley Online Library

DEFINITIONS:

• Renin-angiotensin-aldosterone system (RAAS): A hormonal system that regulates blood pressure and fluid balance by controlling the production of hormones, including aldosterone, which affects sodium and water retention.

• Hyperreninemic hyperaldosteronism: A condition characterized by excess production of renin and aldosterone, leading to elevated blood pressure and potential cardiovascular complications.

• Post-inflammatory hypertension: High blood pressure that arises following inflammation from a viral infection, potentially due to physiological changes in the body.

SUMMARY:

• This case report highlights a 12-year-old boy who developed persistent hypertension after a mild COVID-19 infection, raising concerns about long-term renovascular complications.

• The patient, initially healthy, exhibited significant changes in blood pressure readings months after recovering from COVID-19, suggesting possible renovascular dysregulation.

• Investigations revealed elevated levels of renin and aldosterone, indicating hyperreninemic hyperaldosteronism as a likely consequence of the viral infection.

• Treatment with the ACE inhibitor lisinopril normalized the patient's blood pressure, linking post-COVID complications to the renin-angiotensin-aldosterone system (RAAS).

• This case underscores the necessity for vigilant follow-up care for children recovering from COVID-19 to monitor potential cardiovascular and renovascular issues.

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Article: The National Academies’ 2024 Diagnostic Criteria for Long COVID: Concerns that Could Affect the Rheumatology Community - Calabrese - Arthritis & Rheumatology - Wiley Online Library

DEFINITIONS

• Rheumatology: A medical field focused on the diagnosis and treatment of rheumatic diseases, which often involve inflammation and pain in the muscles and joints.

SUMMARY:

• The National Academies' 2024 Diagnostic Criteria for Long COVID aims to provide guidelines for healthcare professionals to identify and manage this complex condition.

• Concerns remain that the criteria may overlook the nuances of rheumatological manifestations, which could lead to missed diagnostic indicators.

• Rheumatologists fear the criteria might cause misclassification, risking delayed or incorrect diagnoses for patients with debilitating symptoms.

• While the criteria seek to standardize the understanding of Long COVID across specialties, their implementation could lead to discrepancies within rheumatology.

• Experts advocate for collaboration between the rheumatology community and the criteria developers to prioritize patient-centered approaches.

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Article: Effects of Bhramari and Sheetali Pranayama on Cardio Respiratory Function in Post-COVID Patients: A Randomised Controlled Study - Rohini P, A. Saravanan, K. Maheshkumar, K. ThamaraiSelvi, P. Kalyani Praba, Venkataraman Prabhu, 2025

DEFINITIONS:

• Bhramari: A pranayama technique involving controlled breath and humming, intended to calm the mind and reduce stress.

• Sheetali: A pranayama method characterized by inhaling through the mouth and exhaling through the nose, believed to cool the body and calm the nervous system.

• Heart Rate Variability (HRV): The variation in time between heartbeats, an indicator of autonomic nervous system function and overall heart health.

SUMMARY:

• The study assesses the effects of Bhramari and Sheetali pranayama techniques on cardio-respiratory function in patients recovering from COVID-19.

• Conducted as a randomized controlled trial with 90 participants aged 19–40, the research yielded notable improvements in pulmonary function and heart rate variability (HRV) for those practicing pranayama.

• By three months, both pranayama groups exhibited moderate gains in pulmonary function, with these benefits significantly amplified by the six-month mark.

• Bhramari and Sheetali techniques enhance lung capacity and airway function while promoting improved autonomic nervous system function, indicating increased parasympathetic activity.

• The study acknowledges limitations such as its small sample size and the need for larger, multi-center trials to validate the findings.