Long Covid Weekly: #21
Impaired endothelial function?, Sky News Reporter details his LC experience
Hi 👋,
As mentioned last week, the newsletter is partnering with the Visible app to help source articles & research for the newsletter. If you are interested in learning more about the product from the founder, himself, an interview came out this week from HealthRising. It gives the motivation behind the product itself & how the product is differentiated from wearables available today on the market.
The tentative plan is to keep these newsletters going throughout the upcoming holiday season but if we end up not dropping a newsletter one week, we will keep everyone updated!
Not sure if anyone noticed ( or cares) but instead of using an Unsplash thumbnail, we sourced our thumbnail using Dalle-2, the AI 🤖 which can generate images from text. The prompt used was ‘science lab, Sigma 24mm f/8.’
📰 Media
How long COVID ruined my life, from crushing fatigue to brain fog
From Sky News:
I was tired - overwhelmingly, crushingly tired, as if I'd been up for days, when in fact I'd slept all night - and I couldn't think straight. When I tried to text my boss to tell him I wasn't going to be able to make it into work, it took me more than an hour to string a sentence together.
Eventually, I got out a short apologetic message. Then I went back to bed, where I stayed for three days straight. It should have been scary, but I was too tired to be scared. The need for rest overwhelmed every thought or feeling.
It seemed so far off I doubted it would be relevant, especially as I could work on building up my stamina. But when I tried to follow a graded exercise guide I found online - the GP just told me to do a bit more every day - it made me feel awful. Instead of building as I'd hoped, my strength was being sucked away.
But all too often it feels like an uphill battle just to get simple help, or to get recognition from employers, pension funds or government agencies. Despite all the press attention and all the testimonies, it often feels as if people still don't quite believe long COVID exists.
My Take: This is a must-read! Beautifully written. We need more pieces like this to increase exposure to the condition.
Long Covid: Teen with long Covid misses two years of school
From the BBC:
Hayden, from Elvington, near Dover, says his life "completely changed" after he caught Covid in December 2020.
The 15-year-old once enjoyed sports such as swimming and judo, but must now use a wheelchair, and is largely bedridden with symptoms such as severe fatigue.
Long-COVID rate may be similar whether hospitalized or not
From the University of Minnesota:
Nearly 60% of hospitalized COVID-19 patients and 68% of their nonhospitalized counterparts seen at two healthcare centers in Madrid, Spain, early in the pandemic reported still having at least one symptom 2 years later, suggests a study published today in JAMA Network Open.
At 2 years, 59.7% of hospitalized patients and 67.5% of outpatients had at least one persistent COVID-19 symptom. The most common persistent symptoms among both hospitalized and nonhospitalized patients were fatigue , pain , and memory loss.
🔍 Research
Clinical assessment of endothelial function in convalescent COVID-19 patients: a meta-analysis with meta-regressions
Important Definition: Flow-mediated dilation (FMD) is recognized as an accurate clinical method to assess endothelial function. Flow-mediated dilation (FMD) refers to dilation (widening) of an artery when blood flow increases in that artery
results of this meta-analysis suggest that convalescent COVID-19 patients may have impaired endothelial function, as expressed by lower FMD(Flow-mediated dilation) values when compared to controls.
In line with the evidence that diabetes and hypertension are strong cardiovascular risk factors [75], another finding of our models is that a higher difference in the prevalence of such variables or CAD (coronary artery disease) may be associated to a higher difference in FMD between cases and controls.
Life stressors significantly impact long-term outcomes and post-acute symptoms 12-months after COVID-19 hospitalization
From the Journal of Neurological Sciences:
Life stressors were significantly associated with several 12-month outcomes, including worse mRS scores, activities of daily living, NeuroQoL depression, fatigue and sleep measures, and post-acute COVID-19 symptoms.
we identified multiple stressors (present within the month prior to interview) that were associated with the development of post-acute symptoms, most notably financial insecurity and unemployment
Interventions targeted at ameliorating modifiable life stressors merit further investigation.
Muscle Biopsy and Plasma Study into
Post-Exertional Malaise
!study not yet conducted yet
From the Open Medicine Foundation:
CPET testing clearly shows the effects of exertion intolerance in ME/CFS. Earlier studies indicated that PEM may be due to metabolic (the process the body uses to change food and drink into energy) dysfunction and/or dysfunction in the way cells use oxygen.
This study will compare PEM in ME/CFS patients who’ve become ill in the past two years to patients who have had ME/CFS longer, as well to healthy controls. It will use a variety of testing methods on both muscles and blood to document what happens in the body of an ME/CFS patient during and after exercise, looking at both metabolic functions and oxygen use.
Association between long COVID symptoms and employment status
From medrxiv:
Among 15,307 US adults surveyed between February 2021 and March 2022, long COVID was associated with a greater likelihood of unemployment and lesser likelihood of working full time in adjusted models. Further, among those with long COVID, presence of cognitive symptoms was associated with diminished likelihood of working full time, extending recent reports associating cognitive symptoms with poor quality of life among employed individuals .
My Take: This is my 21st newsletter. As a result I can say I have seen a lot of the recent research in the field. It seems that the overwhelming theme is data looking at prevalence and risk factors. Although this is certainly necessary, as a long-covid patient I would love to start seeing more in-depth studies looking at possible treatments & biomarkers as we enter 2023.
Your newsletter is great! I'm going to try and get the word out to people looking for a good source of well curated long covid research.
Amen to your last statement. Thank you again for doing the newsletter. As a physician with Long Covid, it’s been hard to have the energy to look for all the research, which is a lifeblood for me. Your newsletter makes it actually possible.