Thumbnail photo by Dalle-2
Hi 👋,
With the holidays approaching, just wanted to announce that there will be no newsletter for the week of December 26th.
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📰 Media
UK Says Long Covid May Explain Much of Spike in Inactivity Rate
From Bloomberg:
More than 200,000 Britons who left the UK labor market in the year to July reported suffering from long-Covid, official statistics show.
Analysis by the Office for National Statistics found a link between the virus and the soaring levels of workforce inactivity since the pandemic struck, which is posing severe economic problems for the UK.
The ONS was cautious about drawing a firm connection but said “long Covid may have contributed to the decreasing levels of participation in the UK labor market during the coronavirus pandemic.”
It Isn't Just Long COVID. Post-Viral Illnesses Are More Common Than You Think
From Time:
But SARS-CoV-2 is not unique in its ability to cause severe and widespread damage to the body. “There are a dozen other pathogens that are known to cause these post-acute-infection syndromes,”
Viruses both routine and rare are linked to lasting complications, from vision loss and fibromyalgia to autoimmune disorders. Even common pathogens like influenza and Epstein-Barr (a cause of mononucleosis) come with potential long-term risks. Influenza can result in inflammation of the brain and heart, and Epstein-Barr is associated with Guillain-Barré Syndrome, a rare condition in which the body attacks its own nervous system, sometimes leading to paralysis. Both viruses are also believed to be possible ME/CFS triggers.
Post-viral illnesses often don’t have easily observable biomarkers that can be used for diagnosis or research, Bateman says. ME/CFS, for example, is evaluated not based on a single diagnostic test, but largely on a patient’s symptoms
Diagnosis codes for post-viral syndromes now available!
🔍 Research
Tissue specific signature of HHV-6 infection in ME/CFS
🚨Pre-Print Only
From Frontiers in Molecular Biosciences:
Our results show abundant viral miRNA in various regions of the human brain and associated neuronal tissues including the spinal cord that is only detected in ME/CFS patients and not in controls. Our findings provide evidence of tissue-specific active HHV-6 and EBV infection in ME/CFS, which along with recent work demonstrating a possible relationship between herpesvirus infection and ME/CFS, provide grounds for renewed discussion on the role of herpesviruses in ME/CFS.
My Take: I am extremely encouraged by this research! Think this could spur a lot of research into the role of Herpesvirus infection on ME/CFS + Long Covid.
Effectiveness of COVID-19 treatment with nirmatrelvir-ritonavir or molnupiravir among U.S. Veterans: target trial emulation studies with one-month and six-month outcomes
From MedRxiv:
Nirmatrelvir-ritonavir was highly effective in preventing 30-day hospitalization and death. Short-term benefit from molnupiravir was observed in older groups. Significant reductions in adverse outcomes from 31-180 days were not observed with either antiviral.
Increased migratory/activated CD8+ T cell and low avidity SARS-CoV-2 reactive cellular response in post-acute COVID-19 syndrome
From BioRxiv:
Defintions
CD8+ Cells - Induce Cell Death
EBI2 - Epstein-Barr virus induced G protein coupled receptor 2
The expansion of cytotoxic CD8+ T cells is already demonstrated from independent groups to be an important pathogenic component of gastrointestinal and pulmonary PASC. Regarding the nervous system, it has been proven that upregulation of CD8+ T cells contributes to autoimmunity...
Our data are in line with results of other groups demonstrating association of the EBI2 upregulation with neuroinflammation and autoimmunity. EBI2 has been shown to be upregulated in a subtype of ME/CFS, while in multiple sclerosis it has proven to be functionally expressed with a distinct EBI2 expression to lymphocytes migration correlation pattern, also in the absence of Epstein-Barr virus reactivation.
While cellular response directed against SARS-CoV-2 antigens was increased in PASC patients, titers of neutralizing antibodies were not higher in PASC group compared to controls. This suggests that SARS-CoV-2 specific humoral immunity is not involved in the pathogenesis of PASC.
Data-driven identification of post-acute SARS-CoV-2 infection subphenotypes
From Nature Medicine:
we identified four subphenotypes dominated by new conditions of the cardiac and renal systems (Subphenotype 1); respiratory system, sleep and anxiety problems (Subphenotype 2); musculoskeletal and nervous systems (Subphenotype 3); and digestive and respiratory systems (Subphenotype 4).
These four subphenotypes also covered the major PASC conditions that have been reported from existing independent studies, such as cardiovascular, respiratory, neurological and gastrointestinal conditions. Our study verified the co-existence of these dominate subphenotypes and can inform focused disease areas of treatment development for PASC.
My Take: I think work like this is super under appreciated. It is clear that Long Covid is an umbrella term. Not all treatments will work for everyone.
🩺 Hope & Potential Treatments
List of Drug Trials that will give results by the end of 2023
From Reddit