Hi everyone š,
Thanks for being patient with me over the last two weeks. I have a jam-packed newsletter in store for everyone this week. I am also happy to say this newsletter has eclipsed 2,000 followers! Thanks, everyone, again, for your continued support š.
I am also happy to say I am working on a new newsletter on which I will be releasing more info very soonā¦
In this edition, we'll be discussing recent articles that shed light on the challenges facing physicians in diagnosing and treating Long Covid, as well as identifying the individuals most at risk of developing this condition. We'll also be exploring the impact of Long Covid on exercise recovery and the link between increased insulin resistance and depressive symptoms in Long Covid patients. As the world continues to grapple with the ongoing pandemic, understanding the complexities of Long Covid + ME/CFS remains a crucial area of research. So, let's dive in and explore the latest developments in these fields.
Media š°
Researchers Are Getting Closer to Learning How to Treat and Prevent Long COVID
Three years into the COVID-19 pandemic, there is still no proven way to treat or prevent Long COVIDābesides not getting infected in the first place.
Researchers have found promising (though preliminary) signs that certain drugs may reduce the risk of developing Long COVID, and possibly even ease symptoms among people who are already sick.
The latest hopeful news relates to metformin, an accessible and affordable drug thatās been U.S. Food and Drug Administration (FDA)-approved to treat Type 2 diabetes since the 1990s.
People who took metformin had a 42% lower chance of being diagnosed with Long COVID over the following 10 months, compared to those who took a placebo when they first got sick with COVID-19.
Other recent studies have also suggested that Paxlovid, an antiviral drug used to prevent severe COVID-19 among high-risk patients, may help prevent Long COVID in a similar way.
UNSUPPORTED & ALONE, 81% OF POST-COVID SUFFERERS LEFT UNDIAGNOSED
From News Channel Nebraska:
According to new research from RT Medical, while 76% of survey respondents said they saw at least one healthcare provider for help to manage their Post-COVID symptoms, only 19% were diagnosed with Post-COVID, Long COVID or PASC (Post-Acute Sequelae of COVID-19).
The respondents who saw a provider about their Long COVID symptoms, consulted an average of 2.3 healthcare practitioners, with many seeing more than 10 specialists for help.
āThere is a lot of uncertainty in the medical sector around how to diagnose and treat Post-COVID. Itās not uncommon for long-haulers to be told there is nothing wrong with them and the wait times for specialized clinics could easily be several months, if not a year,ā said Dobbin-Mohammed.
RT Medical recently launched an expert-led, online community for people living with Post-COVID, offering a structured healing pathway with Group Support Circles, Live Training Classes, and a Self-Management E-course.
Poll: U.S. Physicians Feel Unprepared to Diagnose and Treat Long COVID
From De Beaumont:
In the poll of 806 U.S. physicians, more than three in four physicians (78%) said Long COVID is a problem.
However, only 7% said they are "very confident" diagnosing Long COVID and only 4% said they are very confident treating the condition.
Funding research on Long COVID should be a national priority, and has the support of 82% of physicians and 76% of the public.
Only 46% of physicians said they are somewhat or very confident diagnosing patients with Long COVID.
Who Is Most at Risk for Long COVID?
A new study of more than 800,000 people has found that in the U.S., COVID ālong haulersā were more likely to be older and female, with more chronic conditions than people who did not have diagnosed long COVID.
The study's findings also indicate that symptoms of long COVID can appear or persist much longer after initial infection than many previous studies had suggested.
The Health Affairs study authors found that the leading risk factors for long COVID included high blood pressure, chronic lung disease, obesity, diabetes, and depression.
Long-covid symptoms are less common now than earlier in the pandemic
From The Washington Post:
Americans infected with the coronavirusās omicron variant are less likely to develop symptoms typical of long covid than those who had covid-19 earlier in the pandemic, according to the largest-ever study of who is most vulnerable to being sickened ā or debilitated ā by the virusās lingering effects.
The analysis of nearly 5 million U.S. patients who had covid, a study based on a collaboration between The Washington Post and research partners, shows that 1 in 16 people with omicron received medical care for symptoms associated with long covid within several months of being infected. Patients exposed to the coronavirus during the first wave of pandemic illness ā from early 2020 to late spring 2021 ā were most prone to develop long covid, with 1 in 12 suffering persistent symptoms
Research š¬
Recovery from Exercise in Persons with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
From MDPI:
Post-exertional malaise (PEM) is the hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but there has been little effort to quantitate the duration of PEM symptoms following a known exertional stressor.
Using a Symptom Severity Scale (SSS) that includes nine common symptoms of ME/CFS, we sought to characterize the duration and severity of PEM symptoms following two cardiopulmonary exercise tests separated by 24 h (2-day CPET)
ME/CFS subjects took an average of almost two weeks to recover from a 2-day CPET, whereas sedentary controls only needed an average of two days.
Almost 10% of subjects with ME/CFS took more than three weeks to recover, with one subject (~1%) with ME/CFS who felt he had not recovered after a full year.
A Case Study of Successful Application of the Principles of ME/CFS Care to an Individual with Long COVID
From MDPI:
We describe the long-term follow-up of a patient who met the Institute of Medicine criteria for ME/CFS at six months following a confirmed acute SARS-CoV-2 infection.
This case is a practical demonstration of applying our multi-disciplinary management approach to ME/CFS in a patient with long COVID, focusing on common comorbidities such as range of motion abnormalities, mast cell activation, allergic inflammation, and orthostatic intolerance.
Mast cell activation may contribute to a hyperinflammatory response in long COVID, and medications used to treat mast cell activation disorders have shown potential in improving symptoms.
Treatment of orthostatic intolerance should be prioritized before advancing aerobic activity to avoid post-exertional symptom exacerbations in those with ME/CFS and long COVID.
Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder
From FrontiersIn:
Autoantibodies against nAChRs have been associated with several diseases, including myasthenia gravis,
An autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients.
Results: Of the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies.
Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients.
Increased insulin (IR) resistance due to Long COVID is associated with depressive symptoms and partly predicted by the inflammatory response during acute infection
From BJP:
Some months after the remission of acute COVID -19, some individuals show depressive symptoms, which are predicted by increased peak body temperature (PBT) and decreased blood oxygen saturation (SpO2)
Long COVID is associated with new-onset IR which may contribute to the onset of depressive symptoms due to Long COVID by enhancing overall neurotoxicity.
Additionally, increased IR in Long COVID is associated with the physio-affective phenome of Long COVID, the inflammatory response of the acute infectious phase, and activated IO&NS pathways.
Hyperglycemia in COVID-19 infection without diabetes mellitus: Association with inflammatory markers
From WJCC:
An Italian study of 271 patients admitted for COVID-19 showed that hyperglycemia was independently associated with increased mortality.
Our study investigated the association of hyperglycemia at presentation with inflammatory markers and the impact of hyperglycemia on mortality and morbidity in non-diabetic COVID-19 patients.
We observed a significantly increased rate of mortality in patients with new onset hyperglycemia compared to those without.
We also observed a significant increase in the mean length of stay in patients with hyperglycemia compared to patients with normoglycemia.
Predictors of impaired functioning among long COVID patients
From IOS Press:
Our study found two factors emerged during both time points, namely Autonomic and Cognitive Dysfunction, suggesting that these two domains represent important phenotypes of acute COVID and Long COVID.
Finally, higher levels of autonomic and gastrointestinal symptoms during the onset of COVID-19 appear to be predictive of greater impairment at time 2 .
Immunometabolic rewiring in long COVID patients with chronic headache
From Biorxiv:
Post-COVID symptoms, including chronic headaches, are an emerging global health concern.
Long COVID patients commonly present neurological symptoms such as fatigue and chronic headaches. The etiology of long COVID-related chronic headaches is not well characterized.
Chronic systemic inflammation may drive the development of long COVID headache regardless of disease severity.
Lipid metabolites and arginine metabolism may contribute to sustained inflammation in long COVID-headache patients.
Dysregulated metabolism of multiple neurotransmitters may be the hallmark of long COVID chronic headache
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Congrats for the 2000 subs mate! Really thoroughly deserved - now for the next 2000 :)
The article about recovery in ME/CFS sort of illustrates why exercise is a bad idea for people with ME/CFS and many with Long Covid--one of the study subjects still hadnāt recovered a full one year after the stress test. This also helps show why the RECOVER study should not be using exercise-based clinical trials. The #ME Action group has written a letter to the NIH asking them to refrain from doing so.