Hi Everyone!
In this issue, we shed light on Long Covid’s association with postural orthostatic tachycardia syndrome (POTS) and the impact of coronavirus vaccines on Long Covid-like illness. We also explore inspiring stories, such as the remarkable journey of Scottish tennis player Maia Lumsden, who conquered Long Covid to make a triumphant return to Wimbledon. Additionally, we delve into scientific research examining the immunologic and autoimmune-related sequelae of SARS-CoV-2 infection, the detrimental effects of Covid-19 in the brain, and potential therapeutic options for Long Covid. We also highlight a significant study on the association between undiagnosed obstructive sleep apnea and the severity of Covid-19. Furthermore, we explore the role of ketogenic medium chain triglyceride supplementation in refueling the post Covid-19 brain and the detection of Alzheimer's disease in those suffering from post-acute Covid-19 syndrome. Lastly, we bring you insights into the physical and cognitive impact of SARS-CoV-2 infection through a large population-based case-control study, as well as exciting news about Berlin Cures' trial of their BC 007 drug for Long Covid.
Media
Article: Majority of Patients With Long COVID Meet Criteria for POTS
DEFINITIONS:
OI (Orthostatic Intolerance) is a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position.
The primary symptom of OI is lightheadedness or fainting.
SUMMARY:
A new study found that (79%) of those with Post-acute sequelae of Covid-19 (PASC) or Long COVID met the internationally established criteria for POTS.
According to the investigators, participants were subject to autonomic testing included beat-to-beat hemodynamic monitoring to assess respiratory sinus arrhythmia, Valsalva ratio and orthostatic changes during a 10-minute active standing test as well as Sudomotor assessment.
The American Journal of Medicine authors see a connection between long COVID and POTS.
My Take:
Again it feels like most people are becoming well aware of something that most people within the LC community knew years ago…
DEFINITIONS:
Long Vax: a debilitating suite of symptoms that resembles Long Covid, which some people experience after receiving COVID-19 vaccines.
SUMMARY:
COVID-19 vaccines have saved millions of lives, and the world is gearing up for a new round of boosters.
But like all vaccines, those targeting the coronavirus can cause side effects in some people, including rare cases of abnormal blood clotting and heart inflammation.
Another apparent complication, a debilitating suite of symptoms that resembles Long Covid, has been more elusive, its link to vaccination unclear and its diagnostic features ill-defined.
SUMMARY:
Maia Lumsden, a Scottish tennis player, is making her return to Wimbledon after battling long Covid.
Lumsden was sidelined for 18 months due to the illness, but has since been able to compete again.
Last year, she made her Wimbledon debut and advanced to the second round of the women's doubles.
My Take:
Lumsden's comeback to Wimbledon is inspiring, especially after her long battle with Long Covid.
It is a testament to her resilience and determination to return to professional tennis.
Research
SUMMARY:
This article explores the immunologic and autoimmune-related sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Acute COVID-19 and PASC are heterogeneous conditions that affect patients differently
In a multicenter cohort study of 215 individuals, Cervia and colleagues found that an immunoglobulin signature could predict PASC development risk
Overall, emerging evidence currently suggests a bidirectional relationship between autoimmunity and COVID-19 infection, with some studies showing that prior autoimmunity may predispose patients to worse COVID-19 outcomes, whereas other studies indicate new onset autoimmunity post-COVID.
PASC can involve multiorgan dysfunction and may be influenced by comorbid conditions such as autoimmunity, hypogammaglobulinemia, cancer, cardio-pulmonary and neuropsychiatric conditions.
SUMMARY:
A number of neurological and psychiatric symptoms have been linked to COVID-19, including anosmia (or loss of smell), ageusia (or loss of taste), cognitive impairment, depression, anxiety, and sleep disturbance.
EBV reactivation after SARS-CoV-2 infection could contribute to acute clinical symptoms and long COVID symptoms.
A retrospective study from Wuhan University (China) was the first to show that subjects co-infected by SARS-CoV-2 and EBV have an approximate three-fold increased risk of severe symptoms compared with subjects infected with SARS-CoV-2 alone
SARS-CoV-2 can enter in the GI tract and cause dysbiosis of the gut microbiota in patients with COVID-19. It is shown that infection of SARS-CoV-2 could damage the intestinal barrier, resulting in dysbiosis of gut microbiome and GI symptoms.
Given the role of the gut–brain axis in systemic inflammation, it is possible that dysbiosis of the gut microbiome in COVID-19 survivors may induce neuroinflammation in the brain through the gut–brain axis
SUMMARY:
In studies conducted in the early phases of the pandemic on large cohorts of symptomatic COVID-19 patients, approximately 15% of patients had severe disease requiring hospitalization, and 5% became critically ill.
Previously undiagnosed OSA (Obstructive Sleep Apnea) was common among hospitalized patients who survived the acute phase of COVID-19. The degree of OSA was associated with the severity of respiratory failure.
We hypothesize potential mechanism of how OSA may worsen the course of COVID-19. First, OSA leads to nocturnal desaturations during sleep, thus worsening the symptoms of acute respiratory failure in severe COVID-19.
My Take:
Understanding the relationship between sleep-related breathing disorders and respiratory failure in COVID-19 patients can help inform treatment strategies and improve patient outcomes. This is a pretty unexplored area of research, imo
Summary:
The impact of long COVID on individuals' lives cannot be underestimated.
This cognitive dysfunction is associated with impaired cerebral glucose metabolism
ketone bodies improve brain energy metabolism in the face of cerebral glucose hypometabolism in other conditions
Medium chain triglyceride (MCT) oil supplementation could potentially improve brain energy metabolism and cognitive function post-COVID-19, providing hope for those affected by long COVID.
Further research is needed to evaluate the efficacy of MCT supplementation and its potential benefits in the long term.
DEFINITIONS:
Remote digital Assessments for Preclinical AD (RAPAs): are assessments that can be conducted remotely through digital technologies to screen for early Alzheimer's disease.
SUMMARY:
The risk of developing Alzheimer's disease (AD) is being discussed in relation to Post-Acute COVID-19 Syndrome (PACS) in older adults..
Remote digital Assessments for Preclinical AD (RAPAs) are important in screening for early AD in PACS patients
Olfaction is the most long-lasting impairment found in PACS patients, but AD olfactory screening is not recommended for PACS patients at this time.
As the experts conclude, graphical markers are widely studied in RAPA, as AD patients report a decline in fine motor control, coordination, and writing or drawing impairments that compromise daily life activities. AD hand movements become slower, less fluid, and less consistent due to reduced precision in wrist and finger positioning
Graphical, SPEECH, eye-tracking, central hearing, and spatial navigation abilities are still usable without any concern, but olfactory function may be altered by PACS and should be avoided in a preclinical AD screening assessment.
My Take:
Caution should be taken when using olfactory screening in these patients, as experts recommend waiting until full recovery is confirmed.
This information provides valuable insights for the development and use of screening methods in the post-COVID-19 era.
SUMMARY:
Persistent symptoms are commonly reported after SARS-CoV-2 infection but correlation with objective measures is unclear.
Conventional clinical tests may not be informative in relating symptoms to a past SARS-CoV-2 infection.
Out of 88 assessed symptoms, 41 were more common in cases than controls. However, relatively few differences were seen in the results obtained from the various medical evaluations (cases had poorer smell and taste test results, slightly less grip strength, and slightly poorer memory recall than controls).
My Take:
This study found that individuals who had previously been infected with SARS-CoV-2 commonly reported persistent symptoms, but there were few differences in objective measurements between cases and controls.
These findings suggest that traditional clinical tests may not effectively capture the relationship between symptoms and a past SARS-CoV-2 infection.
Hope
Article: Berlin Cures initiates trial of BC 007 drug in indication Long Covid
DEFINITIONS:
Phase II trial: a clinical trial that evaluates the safety and effectiveness of a treatment in a larger group of patients than Phase I trials.
Endpoint: a specific measurable outcome used to determine the success or failure of a clinical trial.
SUMMARY:
BC 007’s potential is based on the data generated in the lab using sera from patients with Long Covid. Four cases have been studied to date.
Positive data from this study will be used to initiate a larger Phase III study.
The Case for Ramping up ME/CFS Research by CrunchME
Short and sweet slide deck going over why more research dollars needed to be allocated to ME/CFS!
For those who do not know, CrunchME is a Volunteer data science & engineering org with the goal to help researchers & charities ‘crunch’ ME/CFS + Long Covid
Great newsletter, so many interesting and hopeful articles! Thank you so much for putting this together!