Long Covid Weekly #63: Newsletter reaches 3,000 subs!
Plus Non-Covid related Post-viral syndromes sparks media attention
Hi everyone,
Happy to announce that the newsletter reached 3,000 subscribers within the last week. For everyone who has been here for a while thanks for the continued support, and for those who have recently joined, welcome & thank you!
Our featured pieces include an analysis of long-term symptom profiles after Covid-19, a study on organ-specific immune responses to the virus, and the mysteries behind the distinct tissue and organ pathologies linked to prolonged Covid-19 symptoms. Additionally, we take a closer look at the endocrine system's susceptibility, the potential benefits of certain medications, and the lipid metabolism in convalescent Covid-19 patients.
Media
Article: Long COVID in Adults: United States, 2022: NIH
SUMMARY:
In 2022, 6.9% of adults ever had Long COVID and 3.4% had Long COVID at the time of interview (currently have Long COVID); women were more likely than men to ever have or currently have Long COVID.
Adults ages 35–49 (8.9%) were more likely than adults ages 18–34 (6.9%), 50–64 (7.6%), and 65 and older (4.1%) to ever have Long COVID. Adults ages 65 and older were the least likely to ever have Long COVID.
The percentage of adults who ever had Long COVID was lower in large central metropolitan areas compared with medium and small metropolitan and nonmetropolitan areas. Current Long COVID was lowest in large central metropolitan areas
Article: Informal poll: How long has your long Covid lasted? : r/covidlonghaulers
DEFINITIONS:
Confidence interval: A range of values that is likely to include the population parameter being estimated.
SUMMARY:
Based on an informal poll, the mean "age" of people's current long Covid is 27.4 months.
One doctor stated that in his experience treating post-infectious ME/CFS type syndromes, many of them improve greatly or resolve after 2-6 years.
The duration of long Covid may not be particularly "special" compared to other post-infectious syndromes.
The estimated confidence interval for the total duration of long Covid is 9 months to 7 years.
Reinfection and the likelihood of long Covid from a new variant can restart the duration.
My Take:
A really interesting poll done on Reddit!
DEFINITIONS:
Acute respiratory infections (ARIs): infections of the respiratory tract that mainly affect the nose, throat, and lungs, including pneumonia, bronchitis, and common cold.
SUMMARY:
The study aimed to compare symptom profiles between individuals with previous SARS-CoV-2 infection, individuals with previous non-COVID-19 acute respiratory infections (ARIs), and a control group.
Both SARS-CoV-2 and non-COVID-19 ARIs were associated with a wide range of symptoms more than 4 weeks after the acute infection.
Participants with SARS-CoV-2 infection had increased odds of problems with taste/smell and lightheadedness or dizziness compared to participants with non-COVID-19 ARIs.
Latent class analysis identified distinct symptom severity groups for both SARS-CoV-2 and non-COVID-19 ARIs.
My Take:
This study highlights that both SARS-CoV-2 and non-COVID-19 ARIs can lead to long-term symptoms, indicating the need for further research on post-acute sequelae of ARIs caused by various pathogens.
This study gained a lot of traction from some large media companies
However, these results are not surprising in the least, post-viral syndromes are not a new phenomenon.
Article: “What is wrong with me?” Children face a frustrating lack of answers about long COVID
SUMMARY:
Diagnosis of long COVID in children can be particularly difficult, as other childhood illnesses and conditions with similar symptoms must be ruled out.
Professor Selina Kikkenborg Berg found that around 15% of those presenting with symptoms at 3 months also had symptoms after 12 months.
One of the challenges of long COVID is the current lack of a definitive test that can help diagnose the condition.
Research
DEFINITIONS:
Endotheliopathy: Damage or dysfunction of the endothelium, the inner lining of blood vessels.
Complement: A system of proteins in the blood that helps the immune system eliminate pathogens and other harmful substances.
SUMMARY:
COVID-19 is linked to endotheliopathy and coagulopathy, leading to multi-organ failure.
This study developed an infection-competent human vascular organoid model to study endotheliopathy caused by SARS-CoV-2.
Longitudinal serum proteome analysis revealed aberrant complement patterns in critically ill COVID-19 patients, suggesting a role of the complement system in endothelial damage.
A long-acting antibody targeting complement factor D (CFD) protected endothelial cells and reduced inflammation in both human and macaque COVID-19 models.
DEFINITIONS:
Autopsy: a postmortem examination of a body to determine the cause of death and identify any diseases or injuries.
SUMMARY:
The autopsy of a patient who died of severe COVID-19 revealed SARS-CoV-2 infection in multiple organs, including the lung and gut.
A histological examination showed extensive inflammation and damage in the lung, with the presence of lymphoid tissues at the bronchial epithelium.
Immunofluorescence staining confirmed the presence of viral antigens in the lymphoid tissues of the lung and gut, as well as non-lymphoid tissues.
Overall, our study establishes a foundational framework for enhanced quantitation of organ-specific immunity, and its unbiased approach may streamline biomarker discovery and treatment design for novel diseases with differential pathologies at the organ level.
DEFINITIONS:
TSH: Thyroid-stimulating hormone, a hormone produced by the pituitary gland and controls thyroid hormone production.
aTPO antibodies: Anti-thyroid peroxidase antibodies, immune proteins that attack the thyroid gland.
Prolactin: A hormone that stimulates milk production in lactating women and regulates various physiological functions.
Testosterone: A male sex hormone responsible for male sexual development and maintenance of reproductive tissues.
SUMMARY:
Thestudy aimed to evaluate the lasting effects of COVID-19 on the endocrine system 6 months after initial infection.
The study found significantly lower levels of fT3 and fT4, accompanied by higher levels of TSH and aTPO antibodies, in COVID-19 survivors.
Moreover, the studyfound that patients who underwent SARS-CoV2 infection had higher levels of prolactin and lower levels of testosterone than controls.
Interestingly, differences in testosterone levels were observed only in male subjects.
The study indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection might have long-term consequences on the endocrine system, including the suppressed function of the thyroid gland, prolactin, and male sex hormone secretion.
My Take:
These results suggest that COVID-19 may lead to thyroid dysfunction.
I have not seen many studies looking into the long-term impacts on the endocrine system.
DEFINITIONS:
nirmatrelvir/ritonavir (Paxlovid): an oral medication that has been used to treat individuals with Long COVID and acute reinfection of SARS-CoV-2.
SUMMARY:
Prior case series suggest that a 5-day course of oral Paxlovid (nirmatrelvir/ritonavir) benefits some people with Long COVID.
This study documented a case series of 13 individuals with Long COVID who initiated extended courses (>5 days; range: 7.5-30 days) of oral nirmatrelvir/ritonavir outside (n=11) of and within (n=2) the context of an acute SARS-CoV-2 infection.
Long courses of nirmatrelvir/ritonavir may have meaningful benefits for some people with Long COVID but not others.
The authors encourage researchers to study who, how, and why nirmatrelvir/ritonavir benefits some and what course length is most effective, with the goal of informing clinical recommendations for using nirmatrelvir/ritonavir and/or other antivirals as a potential treatment for Long COVID.
My Take:
This case series highlights the potential benefits of an extended course of nirmatrelvir/ritonavir in individuals with Long COVID.
This is probably the most noteworthy research published this week.
DEFINITIONS:
Small extracellular vesicles (sEVs): a subtype of extracellular vesicles that carry a cargo of proteins, lipids, and nucleic acids and play a role in intercellular communication.
Phosphatidylcholines (PCs): the most abundant phospholipid and a major component of cell membranes.
Diacylglycerols (DAGs): intermediate molecules in lipid metabolism and signaling pathways.
Sphingomyelins (SMs): a class of sphingolipids that are important structural components of cell membranes.
SUMMARY:
The study aimed to examine the lipid profile of plasma-derived small extracellular vesicles (sEVs) in COVID-19 convalescent patients.
Lipids extracted from sEVs were analyzed using targeted liquid chromatography-mass spectrometry.
The study found that the lipid metabolism of convalescent COVID-19 patients remained abnormal, with altered levels of phosphatidylcholines, diacylglycerols, and sphingomyelins.
The lipid abnormalities were associated with clinical indicators of organ dysfunction, coagulation, and inflammation.
My Take:
The findings suggest that lipid abnormalities persist even after recovery from the acute phase of the disease.
As this newsletter now has over 60 editions, this is one of the emerging themes I have noticed.
DEFINITIONS:
CPET: Cardiopulmonary exercise testing is a diagnostic test that measures the efficiency and capacity of an individual's cardiovascular and respiratory system during exercise.
SF-36: The 36-Item Short Form Health Survey is a self-administered questionnaire that assesses health-related quality of life.
SUMMARY:
This study aims to demonstrate that oxygen consumption is a biomarker of ME/CFS and provides a method to classify patients diagnosed with ME/CFS based on their responses to the SF-36 questionnaire.
Two datasets were used in the study: one containing SF-36 responses from 2,347 ME/CFS diagnosed participants, and another containing CPET results of 239 ME/CFS patients.
The results show that the Weber classification, based on peak oxygen consumption, is directly linked to the score on the SF-36 questionnaire.
The study suggests that low oxygen consumption on CPET can be considered a biomarker in patients with ME/CFS.
My Take:
By linking peak oxygen consumption to the SF-36 questionnaire responses, the researchers have identified distinct subtypes of ME/CFS patients.
This finding could help clinicians better assess the health status of ME/CFS patients and personalize treatment strategies.
Shout out to Amy E for contributing to the success of the newsletter! Without her the material would surely be of worse quality.
KUDOS on reaching 3,000 SUBS!!! Your UPDATES and INSIGHTS are VITAL to the LONG COVID community!! Keep the AWESOME info coming!!!