Long Covid Weekly #68: LC connected to allergic diseases? Do Monoclonal Antibody Infusions work? & More
Hi everyone!
In this edition, we explore an interesting interview with Tony Fauci pertaining to Long Covid. We also examine how this condition has brought about significant changes in the disability landscape and what it means for HR departments. Additionally, we delve into various studies highlighting the prevalence of Long Covid, the convergence of immunosenescence and autoimmunity, and the impact of allergic diseases as risk factors.
Media
Article: Is Long COVID Real? Here Is What Tony Fauci Told Me - Scientific American
!Insightful read
SUMMARY:
One of the physicians interviewed was Anthony Fauci, former head of the National Institute of Allergy and Infectious Diseases (NIAID).
As part of the book the author is now writing on contested chronic illnesses, they talked about postviral illnesses such as long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the challenge of understanding our body after an infection has ravaged it.
Fauci said that back then we didn’t have the diagnostics that we do now and that “there would be things about their demeanor and their ability to function, which were markedly compromised for variable periods of time.”
Fauci emphasized the need for more research on postviral syndromes and the importance of long-term funding to support this research.
My Take:
Interestingly, Fauci seems to be very supportive now of post-viral syndromes which could be representative of the changing status quo within the leadership brass of th NIAID and NIH.
Article: Second Infection Hikes Long COVID Risk: Expert Q&A
SUMMARY:
People infected multiple times with COVID-19 are more likely to develop long COVID, and most never fully recover from the condition.
Lead researcher Ziyad Al-Aly, MD, chief of research at Veterans Affairs St. Louis Health Care and clinical epidemiologist at Washington University in St. Louis, spoke with Medscape about his team's findings, what we know — and don't — about long COVID, and what it means for physicians treating patients with the condition.
"Some individuals do experience some recovery over time, but for most individuals, the recovery is long and arduous.
Long COVID can last with them for many years," said Dr. Ziyad Al-Aly.
Article: Long COVID changed the disability landscape. What does that mean for HR? | HR Dive
SUMMARY:
Six out of every 100 adults in the U.S. have long COVID, according to federal data.
The U.S. needs to acknowledge its “ableism culture,” Disability Management Employer Coalition CEO Bryon Bass told HR Dive.
“If long COVID is here to stay, how will leaders address the effects it will have on the workforce and subsequently the business?” The U.S.
Equal Employment Opportunity Commission (EEOC) plans to stick up for people affected by “technology-related employment discrimination” and long COVID.
My Take:
Interesting to see the perspective on Long Covid from a Human Resources website.
Research
DEFINITIONS:
Allergic diseases: Refers to conditions such as asthma and rhinitis that involve an immune response to specific allergens.
SUMMARY:
The systematic review aimed to examine the role of allergic diseases as risk factors for Long-COVID (LC) symptoms.
The review identified 13 cohort studies that investigated the association between pre-existing allergic diseases and LC.
The evidence from these studies supported a possible relationship between LC and allergic diseases such as asthma and rhinitis.
However, the certainty of the evidence was very low, and more research is needed to establish a clear link between allergic diseases and LC.
DEFINITIONS:
Receptor for Advanced Glycation Endproducts (RAGE): a pattern recognition receptor involved in the pathogenesis of various disorders, including COVID-19.
It recognizes a wide range of ligands and is associated with severe or critical COVID-19 cases.
SUMMARY:
The study conducted a single-cell multi-omics analysis of the immune response in COVID-19 patients to understand the molecular basis of the disease.
They identified a severity-associated activation of the receptor for advanced glycation endproducts (RAGE) pathway in monocytes, highlighting its role in COVID-19 pathogenesis.
The study found that monocytes bind the SARS-CoV-2 spike protein via RAGE and that RAGE-S interactions drive monocyte infection.
The longitudinal analysis also identified potential drugs that could reverse COVID-19 immune dysregulation during the initial stage of the disease.
My Take:
I will be honest, I did not completely comprehend everything in this study, but I tried to summarize it to the best of my ability.
DEFINITIONS:
Olfactory training: A technique used to help individuals regain their sense of smell after experiencing anosmia (loss of smell).
It involves exposure to various smells and repetitive sniffing exercises.
SUMMARY:
The study aimed to assess the effect of alpha-lipoic acid as an adjuvant treatment of olfactory training on the improvement of smell loss in post-COVID-19 patients.
The randomized controlled trial included 128 adult outpatients who had persistent smell loss for more than 3 months after COVID-19 infection.
The participants were divided into two groups: the intervention treatment group, which received alpha-lipoic acid associated with olfactory training, and the comparison treatment group, which received placebo pills associated with olfactory training.
Overall, there was a significant difference in olfactory function between baseline and endpoint for both groups.
The study found that alpha-lipoic acid, when used as an adjuvant treatment with olfactory training, did not yield better results compared to olfactory training alone for post-COVID-19 patients experiencing olfactory loss.
Despite improvements in olfactory function observed in both groups, there was no significant difference between the two treatment approaches.
DEFINITIONS:
Monoclonal antibody (MCA): A laboratory-produced antibody that is designed to mimic the natural antibodies produced by the immune system.
It can be used as a therapeutic treatment to target specific pathogens or diseases.
SUMMARY:
The objective of this study was to report cases of complete, rapid remission of severe forms of long COVID following monoclonal antibody (MCA) infusions.
The three index cases presented in this study experienced complete and sustained remission of their persistent disabling disease within a week of MCA infusion.
Each subject rapidly returned to normal health and previous lifestyles/occupations with normalized exercise tolerance, which has been sustained for over two years.
These index cases suggest that MCA infusions may be capable of treating long COVID in certain cases, including those with severe debilitation.
The rapid and complete remissions observed in these cases also provide mechanistic implications for treating and managing other post-viral chronic conditions and long COVID from other variants.
My Take:
Anecdotally, I have heard mixed reviews of this treatment but curious to see if we can get a larger study on this.
SUMMARY:
Ten weeks following the onset of COVID-19, a study found a significant correlation between fatigue severity and T cell phenotypes, regardless of the initial disease severity.
Clinical symptoms and impairment, including fatigue, depression, anxiety, and quality of life, were similar across all patient groups, regardless of initial disease severity.
In terms of the humoral response to SARS-CoV-2 infection, convalescent patients displayed an antigen-dependent increase of S2- and N-specific IgG antibodies compared to S1- and RBD-specific antibodies.
Neutralizing antibody titers were higher in patients with severe acute disease, but there was no association between antibody titers and post-acute sequelae of COVID-19 (PASC) symptoms, including fatigue.
Article: Vortioxetine may improve cognitive function in subgroup of individuals with long COVID
SUMMARY:
A total of 149 participants were randomised to receive either vortioxetine in the range of 5 to 20 mg/day (n = 75) or placebo (n = 74) daily for 8 weeks.
Overall, no significant between-group difference was observed in the overall change in cognitive function
However, in the fully adjusted model, a significant treatment-by-time interaction was observed in favour of vortioxetine treatment.
Among participants whose CRP (C-reactive protein) was above the mean at baseline, a significant improvement in Digit Symbol Substitution Test (DSST) scores was observed in those treated with vortioxetine compared with those who received placebo.
DEFINITIONS:
Immunosenescence: the dynamic restructuring of the immune response that occurs with aging.
Inflammaging: a persistent, low-grade pro-inflammatory state that permeates various tissues and organs throughout the lifespan.
Epigenetic changes: alterations in DNA methylation, histone modifications, and non-coding RNA regulation that influence gene expression.
SUMMARY:
Immunosenescence frames the contextual background within which immune cell composition and functional characteristics, T-cell receptor signaling, cytokine network dysregulation, and compromised regulatory T-cell function occur.
Inflammaging, a persistent, low-grade pro-inflammatory state, is implicated in the pathogenesis of age-related autoimmune susceptibilities and may mediate immune perturbations in Long COVID patients.
Epigenetic changes, such as DNA methylation and histone modifications, play a role in shaping susceptibility to infections and the development of autoimmune conditions in the context of aging.
My Take:
Not completely related to Long Covid but interesting to understand.
The emergence of autoimmune disorders in the elderly and potential mediation of immune perturbations in Long COVID patients highlight the importance of identifying underlying mechanisms.
There's important new info on preventing Covid vax deaths from fibrous clots by Spencer Feldman at https://covidandvaxfaqs.substack.com/p/special-prevent-covid-vax-deaths. He said the vaxes appear to be extremely sophisticated bioweapons (thus not easy to remedy).