Hi everyone,
Hope everyone had a good weekend. Like many with LC, I have a bevy of Mast Cell issues. Especially after contracting LC, my allergies during the winter are the worst ( I have a strong aversion to dust mites). A couple of weeks back, a reader recommended Allergic: Our Irritated Bodies in a Changing World, a 2023 book on the topic of allergies. I have found it to be a good read thus far, and figured I would plug it here in case anyone has the time/energy to read (or in my case audiobook) it.
In this edition, we bring you a collection of articles that delve into the prevalence and impact of Long Covid on individuals, including the staggering statistic that nearly 1 in 4 American adults who contract Covid-19 suffer from Long Covid. We also explore the cognitive dysfunction experienced by Long Covid patients, as well as the potential relief provided by tech-assisted breathing exercises. Additionally, we highlight exciting developments in research funding, such as Albany Med receiving a $3.9M grant specifically for Long Covid studies.
Media
SUMMARY:
A staggering 24% of U.S. adults who received a positive COVID-19 test or diagnosis report symptoms of COVID-19 that lasted three months or longer.
Oklahoma has the highest rate of long COVID, with 34% of adults who had COVID-19 experiencing symptoms for three months or longer.
Long COVID has affected two out of every five adults afflicted by COVID-19 in Los Angeles and Atlanta.
31% of those affected by long COVID report that the symptoms have reduced their ability to carry out daily activities.
My Take:
The continued study into the high prevalence of LC is important for eventually getting more funding.
Article: Cognitive dysfunction after covid-19 | The BMJ
DEFINITIONS:
MOCA: The Montreal Cognitive Assessment (MOCA) is a test that assesses a person's cognitive abilities, including attention, memory, and executive functioning.
SUMMARY:
Cognitive problems are common after acute SARS-CoV-2 infection and can be disabling and frightening.
Symptoms tend to improve, but this may take up to a year.
Those with chronically persistent symptoms lasting more than 12 months have a lower chance of improving.
Symptoms usually fluctuate.
Assessment should be directed to documenting the nature and trajectory of the impairment and excluding alternative diagnoses.
Article: Long COVID: Tech assisted breathing exercises relieve symptoms
DEFINITIONS:
Heart Rate Variability Biofeedback (HRV-B): Tracking HRV alongside breathing techniques to restore the autonomic balance through activation of the parasympathetic nervous system, which steadies heart rate and blood pressure.
SUMMARY:
Simple breathing exercises done twice daily while using a mobile phone app can help relieve the symptoms of long COVID, new research has found.
Resonant breathing, which consists of a four second inhale and six second exhale through the nose repeated for 10 minutes, significantly improved symptoms among the 13 long COVID patients in the University of Leeds study, which is published in the journal Advances in Rehabilitation Science and Practice.
After the four-week intervention, participants reported a reduction in their symptoms, better sleep and improved physical functioning.
The research suggests that resonant breathing is an easy and effective technique that can significantly improve symptoms of long COVID.
Article: Albany Med, seeking signature for long COVID, gets $3.9M grant | The Altamont Enterprise
DEFINITIONS:
Biomarkers: measurable indicators used to diagnose diseases or conditions.
SUMMARY:
Scientists at Albany Medical College are working with scientists at the University of Wisconsin to find a signature, in blood samples, to identify patients who are most vulnerable to long COVID.
Albany Med has been awarded a five-year, $3.9 million grant from the National Institutes of Health to study biomarkers in the blood of patients who have had COVID-19 but continue to experience symptoms for weeks or months after the initial infection.
“Ultimately, our goal is to develop a blood test that pinpoints those who are most susceptible to severe forms of COVID-19 and identifies the likelihood that someone will experience long COVID,” said Ariel Jaitovich, M.D.in a release from Albany Med.
During the first year of the pandemic, Jaitovich and his partners at the University of Wisconsin pioneered the use of mass spectrometry, an analytical tool that measures the mass of biomolecules, to identify the molecular signatures of COVID-19.
Article: I was young and fit, and suddenly too exhausted to get out of bed: Washington Post
SUMMARY:
This testimonial from a person with chronic fatigue syndrome discusses her original illness, dismissive treatment, diagnosis after many years, and the stigma and skepticism people with CFS face.
“In April 1994, I woke up with my body locked in pain — as if nails had been hammered into my joints overnight. When I tried to get out of bed, I found I couldn’t move.”
On a visit to a prominent physician at Mass General, the doctor “physically examined me, with step-by-step narration, as if I were a cadaver in anatomy class. Then he addressed the resident: ‘As confirmed by our diagnostic testing, there is nothing physically wrong with this patient.’ He scribbled on a sheet of paper and handed it to me. ‘Here’s the name of a psychiatrist at Georgetown,’ he said. ‘He’ll be able to help you.’”
“CFS has changed the course of my life. I now know that alternative life paths are no less worthy or fulfilling.”
“Until medicine catches up, however, those disabled by CFS and long covid will continue to suffer and have limited life choices.”
Research
DEFINITIONS:
xenoAMPs: Peptide motifs derived from the SARS-CoV-2 virus that mimic host antimicrobial peptides.
dsRNA: Double-stranded RNA, a common ligand in viral infections that is recognized by the innate immune system.
Multivalent binding: The simultaneous binding of multiple molecules to one receptor or multiple receptors, leading to enhanced immune activation and inflammatory responses.
Cytokine secretion: The release of cytokines, signaling molecules that regulate immune responses, inflammation, and other biological processes.
SUMMARY:
The study explores the possibility that remnants of the SARS-CoV-2 virus, specifically viral peptide fragments, can reassemble with double-stranded RNA (dsRNA) into proinflammatory complexes, leading to immune amplification and inflammatory responses.
The researchers identify viral peptide motifs that mimic host antimicrobial peptides and show that these motifs are enriched in SARS-CoV-2 compared to other low-pathogenicity coronaviruses.
The xenoAMPs from SARS-CoV-2 can assemble dsRNA into nanocrystalline complexes capable of multivalent binding, leading to amplified cytokine secretion in various cell types.
The researchers find that these complexes can induce strong immune activation and cytokine release in uninfected cells, similar to the effects of host antimicrobial peptides.
My Take:
A lot of this went over my head but I found this to be very interesting!
SUMMARY:
This study investigates metabolomic and immune alterations in long COVID (LC) patients with chronic fatigue syndrome (CFS).
LC patients have persistent metabolomic abnormalities 12 months after acute COVID-19 disease, which can also be observed in recovered individuals.
Alterations in metabolic pathways and metabolite levels suggest disturbances in amino acid and nitrogen metabolism, as well as potential deficiencies in serine and sarcosine in LC patients.
LC patients exhibit elevated levels of pro-inflammatory biomarkers and auto-antibodies, as well as reduced ATP levels compared to healthy controls and recovered individuals.
The elevation of pro-inflammatory biomarkers and auto-antibodies suggests an ongoing immune response in long COVID patients.
SUMMARY:
Cognitive symptoms are among the most prevalent features of PCC (Post Covid Condition).
People with PCC have now been shown to demonstrate deficits across a wide array of high-level cognitive functions, including sustained attention, cognitive flexibility, and memory.
Such cognitive impairments have been found to correlate with structural and functional brain changes in PCC.
These observations may fit with the general description of symptoms—“brain fog”—which is commonly used by patients, but there is currently a lack of a robust cognitive signature that distinguishes patients with PCC from those of other people who had SARS-CoV2 infection.
This makes it difficult to diagnose with objective markers, and also to develop treatments for cognitive symptoms in this group of patients.
The study aimed to test if a fundamental deficit—cognitive slowing (here defined as increased time to process information and respond to it)—is present in people with PCC.
The present study reported a significant psychomotor slowing in individuals diagnosed with PCC. Importantly, this cannot be attributed to poor global cognition as measured by a cognitive screening test (MoCA), fatigue, mental health-related symptoms, or speed-accuracy trade-off.
DEFINITIONS:
Electroencephalography (EEG): A diagnostic technique used to record and analyze electrical activity of the brain.
Abnormal EEG: EEG recordings that exhibit abnormalities, such as abnormal discharges or background abnormalities.
Febrile seizure: A seizure that occurs in children due to a high fever, often caused by an infection.
Encephalitis/encephalopathy: Inflammation of the brain or a diffuse disease of the brain that alters brain function.
SUMMARY:
The primary aim of this study was to describe the EEG characteristics caused by COVID-19 infection in children who were showing neurological symptoms and to assess the relationship between COVID-19-related EEG changes and clinical features in these children.
Abnormal EEG findings were detected in 31.20% (N = 39) of the patients. Abnormal EEG was associated with the level of consciousness. Patients in the normal EEG group were more likely to be conscious (P = 0.017). The proportion of patients diagnosed with febrile seizures (P = 0.002) was higher in the normal EEG group than in the abnormal EEG group, while the opposite was true for epilepsy and encephalitis/encephalopathy (P = 0.016 and P = 0.003, respectively).
The febrile response in patients with febrile seizures could reflect an altered function of the cytokine network, with IL-1 and IL-6 being the most likely involved mediators. On the other hand, the SARS-CoV-2 virus induces a systemic inflammatory response, which may promote increased cytokine release, leading to the onset of febrile seizures.
A recent systematic review suggested that patients with pre-existing neurological disorders (including epilepsy) may develop worsening neurological problems after being infected with COVID-19. This finding was also confirmed in thisstudy. Twenty-three patients included in this study suffered from epilepsy, and seven had more frequent seizures after COVID-19 infection than before.
Future research on the relationship of the EEG findings to the clinical state and short- or long-term prognosis of COVID-19 patients may be conducted to help clinicians discern which patients would necessitate an EEG procedure. It would eventually require treatment with the ultimate aim of improving their clinical outcomes.
DEFINITIONS:
T-cell infiltration: the migration of T cells into specific tissues or organs.
SUMMARY:
The pathophysiology and neuropathogenesis of neurologic complications in COVID-19 patients is not well understood.
This study analyzed brain tissue samples from deceased COVID-19 patients and found evidence of T-cell infiltration in almost all brain areas studied.
The olfactory bulb, medulla, and cerebellum showed the highest infiltration of SARS-CoV-2 specific T cells.
The findings suggest a potential link between T-cell infiltration and neurological symptoms in COVID-19 patients.
DEFINITIONS:
Cross-sectional study: a type of observational study that analyzes data collected at a specific point in time to determine associations between variables.
Pulmonary function test: a series of tests that measure lung volumes and capacities, as well as the flow rates of air in and out of the lungs, to assess respiratory function.
Diffusing capacity: a measure of the lungs' ability to transfer gases between the alveoli and the blood.
SUMMARY:
This cross-sectional study aimed to assess the impact of post-COVID-19 lung damage on pulmonary function, exercise tolerance, and quality of life in a cohort of Indian subjects.
The study found that subjects who had recovered from COVID-19 had significant impairment of lung function, with 35% having a restrictive defect, 8.3% having an obstructive defect, and 44.4% having diminished diffusing capacity.
Comparisons between different severity categories of COVID-19 showed that the "COVID-19 pneumonia" group had lower lung function, decreased minimum oxygen saturation, and greater respiratory impairment compared to the "mild COVID-19" group.
This study provides important insights into the long-term pulmonary sequelae of COVID-19 and highlights the need for monitoring and interventions to improve respiratory function and quality of life in recovered individuals.
SUMMARY:
Long COVID is a hot topic in research as it refers to the persistent symptoms that can occur after a person has recovered from a COVID-19 infection.
The number of publications on long COVID has rapidly increased since 2021, indicating the growing interest and research focus on this topic.
The top countries contributing to long COVID research are the United States, United Kingdom, Italy, Germany, and Spain.
The top institutions publishing research on long COVID include Imperial College London, University of Sao Paulo, and University of Oxford.
My Take:
I found this to be super interesting!
The increase in publications on long COVID since 2021 indicates the urgency and importance of understanding and managing these persistent symptoms.
The contributions from countries like the United States and the United Kingdom demonstrate the global attention and collaboration in addressing this issue.
DEFINITIONS:
EBV-IM: Epstein-Barr virus infectious mononucleosis is an infection caused by the Epstein-Barr virus, leading to symptoms such as fever, fatigue, and sore throat.
It has been linked to the development of ME/CFS in some cases.
SUMMARY:
This study followed young people with myalgic encephalomyelitis/chronic fatigue-syndrome (ME/CFS) after they had infectious mononucleosis caused by the Epstein-Barr virus (EBV).
The study found that young adults with ME/CFS had more severe symptoms and a decline in physical and mental functioning compared to adolescents.
After one year, more adolescents (54%) no longer met the diagnostic criteria for ME/CFS compared to young adults who all still fulfilled the criteria.
The study highlighted the need for biomarkers and effective treatments for ME/CFS following EBV-IM to improve medical care and aid recovery.
As always many thanks for your hard work. It is very much appreciated by LC sufferers.
Thanks for the continued synopsis of medical papers.
Have you come across vibration / or electro magnetic impulse therapy that helps? I remember reading way back right at the onset of covid that someone found vibration therapy useful. This particular lady used some type of equipment they used on horses for physiotherapy. I would really like to obtain something like it.
As, We have a power plate at gym and after each session I sit with my legs and arms out stretched on the power plate for 15 minutes. My cells feel as if they have come alive and are dancing. It definitely helps with inflamed and sore ankles and wrists. I have completely come off anti inflammatories. I think my lymphatic drainage has improved somewhat too.
Any feedback would be welcome.