Please retweet! This new study could help us understand #LongCOVID. Consider participating if you’re in the New York City area and even if you don’t have persistent post-COVID symptoms or were never infected by SARS-CoV-2 as the study needs you too!
Post-Viral Autoantibodies in Patients with Cognitive Dysfunction and/or Postural Orthostatic Tachycardia Syndrome (POTS)
The purpose of this study is to understand why patients develop cognitive dysfunction (e.g., brain fog) and/or POTS after a viral illness by testing whether it might be associated with autoimmunity in which abnormal antibodies cause the disease.
Postural Orthostatic Tachycardia Syndrome (POTS) is a condition in which patients become dizzy, lightheaded, or faint especially when standing up. It is sometimes associated with an uncomfortable, rapid increase in heartbeat.
The two study visits will be at the NYU School of Medicine or the first visit could be performed remotely. These visits will last about 1 hour each. During the first visit, you will answer a series of questions about you, your medical history, and your symptoms.
At the second visit, you will have your blood drawn, processed, sent for viral testing and to be analyzed for autoantibodies, which are abnormal antibodies that attack organs and tissues in your own body. This second visit must be performed in-person at NYU.
If you are eligible for the study, which includes being 18 years or older, not pregnant, and have developed cognitive dysfunction and/or POTS within 2 months after a viral infection, then you will complete the questionnaires in the first visit.
Then we will collect your blood samples and send them to our research laboratories for analysis, viral testing, and overseas to an international clinical laboratory that can test for autoantibodies commonly found among patients with POTS and/or cognitive dysfunction.
Please note that these are not commonly performed tests and have not been validated as a way to confirm or diagnose patients with POTS or autoimmunity. There is the possibility that the tests results are inaccurate and we have no way of confirming the results.
There is no cost for participation in the study. If you agree to participate, you will not receive compensation for travel and time. We will also recruit patients without these symptoms in order to compare the results with participants who have these symptoms.
If you like to hear more about this study or enroll, please contact one of our research coordinators by email at: POTSautoantibodies@nyulangone.org

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More from @DaveLeeERMD

13 May
Fatal cases of COVID-19 are associated with antibody responses directed against the S2 subunit of the spike protein. @VirusesImmunity @aaronmring @ericsongg @jasonsknight @YogenKanthi @RayZuoMD @DrDenDunnen @EJohnWherry medrxiv.org/content/10.110…
So why could those anti-spike S2 antibodies be so bad? Shouldn’t they also inhibit the virus? We will think that this study of SARS-CoV-1 provides the answer. There’s a segment in S2 subunit that cross reacts with a critical lung protein. pubmed.ncbi.nlm.nih.gov/20015551/
Given the 90% homology between the S2 subunits of SARS-CoV-1 and SARS-CoV-2, we went looking for autoantibodies against this protein, Annexin A2, among hospitalized COVID-19 patients and found the levels of anti-Annexin A2 strongly predicted mortality. medrxiv.org/content/10.110…
Read 5 tweets
7 May
Does this make any sense? The endothelial damage is likely due to direct damage by the virus yet the evidence is mixed as to whether the virus actually infects endothelial cells?
Discussion about the B cell compartment states that is confusing why patients with deficiencies in antibody production don’t seem to get very sick. But then no real mention of autoimmunity?
I’ll describe the clinical course in simple terms. Here’s what your typical COVID-19 patient looks like who is going to end up in the hospital with severe COVID-19. The first week is a URI that might actually get better. Then 6 to 12 days later the respiratory distress begins.
Read 7 tweets
1 May
There are two patterns to identify among doctors (and other health professionals) which signal evidence they might not be getting the diagnosis right. Both types are very prevalent in discussions of acute and long COVID.
Premature closure is a cognitive error where the physician fails to consider the reasonable alternatives and settles on a diagnosis that does not match the clinical characteristics of the disease. This faulty decision making process often leads to delayed diagnosis.
At the other extreme is labeling disease processes as multifactorial. While every health problem has many contributing factors, this attribution is cognitive cover for the fact that the physician just doesn’t know. It can provide false justification for not investigating further.
Read 4 tweets
17 Apr
I’m realizing that in modern medicine there are these conditions that are viewed as unpopular siblings in certain disciplines. For instance in rheumatology it might be Sjogrens and in neurology it might be POTS.
Those who study more well defined and understood conditions scoff at the poor research in these areas, question the clinical practices, and often label patients with those conditions as difficult or likely falsely attributing symptoms that might not be real.
I wonder if it was the same many years ago when there were other conditions that weren’t well understood. If doctors had the same gall and presumptions. Or maybe back then there was a much more prevalent acceptance that knowledge was limited.
Read 6 tweets
16 Apr
Aptamers. Oligonucleotide or peptide molecules that bind to a specific target molecule. I’m almost certain that this is the one big medical advances that is going to come out of this pandemic.
You already see companies including BioNTech doing something similar by deploying mRNA to treat early MS which is an autoimmune disease. These short segments of mRNA get coded into what are the equivalent of aptamers.
These aptamers can then bind to specific target molecules with a certain degree of specificity depending on the proteins encoded. That could include autoimmune antibodies or other disease causing molecules.
Read 5 tweets

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