This is the most straightforward explanation for chronic symptoms in at least a subset of #LongCovid patients. Partly b/c if the #virus is still present its activity can directly contribute to other phenomena also being documented in LongCovid
2/ Persistence of #SARS-CoV-2 in tissue could lead to shedding of spike protein into blood, which can catalyze the ongoing formation of microclots and hyperactivated platelets
3/ Persistence of SARS-CoV-2 can lead to ongoing downregulation of interferon and/or T cell signaling by the virus, creating an optimal atmosphere for activation of EBV or other #pathogens normally controlled by such immunity
4/ Persistence of SARS-CoV-2 can downregulate the immune response in body sites such as the gut/mouth in a manner that exacerbates #microbiome imbalance, barrier integrity + shedding of pro-inflammatory #bacterial products into blood in a manner that activates cytokines
5/ Persistence of SARS-CoV-2 can perpetuate an inflammatory environment where the #immune system fires on a growing number of viral or microbiome #pathogen proteins, leading to autoantibody production via molecular mimicry
6/ Persistence of SARS-CoV-2 can lead to ongoing #inflammation sensed by the vagus nerve and conveyed to the brainstem in a manner that can augment autonomic, sickness, nausea + pain symptoms
7/ Persistence of SARS-CoV-2 can dysregulate brainstem signaling as described above in a manner that causes microglia to activate and drive #neuroinflammation (which may also contribute to “brain fog” symptoms)
8/ Persistence of SARS-CoV-2 in either the vagus #nerve itself and/or directly in brainstem tissue could contribute to severe #LongCovid cases by fully throwing off their respective signaling
9/ Persistence of SARS-CoV-2 may lead to upregulation of matrix metalloproteinase activity, and/of increased translocation of #bacteria into tissue in a manner that can lead to connective #tissue breakdown
10/ Persistence of SARS-CoV-2 would be expected to lead to continual recruitment of mast cells to infected areas, priming such cells for increased activation to other environmental insults (resulting in #MCAS symptoms)

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More from @microbeminded2

Feb 10
New @polybioRF podcast. I interviewed Dr. Tobias Lanz: MD + researcher in the lab of Prof. William Robinson at the Department of Rheumatology/Immunology at Stanford School of Medicine. Listen on Spotify (open.spotify.com/episode/4bTQss…) or watch on Youtube ()
2/ In the interview Tobias discusses this breakthrough study he led at Stanford. It showed that a cross-reactive antibody can contribute to #MS neuroinflammation thanks to molecular mimcry b/t an EBV viral protein (EBNA1) + a human CNS protein (GlialCAM): nature.com/articles/s4158…
3/ Tobias also describes this recent Harvard study which further implicates #EBV as a driver of MS. He talks about treatment for MS now that #viral activity is understood to be at the heart of the disease process: science.org/doi/10.1126/sc…
Read 7 tweets
Jan 8
New @polybioRF podcast: I interviewed Dr. Alessio Fasano: Chief of the Division of Pediatric Gastroenterology & Nutrition at MassGeneral Hospital for Children. Watch on Youtube () or listen on an App like Spotify (open.spotify.com/episode/3KZGCX…)
2/ Alessio discusses this study: His team showed that in children with MIS-C, #SARS-CoV-2 gut reservoir led to release of zonulin (a biomaker of intestinal permeability) + subsequent trafficking of spike protein to into blood, leading to hyperinflammation: pubmed.ncbi.nlm.nih.gov/34032635/ Image
3/ Alessio and team are using a zonulin inhibitor called Larazotide to improve gut permeability/SARS-CoV-2 spike leakage in #MIS-C (the drug may also have antviral properties). They are ready to start a Larazotide trial in #LongCovid too if funded
Read 4 tweets
Dec 28, 2021
@kimisgubbed @VirusesImmunity @KaminskiMed @Be_Kinderr @jenbrea @ahandvanish Hey! Well hypoxic tissue cld lead to lower O2 extraction, & infected tissue is often hypoxic. Most intracellular pathogens hijack metabolism of cells they infect & “push” host mitochondrial metabolism to anerobic glycolysis (O2 not being used for OXPHOS): ij.hapres.com/htmls/IJ_1341_…
@kimisgubbed @VirusesImmunity @KaminskiMed @Be_Kinderr @jenbrea @ahandvanish 2/ In fact many intracellular #pathogens either directly or indirectly enhance hypoxia inducible factor (HIF-1) stability. HIF-1 is a key glycolytic regulator/transcription factor whose stability reduces reliance on OXPHOS by initiating glycolytic #metabolism
@kimisgubbed @VirusesImmunity @KaminskiMed @Be_Kinderr @jenbrea @ahandvanish 3/ With that in mind @VirusesImmunity, it was interesting that in your brain organoid model, you showed SARS-CoV-2 capable of infecting neurons, where it induced a locally hypoxic environment as measured by staining for HIF-1 alpha: pubmed.ncbi.nlm.nih.gov/33433624/
Read 11 tweets
Dec 23, 2021
People are asking me: what if we did a similar autopsy study to look for #viruses in ME/CFS? Well, several teams that performed single autopsy studies on #ME/CFS patients found evidence of persistent enterovirus infection in subject brain/body tissue
2/ Enteroviruses are (like SARS-CoV-2) single-stranded RNA viruses. They include the coxsackieviruses, poliovirus, echoviruses + rhinoviruses. These viruses cause about 10–15 million #infections each year in the USA alone
3/ This 1994 ME/CFS autopsy study identified positive PCR sequences with similarity to coxsackievirus B3 in samples from the #brainstem and hypothalamus (and also in muscle and heart tissue): acpjournals.org/doi/10.7326/00…
Read 7 tweets
Dec 22, 2021
New preprint: The team did autopsies on 44 patients w/ #COVID-19 to map + quantify SARS-CoV-2 distribution, replication and cell-type specificity across the human body (including brain) from acute infection through over 7 months following symptom onset: researchsquare.com/article/rs-113…
2/ They found that #SARS-CoV-2 was widely distributed, even among patients who died with asymptomatic to mild COVID-19. They also detected persistent SARS-CoV-2 RNA in multiple anatomic sites, including regions throughout the #brain, for up to 230 days following symptom onset
3/ Persistence of low-level #SARS-CoV-2 RNA was frequently detected across multiple #tissue categories among all late cases patients who passed away after 31 days, despite being undetectable in plasma
Read 10 tweets
Dec 19, 2021
New @polybioRF podcast! I interviewed Dr. Resia Pretorius: Department Head/Research Professor at Stellenbosch University in South Africa. Listen on an App like Spotify () or watch on Youtube ()
2/ In the interview Resia talks about how her research team has identified microclots resistant to fibrinolysis + hyperactivated platelets in the blood of #LongCovid patients. We also discuss how we are planning to extend the research to #ME/CFS
3/ When it comes to the LongCovid microclots, Resia describes her earlier research showing that platelets (blood cells that contribute to #clotting) have receptors that recognize a wide range of viral, bacterial, and fungal proteins or products
Read 6 tweets

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