Further evidence of persisting SARS-CoV-2 spike protein in #PASC #LongCovid patients, now if we can just #TreatLongCovid !
@harvardmed

medrxiv.org/content/10.110…
”In conclusion,
the presence of circulating spike in PASC patients up to 12 months post-diagnosis strongly suggests that SARS-CoV-2 viral reservoirs persist in the body…”
”Additionally,
the detection of spike in a majority of individuals included in our PASC cohort
provides strong support for the use of spike as a biomarker for PASC.”
”We were able to detect either S1, spike or N in approximately
65% of the patients diagnosed with PASC at any given time point, several months after infection. Most notably, we
detected circulating SARS-CoV-2 spike in the majority of PASC patients, but in none of the COVID-19”
”The presence of
circulating spike
supports the hypothesis that
a reservoir of active
virus persists in the body”
”Persistent viral reservoirs are a
likely cause of PASC symptoms, but circulating spike may also give rise to
symptoms.”
”Similar to bacterial superantigens, SARS-
CoV-2 spike protein
contains structural motifs that strongly interact with T cell receptors, creating
an imbalance in the T cell receptor repertoire.”
”Unique to SARS-
CoV-2, it is thought
that the superantigen-
like motif may account for the hyperinflammatory response observed in severe COVID-19 and MIS-C patients.”
”Although spike does not instigate a
cytokine storm in PASC…it could act through other mechanisms that interfere with normal cellular function…
spike alone was shown to disrupt signaling
pathways & induce dysfunction in pericytes, vascular endothelial cells, & the BBB”
”Alternatively,
PASC may manifest as cellular exhaustion or the induction of refractory inflammatory response but with persistent tissue localized dysfunction.”
”If PASC is the result of persistent viral replication in tissues outside the lung, it may
also explain why changes in circulating
inflammatory markers may be subtle when
measured in blood, although they may be elevated within a given tissue.”

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More from @Gronnet

Jun 16
7% of participants displayed a previously unidentified set of symptoms that included cognitive deficits, tremor and difficulty balancing. The authors labeled the phenotype (with) Tremor, Ataxia and Cognitive deficit -- PASC-TAC for short. #PASC nbcsandiego.com/news/local/hal…
”At the 6-month follow-up, predominant symptoms shifted from headache and fatigue to memory impairment and decreased concentration. This trend has not been previously reported longitudinally in neuro-PASC.”

onlinelibrary.wiley.com/doi/10.1002/ac…
”We reported 4 patients with no prior neurologic disease who demonstrated a pattern of incoordination coupled with cognitive dysfunction (PASC-TAC). Longitudinal follow-up of these patients demonstrated slow recovery…”
Read 5 tweets
Jun 15
Dogs to the rescue! 🦮 @Em23397 Emilie Seyrat et.al’s amazing SARS-CoV-2 sniffer dogs study, now covered by ⁦@TIME⁩ highlighting the enormous potential for fast & accurate screening, of both acute- and #LongCovid.
#viralpersistence time.com/6187403/covid-…
Almost any dog can be trained to do this type of detection in a matter of weeks, @dgrandjean says. “We could have hundreds or thousands of dogs doing this for almost [no money], and they would be as efficient as PCR”
Canines in (this) study detected evidence of the virus in samples from 23 out of 45 Long COVID patients…but not among any of the sweat samples that came from 188 people without Long COVID. That accuracy rate may be an underestimate, says co-author Emilie Seyrat @Em23397
Read 7 tweets
Jun 5
#LongCovid report from my backyard. It’s been an intense summer day and a packed pool. This is how I want it, being super-social at the core. Now left with some thoughts and reflections…
1st- a shoutout to the friends of #LongCovid #mecfs ppl, the ones who stick with you, even though you’re a gloomy zombie-version of your former self. The ones that says; ”We’ll bring food & dessert, so you don’t have to do anything” There’a a special place in heaven for you guys.
Secondly - Heat intolerance is gonna be an even bigger problem this summer. It’s not even that warm yet, how will I deal with it when it goes up to 90/30+? Body temp was at a steady 38,3 today. As per usual. 🥵
Read 8 tweets
Jun 5
Long COVID is associated with extensive in vivo neuroinflammation on [18F]DPA-714 PET

1st results of a Dutch study (Amsterdam UMC and UMC Utrecht) shows extensive inflammation in the brain in two patients with #LongCovid 1/5
The images show 1 male patient who was hospitalized in the ICU, and 1 woman who went through a relatively mild Covid-19 at home. 2/5
The results have yet to be tested on a larger group of patients. The study will examine a total of 40 patients with a TSPO-PET MRI scan, a technique that can look at inflammatory cells in the brain. 3/5
Read 6 tweets
Jun 2
SARS-CoV-2 persistence in the gut in #LongCovid - new study confirms it, once again.
- SARS-CoV-2 nucleocapsid protein found in 35% (up to 18 mo)
- Abnormalites in both innate and adaptive immune cells
- May signify a non-effective immune response
New findings presented at conference -
30 #LongCovid patients and 40 controls, LC patients had: higher CD14+ monocytes in the bowel and small colon, higher dendritic cells and certain NK subsets. Also CD8+ T cells elevated in colon. CD3-CD19+ B cells lower in the terminal ileum.
This builds on previous paper published by Hadar Meringer in Nature Reviews
nature.com/articles/s4157…
Read 4 tweets
Apr 26
SARS-CoV-2 in the eyes 👁👁 New research from Switzerland confirming earlier results from Erlangen Uni - damage to the retina…a 🧵#LongCovid
1) the research team thinks that three different mechanisms could explain the retinal lesions -
2) First, direct tissue damage through virus infiltration into vessel endothelial cells could cause inflammation and vascular obstruction.
Read 8 tweets

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