Thread by @WesElyMD

1/🧵 Land Mines in Long COVID - @BostonGlobe

Alex was training for 2024 Olympic Trials 🥇

That dream exploded 💣
 
New #LongCOVID science
📌Viral reservoirs at 1 year
📌Cardiac edema at 1 year
📌Dementia at 2 years
📌Hijacked mitochondria

ScreenShot👇
bit.ly/3U77u4r

2/ It’s one thing to concede that Long COVID exists as a societal problem for those w vulnerabilities like advanced age, pre-existing health conditions, or nearly dying in ICU.

What about nationally ranked D-1 long-distance runners⁉️

Paywall so read 🧵
bit.ly/3U77u4r

3/ Alex Schell is 21 & based his life decisions on making the 2024 Olympic trials.
 
“Not only can I not run due to #LongCOVID, I’ve also lost everything I hoped for. Who I envisioned myself to be is a past idea. It’s a monumental loss.” (story w perm)
 
What causes LongCOVID?

4/A cutting-edge explanation of what implants volatile “land mines” of long COVID throughout some patients’ bodies, after even mild COVID, is that people suffering long COVID end up w reservoirs of active SARS-CoV-2 virus in the lungs, brain & GI tract.
 
bit.ly/3Qw8Q5N

5/ This produces ongoing levels of viral spike protein in our blood sometimes as high at 1-year as we had during early infection.

This theory was corroborated in the majority of 37 patients w #LongCOVID & in NONE of 26 control patients.
 
WSJ: on.wsj.com/3DcJzKV

6/ Cardiac Edema:
A new investigation of a selected group of 346 patients with documented mild COVID found diffuse swelling of heart muscle on cardiac MRI at 3 & 12 months after infection vs 95 controls without COVID.
 
go.nature.com/3RRF2lm

7/ None of these people w heart muscle swelling at 3 & 12 months had any pre-existing cardiac conditions & none was even hospitalized for their COVID, yet 73% had shortness of breath, palpitations & chest pain at 3 months with 57% still had these symptoms at 1 year.

8/ In the thread below, I unpack the science of #BrainFog & #Dementia in Long COVID. Basically, our astrocytes & other glial cells are directly infected, which leads to indirect neuronal death & brain shrinking even after mild COVID.

Dastardly 😤

https://twitter.com/WesElyMD/status/1562847021568229378

9/ Brain Science 🧠

…of Long COVID is summarized in this recent @WashingtonPost Op-Ed (screenshot below):
wapo.st/3Tf0WQR

Thank you, @EricTopol, for your highlighting:

https://twitter.com/EricTopol/status/1563899846343667713

10/ In case you missed it, here is @EricTopol’s recent 5 STAR review in @latimes that places new data in context for us.
 
He points out the urgent need for new trials & emphasizes that our best approach to avoid Long COVID is prevention.
 
Ask your doctor about the #BA5 #booster

11/ COVID hijacks mitochondria in both heart muscle & brain cells, which may provide a link to the neck-up & neck-down disease plaguing Long COVID patients.

#Mitochondria allow us to use food & oxygen to harness energy for everything we do in life.
 
bit.ly/3x70vP1

12/ Mitochondria inside Neurons & Astrocytes in the brain are hijacked.
 
This study used biomarkers from an array of patients to show mitochondrial health was sacrificed in long COVID patients, helping explain widespread neuropsychological disability.
 
bit.ly/3D8PCjK

13/ COVID is a form of viral sepsis, and we know that there is an association between recovery from sepsis & mitochondrial dysfunction.
 
@TheLancet - bit.ly/3QEe1AY

14/ People often compare Long COVID to #MECFS, which some posit is often driven by diseased mitochondria.

Unfortunately, we’re still early in this line of research w much to learn before specific therapies are available.
 
bit.ly/3ezusB2

15/ HOPE = Hang On Pain Ends
 
I see 3 paths forward:
☑️ Research
☑️ Prevention
☑️ Empathy & Validation

1st, we must have better trials. The NIH & other groups - eg @microbeminded2’s LCRI @research_long - offer great hope for answers on the near horizon.

https://twitter.com/microbeminded2/status/1567865725250830337

16/ Second, prevention of infection.

Whether by masking or vaxx or both.
 
Remember that COVID-related deaths in 2022 are 5-times lower in vaccinated than in unvaccinated people.
 
Updated graphs available here: bit.ly/3BmgcV5

17/ In addition, vaccination lowers the risk of Long COVID by as much as 75% to 85%, and the new bivalent B5 booster vaccine is now available.

Read 🧵 w data: 👇@JAMA_current

https://twitter.com/WesElyMD/status/1546628748950343682

18/ Third, we can work together as a community to be more empathetic, validate & advocate for those suffering #LongCOVID.

Too many are still silenced & made to feel their invisible injuries are fabricated.

As @edyong209 teaches, they are very real -

bit.ly/3ByYI8h

19/ When interviewing patients for #EDDB, they told me they wished their hand was cut off:

“At least then, Doc, people could see HOW I’m disabled.” Audun Huslid
 
Doesn’t that tear you up?

We must help more, better, faster

Real #People #Real Disease

👇 bit.ly/3tBDVLw

20/🎥👇The disability of Long COVID has kept many people at home for 2 years!
 
The reality of this #publichealth disaster was outlined well by CNN’s @DrSanjayGupta when he recently came to our @CIBSCenter:

See this powerful interview below.

https://twitter.com/WesElyMD/status/1567134760358518786

21/ For this @BostonGlobe piece (tweet 1), Alex Schell told me:

“New research is happening. Maybe a medicine will come out, because I'm not ready to face the possibility that I don't get better. I mean, I just think back to the joys that I experienced through running…

22/fin
…I think of the joys I experienced before I had #LongCOVID. I think life can be that sweet again. There's no choice but to look up.” Alex Schell
 
Today I’m grateful for scientists @virusimmunity for advancing our understanding & hope -

bit.ly/3Buya8e