Thread by @dbdugger

#LongCovidAwarenessDay We have the ability to ensure that these projections do not come to fruition. A 🧵.

https://twitter.com/inducekarmaaa/status/1636061179754815490

After learning that viral persistence and CD4 apoptosis is observed in those with a chronic SARS-Cov-2 infection, just as it is with HIV, I founded a company called SARS-Cov-2 Associated Neurocognitive Decline (SAND) Scan.

I have built my company based upon the principles of HIV medicine. With that in mind, let's discuss where we have gone wrong and what can be done to preserve our intellectual capital, which is that which our economy relies.

In those individuals who experience CD4 apoptosis, there is a very critical date to consider if the individual is to experience CD4 normalization and an maintaining of their immune competence and most importantly, their cognition. It is called the Estimated Date of Seroconversion

Okulicz and others wrote a paper on this very topic. jamanetwork.com/journals/jamai…

There conclusion? "Deferral of ART beyond 12 months of the EDS diminishes the likelihood of restoring immunologic health in HIV-1–infected individuals."

Not only does rapid initiation of antivirals allow for CD4 normalization, it preserves a high CD4 nadir, or the lowest CD4 count for an individual. Ronald Ellis spoke to the criticality of the CD4 nadir here: pubmed.ncbi.nlm.nih.gov/21750419/

"As the risk of NPI (neuropsychological impairment) was lowest in patients whose CD4 cell count was never allowed to fall to low levels before CART initiation, our findings suggest that initiation of CART as early as possible might reduce the risk of developing HAND."

Beyond CD4 normalization and maintaining a high CD4 nadir, rapid initiation also prevents what is referred to as reservoir "expansion." First line medications do not enjoy a high Blood Brain Barrier Penetration Rate so as to not be neurotoxic.

Both Disseminated Intravascular Coagulation and Alzheimer's Disease seek to sequester SARS-Cov-2. It is referred to as the Antimicrobial Protection Hypothesis and is further discussed here. pubmed.ncbi.nlm.nih.gov/30314800/

We face a number of massive challenges with SARS-Cov-2 as we are operating in the dark. We are without a viral load test. We are without a resistance panel. We are only trialing a monotherapy, which have low barriers to resistance.

The booster used is known to cause insulin resistance within 7 days of use, endothelial damage within 30 days of use, hypertriglyceridemia, Type 2 diabetes, and lipodystrophy.

Most disturbing is that we have forgotten that ACE-2 receptors are in the organs required to excrete and metabolize the very medications that will be required to prevent further disease progression.

This journal article is disturbing if it is at all representative of the entire population living with a chronic SARS-Cov-2 infection. journals.lww.com/jasn/pages/art…

Prescribing guidelines allows us to category those with a chronic SARS-Cov-2 infection. Those who will be able to initiate and maintain a regimen.

Those who will initiate and maintain at a dosage that will lead to suboptimal suppression, resistance, and the possibility of forward transmission. Those who will never have the opportunity to take the first pill.

We have an amazing opportunity to borrow from 40 years of evidence medicine to prevent further suffering and cognitive decline. We could find ourselves where hitting this button would be a reality.