Thread by @microbeminded2

I want to add that I see #SARS-CoV-2 persistence as part of a larger picture in which other latent pathogens and/or #microbiome organisms also harbored by a patient play an important role in the ultimate set up symptoms they develop

https://twitter.com/loscharlos/status/1730375440949514370

2/ Pathogens harbored by a patient at the time of SARS-CoV-2 #infection may serve as a predisposing factor to either persistence of the virus or increased disease in the acute phase

3/ E.g. Bartonella is a persistent #bacteria that drives blood vessel dysfunction by infecting #vascular endothelial cells. So someone with Bartonella may be more susceptible to SARS-CoV-2’s detrimental impact on blood vessels, and have more trouble clearing virus from such sites

4/ In addition, acquisition of SARS-CoV-2, or persistence of the #virus, may downregulate the #immune response so that previously dormant infections (e.g. EBV) are further “kicked up” in a manner that drives new symptoms

5/ If someone fails to clear #SARS-CoV-2 and/or immune dysfunction somehow persists after viral clearance, they may also be more susceptible to new infections. These new infections may “add into” their case - further perpetuating disease

6/ The same patterns are true of the collective organisms that inhabit our bodies. Humans harbor trillions of interacting organisms (the #microbiome) in a wide range of body sites

7/ In healthy people these microbiome ecosystems persist in a state of balance, but their activity can become dysregulated under conditions of immunosuppression or imbalance (this is called #dysbiosis)

8/ If a patient already harbors a dysbiotic microbiome at the time of SARS-CoV-2 #infection they may be less likely to clear the virus from certain body sites. For example an imbalanced #gut microbiome might predispose to SARS-CoV-2 persistence in gut tissue

9/ That is consistent with the fact that - for example - women with a more dysbiotic, imbalanced vaginal microbiome are more likely to acquire HIV: ncbi.nlm.nih.gov/pmc/articles/P…

10/ Conversely however, SARS-CoV-2 persistence in a body site like the gut, #oral cavity, #lung etc cld drive immune dysfunction in a manner that facilitates new-onset microbiome dysbiosis in that area, potentially driving new symptoms

11/ Overall then, a particular patient’s failure to clear the SARS-CoV-2 virus is very likely connected to the other persistent pathogens they harbor and to the unique activity of their microbiome ecosystems

12/ These factors differ in each patient, which could be part of why #LongCovid patients experience such a wide range of symptoms despite suffering from potential common underlying #disease mechanisms