Thread by @drclairetaylor

There has been many amazing #LongCovid studies recently I’ve just been mulling them over.
🏆 long covid patients get muscle NECROSIS with exercise.
N-protein in the muscles but ALSO controls.

We are going to find viral persistence everywhere, aren’t we?
No one wants to say it

‘Exercise-induced amyloid-containing deposit accumulation in skeletal muscle’

What???
Why on earth are we telling these people to exercise?
So they can destroy their muscle tissue and deposit more amyloid and feel terrible?

There is a baseline of amyloid in pre pandemic samples but higher in LC patients and higher after exercise

‘The underlying reason…remains Elusive’
Amyloid was Expected to be found in capillaries. Repeating may work this out. ? Issues with lab technique.

Next:
impaired peripheral oxygen extraction (and relatively lower deoxygenation) and a higher concentration of amyloid-containing deposits in skeletal muscle,

Impaired peripheral oxygen extraction means your muscles just cannot work as well as those who do get oxygen.

This would explain why people who were fit and running marathons suddenly can’t walk round the house after Covid
No oxygen= no energy.
You cannot just correct your own damaged physiology..,

‘we found SARS-CoV-2 nucleocapsid protein in almost all patients and healthy controls’
Right ok, it could be viral remnants but body tends to mop things up.
Imagine all these healthy controls actually have viral persistence in their muscles? 😲
That is a horrifying thought.

‘Participants with an infection >6 months prior to study enrollment showed no differences in the abundance of SARS-
CoV-2 nucleocapsid protein, but we cannot exclude additional unknown asymptomatic infections.’
So it may hang about for more than 6 months. Ouch.

In year 5 of the pandemic we cannot tell people whether they have a virus that stays in their body. In their muscle. Organs. Blood vessels. Brain. In their kids.
Can we get a move on and find an answer?
It feels like some people don’t want to know the answer. it will come out.

Other things the study found:
Confirms peripheral impairment in skeletal muscle metabolism in long COVID patients

long COVID is associated with a lower skeletal muscle oxidative phosphorylation capacity.
See complicated diagrams
Imagine this is VERY difficult to fix.

Note these were long covid patients who could walk 4000 steps a day. Some cannot walk 10 steps. We need to also biopsy their muscles and
See if it is worse in those cases. Most long Covid and ME/CFS studies miss the most severe

What is good about this study- it not only nails the issues with long Covid with exercise and post-exertional malaise, it is relevant to EVERYONE. Every single person infected with Covid.
N-Protein in most of the samples- healthy controls or long Covid-we need to take seriously

Yes it does not 100% prove virus is remaining in the body ( viral persistence) but the indication it does means we should act quickly to ascertain if it does.
Before it is too late

Lastly, exercise in LC patients
‘CD3+ T-cells were absent in healthy controls, but present in patients with long COVID before induction of post-exertional malaise ‘

‘More long COVID patients had CD68+ macrophage infiltration in skeletal muscle compared to healthy controls’

There is an immune response to exercise in LC patients. Imagine not being able to exercise? Immune responses can make you feel
Really unwell.

Skeletal muscle after exercise in long Covid-
Figure 5( B)

Large areas of necrotic fibers were observed in 36% of patients with long COVID after exhaustive exercise.
Then they have to try and heal.

Moral of story. Long Covid is bad. We know healthy controls have nucleocapsid in muscles.
If you get Covid you can get long Covid and not be able to exercise. If you get Covid it might never go away. And we are letting it spread into people multiple times/multiple variants. Mad.

Will look at the other studies too. So much learning in the space of a few weeks. We cannot blame the science&researchers
For lack of medical
Progress.
We cannot airbrush out long Covid because it is an inconvenient Truth

Link to study .nature.com/articles/s4146…