In 2017, Alina Sternberg, a psychiatrist, was hit with crushing fatigue and brain fog.

Neurologists told her the symptoms were caused by depression.

"No, I can enjoy my life, and I know what depression is... I’m a psychiatrist!”

It took 6 years to discover the culprit...🧵 Alina's symptoms became progressively worse.

By 2023, she spent most of her days in bed.

Not only was she hit with soul-crushing fatigue, but her memory deteriorated.

One day,she forgot her way home, a place she had lived for 20 years.

Patients with atopic dermatitis are at increased risk of having severe depression.

A new study discovered the inflammatory link and new treatment approach...🧵 Proteomic analysis of 353 serum proteins was conducted on healthy controls and patients with either:
- Major depressive disorder (MDD)
- atopic dermatitis
- psoriasis

The inflammatory profile of those with MDD aligned most closely with atopic dermatitis.

(Both showed strong Th2 (T helper type 2) immune activation)

Read more: buff.ly/XW3rU2E

If this were a healthy brain would light up evenly.

But the brains of Long COVID patients light up in patches...🧵 \ The Discovery:
Researchers from the Department of Nuclear Medicine at Université de Lorraine in Nancy, France, intravenously injected a radioactive tracer into participants with Long COVID and healthy controls.

Here is what they found.

Study: link.springer.com/article/10.100…

One hallmark of Long COVID is a weakened immune system.

One reason this occurs is due to a reduction in specific immune cell populations.

This new study suggests it has to do with the immune cell membrane...🧵 Researchers at UC Davis revealed that specific SARS-CoV-2 proteins can puncture the membranes of immune cells, causing cell death.

But it's only immune cells with this important feature.

Read more:
pnas.org/doi/epdf/10.10…

Neuropsychiatric symptoms, like OCD, can abruptly occur due to a dysregulated immune response to an infection.

Can depleting the antibody-producing immune cells be an effective form of treatment?

Here are the surprising results...🧵 Brain Inflammation Collaborative and Stanford researcher, Dr. Denise Calaprice, together with others at Stanford’s Immune Behavioral Health team, recently published a paper showing that 16 out of 23 (70%) patients with autoimmune OCD had "an unequivocal recovery following treatment with rituximab" (with and w/o co-administration of immune modulators).

But first, let's explain what rituximab does.

Read more:
pubmed.ncbi.nlm.nih.gov/40064151/

A large multi-site study tested natural killer (NK) cells in 36 people with ME/CFS

Here is what they found...🧵 Natural killer (NK) cells from those with ME/CFS showed a significant and consistent reduction in TRPM3 function.

TRPM3 is a calcium ion channel that plays a critical role in NK cell function.

But first, what are NK cells?

The word 'trifecta' is used to describe the diagnostic overlap between:
- Postural orthostatic tachycardia syndrome (POTS)
- Mast cell activation syndrome (MCAS)
- Ehlers Danlos syndrom (EDS)

But what does a connective tissue disorder (EDS) have to do with POTS and MCAS (or vice versa)?

Could an inherited mutation provide a clue?🧵 Hereditary Alpha Tryptasemia (HαT) is a genetic anomaly causing chronically elevated alpha-tryptase levels, an enzyme that degrades components of connective tissue.

Alpha-tryptase is predominantly secreted by mast cells.

Here is where it gets interesting.

Pediatric Long COVID is reported to affect nearly 6 million children in the U.S (1).

These surprising new Long COVID symptoms were recently identified in kids...🧵 Between March 2020 and August 2024, 3 out of 151 prescreened pediatric COVID-19 patients developed obsessive-compulsive disorder (OCD) after infection.

No other infections were detected.

Microclots found in those with Long COVID restrict blood flow in small vessels.

This can cause symptoms such as:
- severe fatigue
- chest pain
- brain fog

New research might have discovered why they are so difficult to dissolve...🧵 French and South African researchers isolated blood samples from:
- 50 Long COVID patients
- 38 healthy volunteers

They found that Long COVID patients had 19.7-fold higher microclot counts than healthy controls.

However, these weren't typical microclots...

Read more: onlinelibrary.wiley.com/doi/10.1002/jm…

The SARS-CoV-2 spike protein localizes in an unusual place outside the brain.

This localization pattern might explain the neuroinflammatory symptoms experienced during:
- SARS-CoV-2 infection
- Long COVID...🧵 Researchers from Ludwig-Maximilians-University Munich, Munich, Germany found that the SARS-CoV-2 spike protein localizes to the skull's bone marrow.

To understand why this discovery is important in the context of Long COVID we must first learn about the following:
- the meninges
- immune cells in the meninges

Read the scientific publication here: cell.com/cell-host-micr…

LIVE from #LongCovid International Conference Boston

New DNA variants enriched in pediatric Long COVID cohorts according to work from Dr. Sindhu Mohandas (USC/Children’s Hospital Los Angeles) and her team...🧵

#LongCovidkids There were several individual gene variants enriched in a pediatric long COVID cohort.

Let's discuss the two highlighted by Dr. Mohandas in her talk...

LIVE from #LongCovid Conference in Boston – mind-blowing data on viral persistence and immune dysregulation.

Key points from ongoing research from Timothy Henrick, MD, and his team at UCSF:🧵

#LongCOVIDIntl Gut biopsies from LC participants find:
- viral persistence (detecting vRNA) found in 20-25% of samples
- Up to 992 days following the first infection

No viral RNA was detected in fully recovered controls.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by:
- Post-exertional malaise
- Unrefreshing sleep
- Brain fog

A new study found that 71% of ME/CFS patients have a condition, which may help explain these core symptoms...🧵 Scientists recruited:
- 57 patients diagnosed with chronic fatigue syndrome
- 25 control participants

The ages and activity levels of the controls matched the chronic fatigue cohort.

71% of the chronic fatigue cohort displayed disordered breathing, unnoticed by those with ME/CFS.

Read more here: buff.ly/PROrAdM

Two consistent hallmarks of ME/CFS are:
- Post-exertional malaise (PEM)
- Chronic fatigue

A new study finds more hints at the drivers of these symptoms...🧵 Researchers from Ian Lipkin's Lab at Columbia University (and others) recruited:
- 56 patients with ME/CFS and
- 52 healthy controls.

Next, they measured the following before and 24 h after exercise:
- Lipids
- Cytokines
- Metabolites
- Plasma proteins

Here is what they found.

Full Study: nature.com/articles/s4432…

A recent paper revealed the shocking prevalence of neuropsychiatric conditions in patients with mast cell activation syndrome (MCAS)

This includes but is not limited to:
- Panic disorder
- Neuropathy
- Depression
- Brain fog
- Tinnitus
- Anxiety
- PTSD
- etc.

Here are the numbers...🧵 Dr. Leonard Weinstock, in collaboration with a group of other prominent researchers, used questionnaires from:
- 553 MCAS patients
- 558 control subjects

The surveys were used to determine the prevalence of:
- 19 neurologic and
- 14 psychiatric disorders

While the link between neuropsychiatric conditions and MCAS isn't surprising, the magnitude of the reported association was...

Read more:
buff.ly/Nl0U8ZX

It's estimated that 65 million individuals worldwide are affected by ME/CFS (1).

However, there are no clinically validated biomarkers.

Here's why that could change...🧵 Researchers from Cornell University sequenced the cell-free ribonucleic acid (cfRNA) from the blood of:
- seditary, healthy controls
- those w/ ME/CFS

They used those RNA sequences to train an AI (machine learning) model.

After training, the model could predict which cfRNA sequences were from an ME patient with 77% accuracy.

But first, what is RNA...

Persistent chronic inflammation slows the production of serotonin, diverting it instead toward the production of quinolinic acid, a neurotoxin.

This is thought to play a role in psychiatric symptoms associated with chronic inflammation and infections.

Here is why...🧵 🧠 The Kynurenine Pathway Background
Often, a linear biochemical pathway can diverge into two pathways, making two different molecules (serotonin and quinolinic acid) from the same reactant (tryptophan).

Biochemical pathways in our cells can be thought of as a waterfall where reactants (tryptophan) rapidly "flow" through a series of enzymatic reactions, producing new molecules.

See the image from above.

Long COVID is more prevalent in women.

Could this new study explain why? 🧵 Researchers from 16 different countries recruited 2390 individuals (age 50 ± 15 years, 49.2% women) to assess the impacts of COVID-19 on vascular aging.

They found that persistent COVID-19 symptoms in women correlated with increased vascular aging.

Here is why this matters.

medpagetoday.com/cardiology/gen…

Data suggest there is a broken ion channel on the surface of white blood cells in patients with (1):
- Long COVID
- ME/CFS

New evidence suggests it can be fixed.

Here is how...🧵 Research from Dr. Sonya Marshall-Gradisnik in Brisbane, Australia, verified that Long COVID patients, like ME/CFS patients, have a dysfunctional calcium ion channel called TRPM3(1).

The function of this ion channel can be restored with low-dose naltrexone (LDN) in ME/CFS-isolated immune cells (1).

New evidence suggests the same for Long COVID patients. (below)

New research provides further proof that ME/CFS is a biological condition.

Researchers from the University of Edinburgh found anomalies in 8 different genomic regions in more than 15,000 people diagnosed with the condition.

Here are the details...🧵 But first, a disclaimer.

The research was published in a pre-print journal, meaning it has yet to be peer reviewed.

Thus, it could contain unverified or flawed data, methods, or interpretations.

Let's dive in.

science.org/content/articl…

45% of those with Long COVID suffer from a sleep disorder (1).

It's so prevalent that it's dubbed 'coronasomnia'.

Here is the science...🧵 \ Coronasomnia:
There is a strong association between Long COVID and the development of:
- insomnia
- sleep continuity disorders
- feeling of non-restorative sleep
- changes in the sleep-waking cycle

However, this is not unique to Long COVID.