A new study in Frontiers in Cardiovascular Medicine looked at a very important question.
Can a history of COVID-19 be linked to impaired coronary blood flow, even when the main coronary arteries look normal?🧵
The authors included 190 patients with unstable angina and normal coronary arteries.
Half of them had a confirmed history of COVID-19.
The other half did not.
The key difference between the two groups was previous COVID infection.
May 7 • 16 tweets • 3 min read
Why do some people develop life-threatening viral disease, while others clear the same virus with only mild symptoms?
One answer is becoming clearer.
In some people, the first line of antiviral defense is already weakened before the virus arrives🧵
That first line is type I interferon.
Type I - especially IFN-α and IFN-ω - act like an early alarm system. When a virus enters the body, they help cells switch into an antiviral state before the infection spreads too far.
May 5 • 23 tweets • 4 min read
A new JAMA Neurology meta analysis on pure autonomic failure (PAF) is highly relevant to the broader discussion around POTS, long COVID dysautonomia, and early neurodegeneration.
Not because PAF is the same as POTS.
It is not. But…🧵@DavidJoffe64
It is important because it shows what can be learned when an autonomic syndrome is carefully defined and followed over time.
May 4 • 17 tweets • 3 min read
A new PECOS study followed children and young people after SARS-CoV-2 infection and compared them with uninfected controls.
The question was simple - do post COVID symptoms in kids fade over the first year?
The answer - not really.
The study included 852 participants aged 0-21.
705 had confirmed SARS-CoV-2 infection
147 were uninfected controls
Among the infected group, 558 completed the 12 month follow-up.
May 3 • 14 tweets • 2 min read
A new large cohort study in Frontiers in Medicine looked at people who developed shingles after COVID-19.
Could shingles after COVID be more than just a painful rash - with possible links to later blood-cancer risk?🧵
The authors used the TriNetX global health network - electronic health records from more than 140 healthcare organizations.
They compared COVID-19 survivors who developed shingles within 1 year with COVID-19 survivors who did not.
Apr 29 • 21 tweets • 3 min read
A new narrative review in Communications Medicine sums up where the field stands on long COVID.
Not as one single, uniform diagnosis, but as a complex, multisystem condition after SARS2 infection🧵
Its value is in the synthesis. It brings together immunology, neurology, vascular biology, metabolism, and clinical medicine into one framework.
Apr 28 • 19 tweets • 3 min read
A heart attack after COVID may not look like the classic heart attack we usually imagine.
A new core-lab study of patients with NSTEMI + COVID-19 suggests something more diffuse. Not just one blocked artery, but a blood-clotting and vessel inflammation problem🧵
First, two key terms.
STEMI is the type of heart attack where the ECG shows ST-segment elevation. It often means a major coronary artery is suddenly blocked.
NSTEMI is a heart attack without that classic ST elevation. It can be less obvious on ECG, but it is not minor.
Apr 27 • 18 tweets • 3 min read
For 2025, the societal cost of Long COVID and ME/CFS in Germany is estimated at €64.4 billion - about 1.44% of GDP.
For Czechia, this would roughly translate to around CZK 120 billion per year if we apply the same share of GDP - 1.44% of the Czech economy.
A simple population-based conversion would produce a higher number (200 billion), but that is an overestimate.
Apr 27 • 21 tweets • 3 min read
A new systematic review looked at what happens to the heart after COVID - not during the acute infection, but months later.
The key point:
A normal ejection fraction does not always mean the heart is completely unaffected.🧵
In people assessed more than 12 weeks after PCR confirmed COVID - especially those with persistent cardiopulmonary symptoms - there is evidence of subtle, and sometimes persistent, cardiac involvement.
Apr 25 • 29 tweets • 4 min read
Exertion and PEM.
A new paper studied people with long COVID using a 2-day (!) submaximal CPET protocol, combined with NIRS measurement on the calf muscle.
The authors looked at what happens to breathing, performance, and muscle oxygenation during repeated exertion🧵
The key finding.
In the long COVID group, muscle tissue oxygen saturation (TSI%) initially increased during exercise, but it did not stay elevated for as long as it did in controls. (Thomas 2026)
Apr 24 • 23 tweets • 3 min read
COVID-19 creates a state of immune dysregulation where the body may lose control over things it normally keeps suppressed - latent viruses, especially herpesviruses, and possibly even dormant cancer cells.
A new study on EBV and CD8 T cells fits into this bigger picture.🧵
The point is not simply that EBV can reactivate during COVID. We already have quite a lot of evidence for that.
In hospitalized patients with acute COVID, EBV reactivation was very common - around 68-73% - and it was seen not only in critical cases, but also in moderate disease.
Apr 23 • 13 tweets • 2 min read
In this cohort, children exposed to SARS-CoV-2 in utero showed higher rates of developmental delay and were also more likely to screen positive on an autism screening tool than pre pandemic controls🧵
The developmental delay signal comes from the group’s earlier work in the same cohort. In the abstract, the authors cite a rate of 11.6% in 172 exposed children versus 1.6% in 128 pre pandemic controls.
Apr 23 • 25 tweets • 5 min read
This important study suggests that children and young adults with Long COVID show microclots, increased NETosis, and other signs of vascular inflammation.
It also points to spike immune complex-activated neutrophils as a possible driver of endothelial damage🧵
The study included 84 people age 25 and under. 61 with Long COVID and 23 controls. The researchers looked at cardiovascular symptoms, microclots, endothelial markers, neutrophil activation, cell-free DNA, and spike protein in plasma.
Apr 22 • 14 tweets • 3 min read
Mental health problems have risen since the pandemic. And the evidence keeps growing that the main part of that burden may be a biological consequence of infection itself 🧵
A new preliminary study in older adults adds to that picture.
Researchers studied 24 adults aged 60+.
12 with persistent cognitive symptoms lasting more than 6 months, and 12 healthy age matched controls.
Apr 21 • 10 tweets • 2 min read
A tumor does not enter a vacuum. It enters a real immune landscape - and after COVID, that landscape may not be the same🧵
One breast cancer study looked at 372 patients with early triple-negative breast cancer treated before surgery with pembrolizumab plus chemotherapy. Overall, 61.3% had a pathologic complete response.
Apr 20 • 23 tweets • 3 min read
A useful Germany-based study looked at what happened after seasonal COVID vaccination moved into routine care. It used real-world insurance data to compare vaccinated and unvaccinated adults during the 2023/24 autumn-winter period🧵
The main pattern was consistent. Vaccinated people had fewer severe outcomes. COVID-related hospitalization was lower. Respiratory and cardiovascular hospitalizations were also lower. New long COVID diagnoses were lower too.
Apr 18 • 16 tweets • 3 min read
We now have a complementary study that helps extend the picture. If the first paper suggests post-COVID biology may exist on a spectrum, this second one suggests recovery itself may also be real, prolonged, and only partial.🧵
This was a 2 year longitudinal proteomics study of hospitalized COVID survivors. The researchers profiled plasma at 6 months, 1 year, and 2 years after symptom onset and compared it with matched healthy controls.
Apr 17 • 17 tweets • 3 min read
A new Scientific Reports study adds an important nuance to the long COVID conversation. The biggest difference was not between people with PCC and without PCC, but between uninfected people and everyone who had recovered from SARS2🧵
Long COVID may be part of a broader post-infectious biological spectrum, where symptomatic PCC represents the more clinically visible end of a continuous dysregulation rather than a completely separate category.
Apr 16 • 22 tweets • 4 min read
A new study asks a deceptively simple question - is Long COVID just a slower recovery, or is it a persistent immune disorder? Their data point toward the latter !🧵
For this single-cell analysis, the authors selected 9 women from a prospective cohort of patients hospitalized with COVID-19. Blood was collected during acute infection, at 3 months, and again 18-24 months later. Some recovered without long-term complications. Others developed pulmonary or cardiovascular Long COVID.
Apr 15 • 15 tweets • 3 min read
A new first trimester study makes an important point. Even when direct detection of SARS-CoV-2 in placental tissue is minimal, the early maternal-fetal environment can still be meaningfully disrupted - immunologically and developmentally🧵
Biological harm does not have to depend on heavy, obvious viral presence inside the tissue itself.
Apr 14 • 24 tweets • 4 min read
Very small study, but a genuinely interesting one on long COVID.
After reinfection, the biology did not simply replay the first infection - and in this cohort, the booster did not worsen the measured inflammatory/neurology protein profile🧵
The authors measured 182 inflammatory and neurology related proteins in plasma - 6-9 months after primary infection
after a booster
after breakthrough infection.
In a subset, they had longitudinal samples at 3 timepoints, which makes the paper much more interesting than a simple one time comparison.
