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Zdenek Vrozina Profile picture
Zdenek Vrozina
@ZdenekVrozina
Health Care Consulting
Mar 28 • 21 tweets • 4 min read
Why might insulin resistance go up after COVID? Probably not because of one single cause, but because of a whole network of inflammatory and metabolic changes. A new narrative review.🧵 Some people seem to have worse blood sugar control and higher insulin resistance after COVID. What this paper argues is interesting - it’s probably not one clean, simple mechanism. It’s more like a web of biological processes that can keep reinforcing each other.
Mar 25 • 12 tweets • 2 min read
Patient-derived IgG in Long COVID appears functionally pathogenic - and in some cases, this autoreactivity persists for years🧵 At the heart of the paper is a pretty important question. We already know that Long COVID has often been linked to autoimmunity, but that alone does not tell us whether these antibodies are actually doing harm or whether they are simply a byproduct of the illness.
Mar 24 • 24 tweets • 6 min read
One of the most interesting theories in ME/CFS - and in Long Covid too - is the IDO metabolic trap idea from Robert Phair and Ron Davis. Not because it’s proven, but because it’s one of the few theories that tries to explain why people get stuck. It doesn’t treat post viral illness as vague bad luck, or as a list of symptoms floating around. It asks a harder question - what if the body isn’t failing to recover - what if it’s been pushed into the wrong stable state?
Mar 23 • 17 tweets • 2 min read
The real headline here is simple - this preprint study set immunity debt against SARS-CoV-2 as rival explanations for rising invasive strep - and only one of them held up in the data🧵 This study asks a very specific question. What best explains the post-pandemic rise in invasive group A streptococcal infections (iGAS)?
Mar 23 • 22 tweets • 4 min read
An interesting new review proposes that Long COVID is not just about what keeps the immune system on, but also about what fails to turn it off🧵 This review proposes a striking model for Long COVID. A self sustaining loop in which lingering danger signals keep innate immunity activated, tissue injury generates new inflammatory cues, and the normal transition from inflammation to repair never fully happens.
Mar 22 • 17 tweets • 3 min read
This is not another generic long COVID paper. It looks at patients who reached neurological care for post COVID cognitive symptoms - and finds both objective deficits and a thalamic MRI signal🧵 It looks at a very specific group - patients who ended up in neurology post-COVID clinics because of new cognitive symptoms after SARS-CoV-2 infection.
Mar 21 • 24 tweets • 4 min read
Long COVID may not begin only after the acute infection has passed. In at least some patients, the immune system appears to go off track from the very start. A breakthrough study.🧵 What makes this study especially interesting is that it does not just describe what patients with long COVID look like later on. Instead, it looks for differences already during acute hospitalization and then again three months later. That is its main strength - it tries to capture whether a risk immune signature is already present early.
Mar 20 • 11 tweets • 2 min read
Although this survey based study suggests some improvement over time, the burden of long COVID remains high, with millions of adults still affected and true biological recovery remaining uncertain🧵 This study analyzed data from the US National Health Interview Survey from 2022 to 2024 to examine how common long COVID is and how often people report recovering from it.
Mar 20 • 9 tweets • 2 min read
After SARS-CoV-2 infection, the risk of later EBV mononucleosis was higher than in people without recorded COVID-19.
A study based on nationwide Swedish registries followed nearly 10 million people🧵 10 mio people aged 3-100 years from January 1, 2020, to November 30, 2022.
The authors divided participants into those without a COVID-19 diagnosis, those with a positive PCR test without hospitalization, and those hospitalized with COVID-19.
Mar 19 • 16 tweets • 3 min read
For many people, COVID did not end when the infection cleared - it evolved into a longer and far more complicated story.
This paper presents Long COVID as a heterogeneous, multisystem condition that can affect nearly every organ system🧵 This paper is a broad, wide ranging review of Long Covid. @elisaperego78 describes Long COVID as a heterogeneous, multisystem disease that can affect almost the entire body, with effects ranging from subtle or barely noticeable changes to severe disability or even death.
Mar 19 • 16 tweets • 3 min read
In this cohort of healthcare workers infected with the original SARS2 variant, symptoms were still present even after a median of 47.5 months (!).
Brain fog may persist.
This is a prospective multicenter cohort study from Switzerland🧵 The study was designed in a fairly sensible way. The authors did not automatically treat every complaint as long COVID, but instead compared 24 chronic symptoms between the previously infected group and an uninfected control.
Mar 18 • 19 tweets • 3 min read
An interesting and biologically plausible pilot study that provides a fairly strong signal that pediatric Long COVID may be associated with impaired microcirculation and increased arterial stiffness🧵 The study builds on earlier adult research suggesting that persistent symptoms after COVID may be linked to capillary loss and endothelial dysfunction.
This was an observational comparative cohort study, not a randomized or interventional trial.
Mar 18 • 11 tweets • 2 min read
The study supports concern that long COVID may be associated with an increased risk of mild cognitive impairment, including impairment with features resembling early Alzheimer’s disease🧵 The study examined whether people with long COVID have a higher incidence of mild cognitive impairment (MCI) than people who had COVID without persistent symptoms and than COVID negative controls.
Mar 16 • 21 tweets • 3 min read
A new long COVID paper suggests that, in a subset of patients, the picture may involve circulating microaggregates, impaired capillary flow, and - EBV-related immune activation🧵 A study describes a subgroup of patients who had so called microaggregates in blood, along with stronger T-cell responses to EBV.
The main idea is that, in some patients, long COVID may involve a mix of impaired microcirculation and immune activation linked to latent herpesviruses.
Mar 14 • 20 tweets • 4 min read
This Long COVID study feels scary for a reason - it hits an immune axis immunologists already know from HIV, HBV, sepsis, and cancer. That makes the result more biologically plausible, not less🧵 A study looked at women with Long COVID with an ME/CFS phenotype using single-cell RNA sequencing of peripheral blood 12 months after acute COVID. It was a detailed look at which immune cells were present, how many there were, and what state they were in.
Mar 13 • 19 tweets • 4 min read
A new preprint examines gut biopsies from people with LongCOVID and healthy controls. It does not just ask whether SARS2 Spike is present in tissue, but also what is happening in the surrounding tissue using spatial transcriptomics. That is probably the most interesting part of the paper.🧵 An important detail.
Spike was detected in all Long Covid gut samples studied! But in the colon, the crucial finding was not simply presence of Spike - it was the abnormal immune microenvironment around Spike+ regions.
Mar 13 • 25 tweets • 4 min read
When a child looks fine after COVID but is suddenly exhausted, foggy, short of breath, or no longer coping with school the way they used to, parents often feel something is wrong long before anyone can explain it🧵 This review argues that long COVID in children is real, often underestimated, and important to take seriously - not to create panic, but to help families recognize it early and respond with care and common sense.
Mar 13 • 12 tweets • 2 min read
Students who recovered from COVID-19 showed slower reaction times, but implicit motor learning appeared to remain intact. In other words, this may be less about - can the brain still learn? - and more about how efficiently it processes and executes a response🧵 The study included 84 college students. 24 COVID-recovered participants and 60 controls.
They completed a remote serial reaction time task (SRTT), a classic paradigm that can separate general response speed from implicit sequence learning.
Mar 12 • 19 tweets • 3 min read
Even in the Omicron era, long COVID remained common. A preprint meta-analysis showing that the burden persisted, even as the symptom profile shifted.🧵 This study is interesting because it does not just ask how common long COVID is. It looks at two things at the same time.
Which SARS-CoV-2 variant caused the infection, and how long after infection symptoms were assessed.
Mar 12 • 20 tweets • 3 min read
Most explanations for why SARS-CoV-2 spread so efficiently focus on the spike protein.
This paper goes in a different direction.
It’s mostly a hypothesis paper - but an interesting one - asking whether part of the story lies in the physical architecture of the virus itself🧵 Instead of spike, the authors focus on two structural proteins.
M (membrane protein)
N (nucleocapsid)
These proteins form much of the virus’s structural shell.
Mar 11 • 13 tweets • 2 min read
One study among many highlights the potential role of HEPA air cleaners in classrooms. A modelling study published in 2024 explored how filtration and ventilation interact🧵 This modelling study looked at how portable HEPA air cleaners affect classroom air quality, airborne viral material, CO₂, and energy use in naturally ventilated school classrooms. It compares three main scenarios.