We have passed the peak of this COVID wave which was the second highest wave of COVID infection during the entire pandemic. Wastewater virus levels in the United States are still “VERY HIGH” though, with JN.1 now causing more than 85% of cases. We are on the downward slope of the wave, but there are still approximately a million new COVID cases in the U.S. every day and about 1 in every 33 people is infected.
You can see from JP Weiland’s graph below that COVID cases are still much higher now than many other times during the pandemic. Despite the feeling that COVID is over, it is still best to try to avoid a reinfection if possible because of the continued risks of Long COVID from reinfections.
But this is not really true. Immunity from COVID vaccination and from prior infection may protect against severe disease, but immunity to infection wanes more quickly against the newer variants. Also, less than 22% of adults have received the latest COVID vaccine, so most people are not well protected against the latest variants. Antiviral treatments may be more available now than earlier in the pandemic, but as a new CDC study from this week shows, many health care providers do not prescribe antiviral medications even to high risk people.
(Remember, the Test2Treat telemedicine program offers free virtual care and treatment for COVID and for Flu, 24 hours a day, 7 days a week, whether or not you have insurance. No appointment is needed.)
More than 70% of US household COVID spread starts with a child. Under the new CDPH guidelines, COVID-positive kids will infect other children, teachers and staff at schools, as well as household contacts. Some of these people may be at high risk of severe disease from a COVID infection (older person, person with obesity or depression, pregnant individuals, baby siblings who cannot be vaccinated against COVID). Also, the risk of getting Long COVID increases with every additional COVID infection. Long COVID can cause severe disability, and although children get Long COVID less frequently than adults, they can still get Long COVID which could affect their learning and their lives forever. SARS-CoV-2 infections have also been shown to increase the risk of many chronic diseases including heart disease (including heart attacks and arrythmias), stroke, and diabetes. The CDPH recommendation that COVID-positive individuals can return to their jobs or to school is bad advice.
COVID and the Brain
A study using stem cell derived dopamine neurons shows that SARS-CoV-2 targets dopamine neurons in the brain. Autopsy specimens confirmed this finding. Once infected by SARS-CoV-2, dopamine-producing neurons lose their ability to grow and divide. They also stop producing dopamine and send out signals that trigger inflammation instead. Parkinson's disease is caused by the death of dopamine-producing neurons in the brain- specifically in the substantia nigra in the midbrain and this area is affected by COVID.
Some years after the 1918 Spanish flu epidemic, there was an increase in Parkinson’s cases. This new study suggests that there may be an increase in Parkinson’s cases related to COVID infection in the near future as well. Using high-throughput screening, the researchers in this study identified three FDA approved drugs that may protect the dopamine neurons in the brain from being infected by COVID. Riluzole (glutamate inhibitor for ALS), Metformin (oral type II diabetes medication), and Imatinib (tyrosine kinase inhibitor used for some leukemias) may be useful in protecting dopamine neurons from SARS-CoV-2 infection. The authors also recommended long-term monitoring of neurological problems in people who have had COVID-19.
Regarding COVID and the brain, a new multicenter study shows that people with Long COVID have severe cognitive slowing that is 2 to 3 standard deviations slower than controls. Comorbidities such as fatigue, depression, anxiety, sleep disturbance, and post-traumatic stress disorder did not account for the extent of cognitive slowing in patients with Long COVID. Severe slowing of brain function affects individuals, but it also has major implications for the work force and the economy on a population level.
Figure 1F: Simple Reaction Time (SRT) test
These studies on the effects of SARS-CoV-2 on the brain really concern me and are yet another reason that it is not wise to not allow COVID-positive children to go back to school and COVID-positive workers to go back to their jobs where they can infect others.
A new multicenter study looked at more than 6500 proteins over time in the blood of people who had a COVID infection and those that did not. They found that proteins related to activation of the complement cascade were elevated in Long COVID. In our immune systems, the complement pathway reacts to the presence of viruses and bacteria by telling our bodies to destroy these invaders. If the complement system remains activated in a microbe-fighting state, it can start to injure healthy cells leading to tissue damage, microclots in the blood, and may actually lead to Long COVID symptoms.
The blood biomarkers for complement activation in Long COVID at 6 months were the same as the elevated complement factors found in severe acute COVID infections. These elevated complement proteins resulted in endothelial cell (cells that line blood vessels) damage and microclots, which then in a vicious cycle, further activated the complement system to crank up more inflammation, microclotting and tissue damage. Understanding the abnormal activation of the complement pathway may offer both biomarkers to diagnose Long COVID and targets for drug therapy to treat Long COVID.
This study also showed that the severity of Long COVID symptoms related to the reactivation of dormant viruses in the body such as CMV and EBV. Monocyte-platelet aggregates were also found in the blood of people with Long COVID in this study as shown in the diagram above.
Interestingly, these findings relate to another study from last week that showed that in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), immune dysregulation after exercise was related to the activation of monocytes and platelets as seen by single cell RNA-sequencing at baseline and after exercise. A study published in late 2021 showed that the SARS-CoV-2 spike protein induces a pro-inflammatory immunometabolic response in monocytes that can be suppressed by Metformin. It will be interesting to see the results of 2 clinical trials (one in the Netherlands and one from McMaster University) that are presently testing metformin as a treatment for Long COVID.
In other Long COVID news, an open-label randomized clinical trial from Iran that was published in Nature magazine last week showed that Amantadine given twice daily for two weeks significantly reduced fatigue in Long COVID. Amantadine is an antiviral drug and dopamine promoter that has been used for Parkinson’s disease and to treat Parkinson's-like symptoms from medications. It previously was also used to treat Influenza A, but the influenza virus became resistant to Amantadine over time.
Long COVID advocacy and the recent Senate HELP Committee meeting
On January 18, 2024, the Health, Educations, Labor and Pensions (HELP) Senate Committee had a meeting on Long COVID led by Senator Bernie Sanders. Long COVID patients and allies from the Long COVID Moonshot advocacy group called their senators in advance and therefore all 15 senators on the committee showed up. Long COVID patients Angela Vazquez (of Body Politic), Rachael Beale, and parent Nicole Heim gave testimony, as did a panel of Long COVID medical experts including Dr. Michelle Harkins, Dr. Ziyad Al-Aly, Dr. Charise Madlock-Brown, and Dr. Tiffany Walker. You can watch the recording of the committee meeting here and can read the transcript of testimony here or under each panel member’s name on the Senate HELP Committee website.
People with Long COVID relayed their difficulties accessing the medical system and how they were gaslighted by some doctors. They want treatments for Long COVID and want clinical trials to be funded by the government. Physicians like Dr. Al-Aly who studies the epidemiology of Long COVID discussed how reinfections increase the risk of contracting Long COVID. He also relayed how the burden of disease and disability in Long Covid is similar to that of heart disease and cancer. There are currently no approved treatments for Long COVID and an “Operation Warped Speed” type effort is needed to find treatments as quickly as possible for this disabling disease.
In non-COVID news, there have been recent measles outbreaks in the US and in other countries including the UK. Measles can cause "immune amnesia" which makes your immune system forget all prior infections and vaccinations. It can wipe out immune memory cells so that one’s immune system needs to relearn what is good and what is bad.
1/24/24 Science Translational Medicine: SARS-CoV-2 viral clearance and evolution varies by type and severity of immunodeficiency https://buff.ly/3vPZjlu
Hematologic malignancy or transplant patients with severe immunodeficiency:
longest time to SARS-2 viral clearance
increased intrahost viral evolution associated with resistance to antibody therapy
marked by impaired humoral and T cell responses.
Autoimmunity or B cell deficiency patients with severe immunodeficiency:
impaired humoral responses but intact T cell responses
Nonsevere immunodeficiency patients:
intact SARS-CoV-2–specific immunity mostly comparable to control participants.
1/25/24 Sky News (UK): Doctors whose lives were devastated by Long COVID to sue NHShttps://buff.ly/3SaRwWZ
Hundreds of doctors are planning to sue the NHS over claims inadequate PPE on the frontline has left them with long COVID, disabled, and in financial ruin.
Testing
1/11/24 PBS KQED: Why Your Negative COVID Test Might Be Less Reliable in 2024 https://buff.ly/3vI6z2P
Because people have some acquired immunity from COVID vaccinations and/or prior COVID infections, your whole immune system revs up as soon as it detects the virus and you feel sick sooner than in 2020. You get the symptoms before the viral level is high enough to be positive on a rapid antigen test and before you are contagious. Some people are not positive until day 4 or 5 of symptoms.
"The bottom line is: If you’re testing because you’ve started feeling unwell, it’s unwise to assume in 2024 that a negative result automatically means you don’t have COVID-19, because you might just be testing too early."
3/2023 Cognition and Mental Health in Pediatric Patients Following COVID-19 https://buff.ly/47AXsOO
Review of 102 studies on long term cognitive difficulties (Long COVID) in children.
"The review revealed that the main long-term cognitive symptoms following COVID-19 were memory and concentration deficits, sleep disturbances, and psychiatric states such as anxiety and stress.
In addition to the direct physiological effects of a viral infection, there are psychological, behavioral, and social factors contributing to cognitive impairment, which should be addressed regarding the pediatric population.
The high prevalence of neurocognitive symptoms in children following COVID-19 emphasizes the importance of understanding the mechanisms of nervous system involvement.”
CDPH (California Dept Public Health) new guidelines:
1/9/24 California Dept of Public Health (CDPH): COVID-19 Isolation Guidance https://buff.ly/492Jma6
COVID-19 isolation recommendations move away from five days of isolation and instead focus on clinical symptoms to determine when to end isolation.
You can go to work or school if you have an active COVID infection, but no fever or symptoms are getting better without doing a rapid antigen test.
8/3/22 JAMA: Duration of Symptoms and Association With Positive Home Rapid Antigen Test Results After Infection With SARS-CoV-2 https://buff.ly/3u3KKu3
1/15/24 KRON4 News: Oakland schools allow COVID-positive students to attend class https://buff.ly/3Hk3DvL.
COVID-positive students no longer have to stay home, if they have no symptoms, but they should wear a mask at school while indoors.
No further 5-day isolation period following a COVID-19 positive test.
California Department of Public Health officials said impacts from COVID are reduced, compared to prior years, because of “broad immunity from vaccination and/or natural infection, and readily available treatments for infected people.”
1/15/24 Lancet (UK): Access to COVID-19 vaccination and COVID-19-related hospital admissions and mortality https://buff.ly/47FlCYr
The role of vaccination in COVID-19 is to mitigate the severity of the illness, reducing the risk of complications and mortality, rather than avoiding all COVID-19 infections.
Among 67 million people in the UK, consequences of not getting a Covid vaccine, especially among older adults, age 75+:
Missing 1 shot had a similar risk of severe Covid as missing all 4 shots (2.7 vs 3.1-fold, respectively), emphasizing waned immunity
1/16/24 BioRxiV: Discovery and Characterization of a Pan-betacoronavirus S2-binding antibodyhttps://buff.ly/496mkyL
Antibody 54043-5 was shown to bind the S2 subunit of spike proteins from alpha-, beta-, and deltacoronaviruses.
Although non-neutralizing, 54043-5 induced Fc-dependent antiviral responses.
Implications for a pan-coronavirus vaccine.
Antiviral treatments
1/25/24 CDC MMWR: Underuse of Antiviral Drugs to Prevent Progression to Severe COVID-19, Veterans Health Administration, March–September 2022 https://buff.ly/3UkpbjP
110 immunocompromised patients (organ transplantation or hematologic malignancies) at the Veterans Administration
80% were not offered Paxlovid, half of which were told their symptoms were too mild.
20% of patients were offered Paxlovid but declined.
Unlike with Paxlovid or other SARS-2 antivirals, this trial with Simnotrelvir was conducted mostly on healthy young adults, none of whom had severe symptoms. Simnotrelvir reduced viral load and symptoms more quickly than placebo.
1/18/24 NEJM: Oral Simnotrelvir for Adult Patients with Mild-to-Moderate Covid-19 https://buff.ly/3S3bVx1
750 mg of simnotrelvir plus 100 mg of ritonavir or placebo twice daily for 5 days started by day 3 of illness for mild to moderate COVID infection.
Several small-molecule drugs (e.g., nirmatrelvir and ensitrelvir) targeting the SARS-CoV-2 3-chymotrypsin–like cysteine protease enzyme (3CLpro, also known as main protease [Mpro]) are available.
In this phase 2–3 trial of treatment for mild-to-moderate Covid-19, simnotrelvir plus ritonavir shortened the time to symptom resolution by approximately 1.5 days among patients who received treatment within 3 days after symptom onset.
Simnotrelvir had more benefits for the alleviation of respiratory symptoms than placebo.
In addition, simnotrelvir was associated with an additional decrease in viral load until day 9.
1/17/24 Nature: Potent new pill provides COVID relief for the masses https://buff.ly/3vCzzcm
Simnotrelvir shortens symptoms for those with mild infections and is sold at a lower price in China than Paxlovid. It was tested in younger people.
It uses ritonavir like Paxlovid does, so it has the bad taste and can interact with medications.
hPSC-derived midbrain dopamine (DA) neurons—representing one of the main neurodegeneration targets in Parkinson’s disease (PD)— can be infected by SARS-CoV-2 , but cortical neurons do not become infected by SARS-CoV-2.
Not all neuronal populations are equally permissive to viral infection.
SARS-CoV-2 infection of hPSC-derived DA neurons triggers cellular senescence especially in the substantia nigra of the brain.
High-throughput screening to identify drug candidates blocking SARS-CoV-2 induced senescence of DA neurons
Three FDA-approved drugs were identified to rescue senescence of DA neurons: Riluzole (glutamate inhibitor for ALS), Metformin (oral type II diabetes medication), and Imatinib (tyrosine kinase inhibitor used for leukemia).
Our findings demonstrate that hPSC-derived dopamine neurons are susceptible to SARS-CoV-2, identify candidate neuroprotective drugs for COVID-19 patients, and suggest the need for careful, long-term monitoring of neurological problems in COVID-19 patients.
1/24/24 Fortune Well (Erin Prater): COVID survivors may be at a greater risk of Parkinson’s Disease-like symptoms in the future, researchers warn. What you need to know to protect your health https://buff.ly/3HxGw0X
"Once infected [by SARS-CoV-2], such cells [dopamine-producing neurons in the brain] can lose their ability to grow and divide, researchers found. The cells also stop producing dopamine and instead send out signals that cause inflammation."
"ALS drug riluzole, diabetes drug metformin, and cancer drug imatinib appear to prevent the aforementioned type of neurons from becoming infected with COVID and, thus, losing their ability to function properly."
Excellent review of the latest Long COVID research showing:
1. Long COVID and immune dysregulation via the complement cascade:
Immune dysregulation in Long COVID with a new study showing the activation of the complement cascade resulting in inflammation, endothelial cell damage and microclots which then further activates the complement system. Monocyte-platelet aggregates in the Long Covid participants also noted.
ME/CFS study also showed immune dysregulation in Long COVID with activation of monocytes and platelets, which worsen with exercise.
2. COVID causes Brain damage
Brain aging study of hospitalized COVID patients.
Study of human iPSCs showing that SARS-CoV-2 targets dopamine nerves in the brain which could lead to a Parkinson's-like disease. Metformin, imatinib, and riluzole could treat this at least partially.
3. Vaccination, especially 3 doses or more, protects against Long COVID
4. Two review articles on cardiovascular impacts of Long COVID
5. Recent Senate HELP Committee meeting on Long COVID 1/18/24
1/19/24 Science (Cervia-Hasler et al, U Zurich): Persistent complement dysregulation with signs of thromboinflammation in active Long Covidhttps://buff.ly/494OM4p
"patients experiencing Long COVID exhibited changes to blood serum proteins indicating activation of the immune system’s complement cascade, altered coagulation, and tissue injury (see the Perspective by Ruf below).
“At the cellular level, Long Covid was linked to aggregates comprising monocytes and platelets. These findings provide a resource of potential biomarkers for diagnosis and may inform directions for treatments." —Sarah H. Ross
“CONCLUSION
Our data suggest that active Long Covid is accompanied by a blood protein signature marked by increased complement activation and thromboinflammation, including activated platelets and markers of red blood cell lysis.
Tissue injury may also be complement-mediated and, in turn, activate the complement system. (vicious cycle)
Moreover, complement activation may be driven by antigen–antibody complexes, involving autoantibodies and antibodies against herpesviruses, as well as cross-talk with a dysregulated coagulation system.
In addition to offering a basis for new diagnostic solutions, our work provides support for clinical research on complement modulators for patients suffering from Long Covid.”
Links between the complement and coagulation systems could lead to Long Covid therapies.
“Cervia-Hasler et al. undertook a proteomic screen measuring serum levels of 6596 human proteins.
Prospective study of 40 Long Covid patients, 73 recovered patients, and 39 healthy controls.
Most serum biomarkers that were elevated in patients with Long Covid at 6 months overlapped with those elevated in severe acute COVID-19.”
Localized activation of the innate immune defense complement system as a likely culprit that induces thromboinflammation and prevents the restoration of fitness after acute COVID-19.
1/23/24 Smithsonian: Scientists Find Indicators in Blood Linked to Long Covid, Hinting at Future Treatments https://buff.ly/496BXpU
"Patients with long Covid showed increased activation of the complement system, which targets pathogens and damaged cells. When it’s too active, this system can also damage healthy cells, writes Stat News’ Elizabeth Cooney. This heightened activity appeared when the long Covid patients were first infected, as well as during a follow-up after six months.
Other recent research, which has yet to be peer reviewed, also found a link between the complement system and long Covid, according to MIT Technology Review’s Cassandra Willyard.
In the new study, patients with long Covid had lower levels of a protein that helps prevent blood clots and higher levels of proteins tied to clot formation, writes Nature News."
1/18/24 STAT News: Could long Covid’s signs of immune dysregulation in the blood lead to a diagnostic test?https://buff.ly/42rPRRL
"Scientists at the University of Zurich discovered high levels of proteins involved in the complement system — an important part of the immune system bridging innate and adaptive responses — that were disrupted in people with long Covid symptoms, but not in those who got better after the initial Covid-19 infection or in those who had recovered from long Covid symptoms after six months. The team also found damaged red blood cells and platelets as well as signs of harm to the endothelial cells that line blood vessels.
These biomarkers appeared after the researchers performed high-throughput analyses of more than 6,500 proteins found in the blood serum of 113 people infected with Covid, including 40 people who developed long Covid, and controls who were not infected."
10/28/23 MedRxiV (Cardiff, UK): Complement dysregulation is a predictive and therapeutically amenable feature of Long COVIDhttps://buff.ly/47cvSHG
Four blood complement markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power for Long COVID of 0.785.
Long COVID Advocacy: The Senate HELP Committee meeting
On January 18, 2024, the Health, Educations, Labor and Pensions (HELP) Senate Committee had a meeting on Long COVID. Long COVID patients and allies from the Long COVID Moonshot organized together to call their senators and therefore, all 15 senators on the committee showed up.
Patients were represented by Angela Vazquez (of Body Politic), Rachael Beale, and parent Nicole Heim.
People with Long COVID sit in the audience in the U.S. Senate hearing about Long COVID on January 18. (Drew Angerer / Getty Images)
Sita has Long COVID. She went to Washington DC for the Senate HELP Committee meeting on Long COVID. Unfortunately, she was infected with COVID on the trip.
1/24/24 Fortune: 'On par with cancer and heart disease': Experts, patients warn Congress about the burden of long COVID as the government blows through $1.15 billion without finding a cure https://buff.ly/3vQpQiz
The burden of disease and disability in Long Covid is on par with heart disease and cancer.
Long Covid has wide and deep ramifications on the labor market and the economy – some estimates suggest that the toll of Long Covid on the U.S. economy is $3.7 trillion – on par with the 2008 recession.
People can get Long Covid after reinfection. Research from the US and Canada is clear. Even if people managed to emerge unscathed after the first infection, they may get Long Covid after reinfection. The national RECOVER program found 10% of people with one infection had Long Covid, compared to 20% of those with 2 or more infections.
The risks of getting Long Covid after reinfection are not known to the general public.
The best way to prevent Long Covid is to prevent COVID in the first place. This requires a multilayered/multipronged approach.
There are zero FDA approved medications for the treatment of Long Covid.
The ongoing and planned trials for Long Covid are too slow and too small (i.e. underpowered) to provide definitive answers.
Long COVID and Cognitive Slowing (Brain):
1/25/24 Lancet: Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study https://buff.ly/42h4lDU
Multicenter study in Germany and the UK.
There is pronounced cognitive slowing in people with Long COVID (PCC) compared to matched controls who previously had COVID-19 but did not get Long COVID (No PCC) and to controls who never had COVID infection (No COVID).
Cognitive slowing 2-3 standard deviations slower than healthy controls.
Comorbidities such as fatigue, depression, anxiety, sleep disturbance, and post-traumatic stress disorder did not account for the extent of cognitive slowing in patients with PCC.
Cognitive slowing on the SRT was highly correlated with the poor performance of patients with PCC on the NVT (number vigilance test) , a measure of sustained attention.
Vaccines protect against LC in adults and children.
Root causes- viral persistence, immune dysregulation, gut microbiome, autoimmunity, reactivation of latent viruses
LC patients and scientists are collaborating.
And more.
1/16/24 Cell: Single-cell transcriptomics of the immune system in ME/CFS at baseline and following symptom provocation https://buff.ly/3O6zvbf
For ME/CFS, single cell RNA-seq at baseline and after exercise shows monocyte dysregulation that correlates with disease severity.
Platelets are also dysregulated, but this dysregulation resolves after exercise.
11/11/2021 Frontiers of Immunology: Metformin Suppresses Monocyte Immunometabolic Activation by SARS-CoV-2 Spike Protein Subunit 1 https://buff.ly/47Wl4O4
SARS-CoV-2 spike protein induces a pro-inflammatory immunometabolic response in monocytes that can be suppressed by metformin, and metformin likewise suppresses inflammatory responses to live SARS-CoV-2.
1/16/24 Nature Scientific Reports: A randomized open-label clinical trial on the effect of Amantadine on post Covid 19 fatigue https://buff.ly/4273G7C
62 patients, half had been hospitalized with COVID.
30 LC patients received Amantadine and 32 received placebo.
Amantadine 100 mg BID for 2 weeks significantly reduced fatigue in Long COVID.
Amantadine is an antiviral drug and Dopamine promoter that has been used for Parkinson’s disease and to treat Parkinson's-like symptoms from medications. It previously was also used to treat Influenza A, but the influenza virus became resistant to Amantadine.
1/11/24 Nature Reviews Neurology: Post-COVID dysautonomias: what we know and (mainly) what we don’t know https://buff.ly/48APV3M
Review of literature on autonomic nervous system (ANS) abnormalities in people with Long COVID.
Studies on autonomic nervous system (ANS) abnormalities in people with post-COVID syndrome (PACS) have been largely observational and descriptive, based on symptom inventories or objective but indirect cardiovascular measures; the hormonal and enteric components of the ANS have generally been ignored.
Affects many organs: Given the multiple components of the ANS and the distribution of autonomic nerves to all body organs, post-COVID dysautonomias can be expected to have a wide variety of symptoms.
The 2022 AAS meeting revealed a remarkable lack of consensus on the objective measures of autonomic dysfunction used to assess patients with PASC. This heterogeneity might account for the differences in autonomic symptom frequencies reported by different groups.
The abnormal HRV (heart rate variability) results suggest an attenuation of baroreflex and/or cardiovagal function in patients with PASC, which is also found in other pathophysiological states such as hypertension, heart failure, anxiety and takotsubo cardiomyopathy.
Augmented vascular responsiveness related to endothelial dysfunction is a feature of PASC that also occurs in acute COVID-19.
Data suggest that reduced small-artery relaxation in patients with PASC involves both endothelial dysfunction and pathological changes in the vascular architecture.
2/2024 Journal of Investigative Dermatology: SARS-CoV-2–Induced Vasculitic Skin Lesions Are Associated with Massive Spike Protein Depositions in Autophagosomes https://buff.ly/3Hlw78A
SARS-CoV-2 spike protein colocalizes with major autophagy proteins LC3B and LC3C in vasculitic COVID-19 skin disease
Multiple autophagosomes in both endothelial and vascular-associated cells were our major ultrastructural finding in vasculitic COVID-19 skin disease.
Video of path slides from vasculitic lesions from COVID infection that goes with this article above:
1/12/24 MedRxiV (Yale): Impact of COVID-19 vaccination on symptoms and immune phenotypes in vaccine-naïve individuals with Long COVIDhttps://buff.ly/3tWit8L
Patients w/ previous COVID infection had higher risks of digestive diseases, including
GI dysfunction (HR 1.38),
peptic ulcer d/s (HR 1.23),
GERD (HR 1.41),
gallbladder d/s (HR 1.21),
severe liver d/s (HR 1.35),
non-alcoholic liver d/s (HR 1.27) &
pancreatic d/s (HR 1.36)
The risks of GERD were increased stepwise with the severity of the acute phase of COVID19 infection. Even after 1-year follow-up, GERD (HR 1.64) and GI dysfunction (HR 1.35) continued to pose risks to COVID-19 patients.
Compared to those with one SARS-CoV-2 infection, reinfected patients were at a higher risk of pancreatic diseases (HR 2.57).
COVID-19 patients are at a higher risk of developing digestive diseases. The risks exhibited a stepwise escalation with the severity of COVID-19, were noted in cases of reinfection, and persisted even after 1-year follow-up.
Long COVID Disability and student loan forgiveness11/28/23 Forbes: New Student Loan Forgiveness Application Helps Borrowers With Medical Issues https://buff.ly/4b2UJ3g
Written by Adam S. Minsky who has a unique law practice devoted entirely to assisting student loan borrowers and their families.
Measles causes "immune amnesia" and basically causes your immune system to forget all prior infections and vaccinations. It can wipe out immune memory cells so that your immune system needs to relearn what is good and what is bad.
By killing immune memory cells, measles can make people susceptible to other infections.
Measles can also sabotage your immune system & erase its memory of how to fight all kinds of infections for years.
"Essentially, when you're infected with measles, your immune system abruptly forgets every pathogen it's ever encountered before – every cold, every bout of flu, every exposure to bacteria or viruses in the environment, every vaccination. The loss is near-total and permanent. Once the measles infection is over, current evidence suggests that your body has to re-learn what's good and what's bad almost from scratch."
1/17/24 Lancet: Resurgence of Mycoplasma pneumonia by macrolide-resistant epidemic clones in China https://buff.ly/423MCj5
Azithromycin is the macrolide used for children under age 8.
Mycoplasma have no cell wall and are resistant to penicillins.
In November, Dr. Annie Sparrow reported that the mycoplasma pneumoniae in children in China was resistant to the only antibiotic for children under age 8. Antibiotics are available over the counter in China which can increase antibiotic resistance. The new Lancet article confirms this.
11/28/23 Foreign Policy: Chinese Hospitals Are Housing Another Deadly Outbreak https://buff.ly/3QSfWnu
The surge in hospitalization of children in China is Mycoplasma pneumoniae which appears to be antibiotic-resistant to azithromycin, the only antibiotic for children under age 8.
Children are hooked up to IV drips on the stairs at a children's hospital in Beijing on Nov. 23.
1/17/24 STAT news: A new, non-invasive test could help predict the quality of embryo used for In-Vitro Fertilization (IVF)https://buff.ly/3U4h0HV
By looking at extracellular RNA (exRNA) from the cell culture fluid used to grow the embryos, the researchers were able to detect embryo quality non-invasively.
1/22/24 BBC: No cervical cancer cases in fully HPV-vaccinated women in Scotland who were given their first dose at age 12-13 years https://buff.ly/3vKpLNo
HPV vaccine stops women in Scotland from getting cervical cancer. There were no cases of cervical cancer in fully HPV-vaccinated women in Scotland who were given their first dose at age 12-13 years.
1/22/24 J National Cancer Institute (Scotland): Invasive cervical cancer incidence following bivalent human papillomavirus (HPV) vaccination: a population-based observational study of age at immunization, dose, and deprivation https://buff.ly/3Ojx4Sz
The bivalent HPV vaccine prevents the development of invasive cervical cancer if given at 12-13 years of age.
At older ages, 3 doses are required for statistically significant vaccine effectiveness.
Women from more deprived areas benefit more from vaccination.
1/23/24 NY Times: Gene Therapy Allows an 11-Year-Old Boy to Hear for the First Time https://buff.ly/3u6KDhi
A genetic treatment targeted congenital deafness from a mutated otoferlin gene with successful restoration of hearing.
Thank you for compiling all of this information. The current state of covid is so disheartening. We have never stopped masking in N95/KN95/KF94 masks and yet my husband brought covid home for the first time this week. And my 6yo just test positive too - although absolutely no symptoms. I’ve just been testing myself and my 2 and 6yo daily to catch infections early. It’s just crazy that I would have never otherwise tested her - how many people are walking around and have no idea they have covid or just test once and move on with their day. Hoping all the hard work of isolating my husband and 6yo means my 2yo and I will be spared.
Thank you, thank you, thank you from this LC reader. Your newsletter is a lifeline for me (and many others). Cheers.
Thank you for compiling all of this information. The current state of covid is so disheartening. We have never stopped masking in N95/KN95/KF94 masks and yet my husband brought covid home for the first time this week. And my 6yo just test positive too - although absolutely no symptoms. I’ve just been testing myself and my 2 and 6yo daily to catch infections early. It’s just crazy that I would have never otherwise tested her - how many people are walking around and have no idea they have covid or just test once and move on with their day. Hoping all the hard work of isolating my husband and 6yo means my 2yo and I will be spared.