Sofia Breland, MD 🇸🇪🌎

#LongCovidAwarenessDay “It’s been 7 hours and 1080 days ago, since…” Since life as I knew it changed in an instant. I long to be able to walk, play soccer… or even take a shower without having to plan in advance. I long. But not for Covid. We exist. We need help. ❤️

Would like to note that many of us who are virologists, microbiologists m, immunologists and ID specialists have had this fear since the beginning of just given the nature of corona viruses Personally, imo there is enough evidence to state it is. Why do I believe that?

A fascinating new study by Vishnu Shankar et al. @stanfordimmuno shows that oxidative stress is a shared characteristic of ME/CFS and Long COVID in lymphocytes due to inability to clear reactive oxygen species. This happens in sex-specific manner. (1/) pnas.org/doi/abs/10.107…

@surf4children I agree. Do you have a link to this graph/picture (I’d like to read more about it)?

when drs say “danilo use of IVIG is off label” they should ask themselves “why I leave patients suffering when there is a treatment with a 50-70% evidence based chance of helping them feeling better ? #LongCovid #MECFS

Närstående som tar avstånd och läkare som hävdar att postcovid inte finns. I en ny rapport från Svenska Covidföreningen uppger många drabbade att de känt sig misstrodda av både vårdpersonal och människor de bryr sig om. covidforeningen.se/ny-rapport-pos…

Why is there immediate PEM and then PEM on a 1-2 day delay? I wonder if it helps to borrow from DOMS (delayed onset muscle soreness): - Immediate: Build up of lactic acid from use of anaerobic energy pathway triggers pain receptors (but can resolve quickly) - Delayed: Immune response/inflammation takes time, 1-2 days, to build to a point where it triggers pain receptors

Wanted to put forward a thread about #PEM since there have been some new developments and also because I just need to get some of this out of my head and work through it. Folks with infection- and exposure-associated chronic illnesses (IACIs) like #LongCOVID, #MECFS, 1/

@HHjelte Beklagar sorgen, Henrik ❤️

Vila i frid kära pappa. Du har idag somnat in i Alingsås. Du kämpade mot cancern i 3 år. Du var världens bästa pappa, make, svärfar och farfar! Du var väldigt ledsen nu på slutet då du ville leva. Och vi ville att du skulle leva. ❤️❤️❤️

@KYMaverick1 I agree with you. As far as I know the ME didn’t look more into the ecchymosis to try and determined if it all was due to basilar skull fracture or direct frontal trauma, or am I wrong? Notably JOK only had swelling of his right eye at the scene, swelling of both only after CRP.

I believe the golf-ball-sized hematoma above John O’Keefe’s right eye, as reported by Timothy Nuttall, likely resulted from a separate blunt force trauma, such as a punch, rather than a coup-contrecoup injury. My analysis evaluates medical evidence and testimony to determine whether the hematoma was caused by a coup-contrecoup mechanism or a distinct blunt force trauma. Orbital roof fractures can result from either direct blunt trauma or contrecoup trauma, but 80–90% are typically caused by direct blunt injury. A hematoma is a collection of blood outside blood vessels, often due to trauma. The golf-ball-sized hematoma above O’Keefe’s right eye is likely a subcutaneous or subgaleal hematoma, located under the skin or between the scalp and skull, and is typically caused by direct trauma, such as a blow to the head or face. Dr. Wolf testified that O’Keefe’s facial lacerations were not linked to a coup-contrecoup mechanism, supporting the occurrence of separate direct trauma to the face. Ocular ecchymosis (bruising around the eye) could result from a basal skull fracture or direct blunt trauma, suggesting that either or both may have contributed. Even if a contrecoup injury occurred, the golf-ball-sized hematoma above O’Keefe’s right eye is most likely due to direct blunt trauma. Its external location, large size, and swollen appearance are consistent with a subcutaneous or subgaleal hematoma caused by a forceful blow to the forehead or orbital area. Contrecoup injuries typically cause internal brain damage, such as contusions or intracranial hematomas, not external hematomas. Medical literature does not support contrecoup injuries causing subcutaneous or subgaleal hematomas, as their mechanism involves brain movement, not external soft tissue damage. This conclusion supports the defense’s theory of the case.

@SleuthieGoosie They don’t know CPR? There’s a FIRST RESPONDER in the house! 83 ft away.

Clearest I’ve heard so far. Jen McCabe’s 911 call. Curious what stands out to you. #KarenRead

@aburkhartlaw I’ll repost this here, after I had asked this I saw a video by @BrotherCounsel where he discussed this aspect. What is your take on this?

Oh hey, I hear Bev has a thing about candor to the tribunal. How interesting that Brennan fails to mention the most recent authority on this issue, Smith v. Arizona, that specifically rejects the reasoning from Williams he's suggesting the court use. supreme.justia.com/cases/federal/…

Barn och ungdomar med postcovid är väldigt utsatta. Vi måste vara bättre än så här. Vi måste kunna erbjuda utredning, vård och stöd även i Sverige.

@aburkhartlaw TY @aburkhartlaw. Could Brennan use the fact that the original analyst testified in the first trial (and KR had an opportunity to confront her)? I hope not, bc this seems like Brennan is trying to sneak another interpretation of the results into this trial.

In Smith, SCOTUS recognized that for one analyst to base conclusions on another's work necessarily requires the testifying analyst to assume the truth of the non-testifying analyst's work and reports.

I am excited to travel to Amsterdam next week to visit @DrDenDunnen and @RobWust for joint projects. I will also be in Groningen for the ID-DarkMatter-NCD & ME/CFS Lines Joint Consortium Meeting. With the theme “Unraveling Post-Infectious Immune-Related Disorders.

Very excited and honored to visit @TheCrick to give the Crick Lecture and the 2025 Honess Lecture for Immunology this week on the "Immunology of Post-Acute Infection Syndrome"! crick.ac.uk/whats-on/crick…

This week for #LongCovidAwarenessDay, we’ve compiled a fact sheet of up-to-date statistics & citations on Long COVID. Data is one of the most useful tools to strengthen understanding of #LongCovid. We hope this resource helps our community's fight.🩵 patientresearchcovid19.com/2025-long-covi… 1/

@aburkhartlaw @Joe04j @TedDanielnews Thank you for a great response! I hope you can go through the motion to dismiss (if the redacted copy is released from being impounded), I’m always looking forward to your analyses!

I don't necessarily mean interlocutory appeals; many of these issues could be raised after trial, but some could be viable to request interlocutory review. Whether they'd have to go to Judge Bev first depends on whether the issue has already been litigate in the trial court. So something like removing Jackson, yes, they can go straight to SJC and there's a decent basis to ask for interlocutory review. Something like jury pool taint, they'd need to make a record in a motion to Judge Bev - usually publicity issues are raised in a motion to change venue - and then they could appeal after she denied it - but probably only after trial.

NEW: Karen Read's lawyers have filed a motion to get her case dismissed "for extraordinary governmental misconduct". The motion and supporting paperwork from attorney Alan Jackson have been impounded. #boston25

@KYMaverick1 @bayarea_bias Ty! Yes, that’s a fair question (Bederow), but do u she would spend time/money on an appeal if his pro had vice is denied? Maybe she was talking about “just” Jackson (and not both him and Yanetti). Alessi seemed to insulate DY from Jackson (so Bev wouldn’t kick them both off?)

@sofbreland @bayarea_bias I think if Jackson is excluded there would most certainly be an interlocutory appeal especially after Read comment saying if one of her attorneys is excluded she would appeal. I found it interesting she said one of her attorneys. Was she including Bederow in that statement?

I haven’t posted today yet because I wanted to listen to the proceedings and reflect on them for a few hours. Following hearings under this judge is challenging due to her apparent bias: the prosecution can speculate and make unsubstantiated claims without rebuke, while the defense faces constant scrutiny and a stricter standard. Jackson’s pro hac vice status could theoretically be revoked, though I doubt it will happen. Unlike Brennan, who regularly misleads the court with impunity, I don’t believe Jackson did so intentionally. If his status were revoked, it would likely halt the trial, sparking an immediate appeal—either to the Supreme Judicial Court or a federal court on Sixth Amendment grounds. Still, I expect a milder sanction is more realistic if the judge finds one is needed. The events at the close of the February 18th hearing may pose an irreparable problem for the CW, potentially justifying a mistrial with prejudice or at least a motion to recuse the judge. That said, I doubt the defense will pursue these outcomes. Regarding the ARCCA experts, their exclusion seems unlikely since any prejudice could be easily mitigated. But if Jackson’s actions led to such a ruling, it would hand Read a solid appellate argument. Ironically, Brennan’s best point was his closing remark in the February 16, 2025, pleading. Yet I suspect the defense slipped up there, writing “who were not hired for or paid for by the defense” when they likely meant the experts weren’t hired or paid to conduct the reconstruction. In conclusion, it is my assessment that the judge will strive to maintain the trial’s scheduled start date of April 1, opting to impose any sanctions in a manner that minimizes disruption to the proceedings. It is possible that the judge was the one "duped" by accepting Brennan's statements as fact regarding the feds providing the discovery rather than the defense without further scrutiny. Notably, no declaration was made on the record today confirming the conclusion of the federal investigation. Now, we wait.

@aburkhartlaw @Joe04j @TedDanielnews Do you mean interlocutory appeals? Do they have to appeal to Bev first or do they go to SJC?

So far, unlikely. If Jackson is removed, it's an appeal issue. If AARCA is excluded, it's an appeal issue. If the defense continues to make a record of her disparate treatment of the parties to support disqualifying her for bias, it's an appeal issue. If the jury pool is tainted by this, it's an appeal issue.

@KYMaverick1 @bayarea_bias TY for your well informed and fair statements. I’m not from the US, how would the defense go about what you mentioned here? Is it an interlocutory appeal?

If Jackson were excluded, I would anticipate not only potential Sixth Amendment concerns but also an unequal application of the law between the prosecution and defense (judicial prejudice against the defendant). In such a scenario, it is unlikely that Judge Cannone would be permitted to remain on the case, and the possibility of an outright dismissal could arise. By removing Jackson while seemingly overlooking Brennan, she risks creating significant legal complications and inconsistencies. I don’t see her opening that can of worms. Honestly, I don’t think Brennan thinks that far ahead.

I am excited to be part of this paper: "Targeting the SARS-CoV-2 reservoir in long COVID" by @microbeminded2 @MichaelPelusoMD and team, describing clinical trial recommendations for long COVID @polybioRF thelancet.com/journals/lanin…