Funky Grooving

Current status and future perspectives on the mechanistic and pathophysiological understanding of long COVID 🚨JUST DROPPED YESTERDAY and rips open the black box of Long COVID: Viral persistence up to at least 24 months. Fibrin microclots that laugh at fibrinolysis. Autoimmune storm. Mitochondrial sabotage. An up-to-date full mechanistic map is finally here! No more guessing. This changes everything, let’s dig into this overview👇, better yet…..read it yourself!! #MustRead ➡️Global Impact & Context: - Long COVID (PASC) affects >400 million people worldwide, incurring >$1 trillion in annual economic costs, - Core symptoms, debilitating fatigue, cognitive dysfunction (“brain fog”), sleep disturbances, and post-exertional malaise (PEM) in 50–80% of cases, persist months to years’ post-infection, with a mechanistic overlap to ME/CFS, ➡️Core Mechanisms: 1. Immune Dysregulation: - Persistent systemic inflammation features elevated cytokines (IL-6, TNF-α, IL-1β) detectable up to 14 months, driving T-cell exhaustion (reduced CD8+ IFN-γ/TNF-α production) and monocyte activation (COX-2, IL-8Rβ, CXCR6), - Autoantibodies (anti-GPCR, anti-PITX2, anti-FBXO2, ANA/ENA) persist 12–14 months and correlate directly with fatigue, dyspnoea, palpitations, and cognitive impairment with molecular mimicry, gut dysbiosis and latent herpesvirus reactivation (EBV, HHV-6) amplifying autoimmunity, 2. Viral Persistence & Reactivation: - SARSCoV2 RNA, spike protein, and antigens remain detectable in brain, muscle, gut and plasma up to 14–24 months in ~60% of cases, fuelling chronic low-grade inflammation, - EBV/CMV reactivation signatures are common with spatial transcriptomics highlighted as a possible next tool to map tissue reservoirs, 3. Endothelial/Microvascular Pathology: - Glycocalyx shedding (elevated SDC-1), capillary rarefaction and endothelin-1 elevation create a pro-thrombotic state, - Platelet hyperactivation releases vWF/FVIII, forming anomalous fibrin(ogen) microclots that resist fibrinolysis and these circulate and fragment during exertion, causing hypoxia, ischaemia-reperfusion injury, and PEM, 4. Autonomic Dysfunction: - Present in ~50% of patients (POTS predominant), driven by hypovolaemia (70%), small-fibre neuropathy (20–40%), vagus-nerve damage and microclot-induced compensatory tachycardia with 4-fold norepinephrine spikes, 5. Mitochondrial Impairment & Neuroinflammation: - Skeletal-muscle biopsies show reduced respiration, cytochrome c oxidase activity and WASF3-mediated supercomplex disruption, producing rapid lactate rise and PEM within 48 h, - Systemic cytokines breach the blood–brain barrier, sustaining microglial activation and cognitive sequelae, ➡️Diagnostic & Therapeutic Gaps: - No validated biomarkers or subtype-specific criteria exist. - Graded exercise is contraindicated. - Observational promise exists for IVIg, low-dose naltrexone and apheresis, but large RCTs are urgently required. ➡️Future Priorities: Calls for subtype-specific research, large-scale RCTs, advanced techniques (spatial transcriptomics, proteomics), and interdisciplinary collaboration to develop precision diagnostics and therapies. ‼️This exceptional review delivers a masterful, evidence-based roadmap that not only clarifies Long COVID’s complex pathophysiology but stimulates the scientific community toward urgently needed mechanistic breakthroughs and effective, patient-centred interventions. ‼️Bottom line: Long COVID is not a single disease but a complex, multisystem condition that can impact your life seriously! #AvoidSars2 #AvoidReinfections A huge thanks to all authors, @DrMark_Faghy @DavidJoffe64 @PutrinoLab @DaniBeckman @resiapretorius @Sunny_Rae1 are only some of them!👏👏 nature.com/articles/s4385…

Have you wondered why unions haven’t kicked the door in on COVID denialism in the workplace? The Disability Caucus at CAPE - a Canadian union representing over 27,000 federal workers - is here to tell the world THE WAIT IS OVER! 🧵

Novavax will be available in BC for the fall!!! My MLA’s constituency office sent me an email today confirming that it should be “available province-wide in select pharmacies.” Advocacy works! Thanks @Biff234523 @DoNoHarmBC @Friesein and all those who have raised your voice.

Group update: I’m working my way through msging all who’ve expressed interest - 40+ of you! And that’s just in Ontario. Don’t ever believe that you’re the only one who cares about COVID. So many others are out there, feeling the same strain - seeking to be seen & understood.

💯🎯 Based on modeling work I've done, if >25% ppl mask (N95), we eliminate massive waves. The power of masking! It is not linear, 25% masking reduces new daily infections by more than 60%. You CAN make a difference.

"We want medications for our lungs, our hearts, our stomachs, our immune systems, our brains — damaged by the Covid virus." "Real care, not cognitive behavioral therapy. Not meditation." France, this week. At a psychologists' conference, Long Covid patients refused to be ignored. Grabbed. Pushed. Still speaking. The full statement ⬇️ Translation: @GreeneWendy

@KashPrime @dotu56 @BogochIsaac That was my thought exactly when I read the results. Showing an impact on reducing LC is a crucial measure that impacts quality of life individually and economic costs societally re disability and workforce, as well as health care

@BogochIsaac The real endpoint they should check for is long Covid risk reduction. That's what's still plaguing the public.

1/ In today’s mostly vaccinated populations, Paxlovid does not seem to reduce hospitalization or death from COVID in higher-risk adults. Earlier trials (EPIC-HR) showed ~90% risk reduction, but this was in unvaccinated high-risk patients. tinyurl.com/yc2fj8k5

We must reiterate there are biomarkers in Long Covid. There are thousands of publications on Long Covid. There is severe failure in designing trials based on pathophysiology and provide adequate access to care and disability services. People have died because of this

@CovidSolidarit1 There is a Covid Conscious therapist directory too

Is there a support group for Covid realists who don’t deny the health impacts of repeat infections and look facts straight in the face? Because it’s hard going and the future’s looking rather grim. I feel need to give each support somehow - even on ‘transcendental’ level.

@CovidSolidarit1 Echoing what others have said. Facebook Still Coviding groups have helped me. Covid 19 Resources in Canada has monthly discussions that help me. There have been US led grief support groups, but I'm not sure who runs them

This week, Whoopi Goldberg raised awareness of workers disabled by #LongCOVID and called for more transparency on trials on federal websites. x.com/ABrokenBattery…

New paper with colleagues from @pfizer and @IQVIA_global on the impacts of COVID vaccines on costs and healthcare use in Ontario. Read the full thread over on @bluesky journals.plos.org/plosone/articl… bsky.app/profile/dfisma…

Support the work we do by making a donation! 💙 All donations are tax deductible and support our Free Request Program. 😷 donatemask.ca/donate-form #NationalVolunteerWeek #Volunteer #Charity #MaskUp #Donate

This is absolutely correct. Regardless of whether the virus becomes endemic or not doesn't change the facts that (a) the virus is dangerous, and (b) we should be mitigating the risk of infection. Endemicity doesn't alter the virus in any way.

Pancreatic cancer is one of the five major cancers in the U.S., and with the worst case-fatality ratio among these. Part of the reason it gets discussed so little is because there are so few survivors relative to the other major cancers. x.com/i/status/19067…

@michael_hoerger I lost a family member to pancreatic cancer and I have been doing advocacy and public education about symptoms ever since. We have to carry the torch when they have lost their voice too soon.

Part of the reason this article has gone viral is the photograph that depicts complex *affect* (the totality of emotion) in a way AI cannot recreate and people who have not survived pancreatic cancer cannot fully comprehend.

COVID-19 is still spreading. Respirator masks are still one of the simplest ways to reduce risk, for you and the people around you. #COVID19 #COVIDIsNotOver #COVID #LongCOVID #InfectionPrevention #PublicHealth #LongCOVIDAwareness

This was me about 15 years ago. I knew the job was killing me, but I felt I couldn't leave. Made a lot of decisions afterwards and thankfully am in a much better place now. The Pitt does dramatize things significantly, but the tension is there. You need to be very well supported to handle seeing so much suffering and death. Where I worked back then was not great; overwhelming numbers, poor staffing meant that we were all scheduled 2x more shifts than we wanted, we were making mistakes examining patients in cramped hallway beds. A relationship fell apart, the quality of my work suffered, and I was not doing well. I sat down after one particular night shift, right after getting screamed at by a similarly stressed colleague, and wrote, on paper, a contract for myself. I would leave for 6 months and get my life and my head sorted out. I signed it sealed it in an envelope and kept it on my desk. I travelled, met old friends, applied for and took on some new part-time jobs, rediscovered my tech skills, eventually met the nice young lady who became my wife, and gradually found balance. Now I work (part-time!) at an awesome place with great colleagues, we have each other's backs, and there is a fantastic culture of collaboration, education and cultivating life-saving skills and knowledge that is hard to put into words. I mix it up with a clinic practice, admin, teaching, startup, media work and other duties to keep it interesting. I hope colleagues reading this and feeling burned out also find their way out of the darkness and into the light! Overall the biggest problems at the Pitt that I see: - Shifts are too long, 12-15 hours with that kind of volume and acuity is insane. Most places switched to 6-8 hours ages ago. You should only be in the 'hot' seat seeing new patients, for 3-4 hours max. - Not enough attending physicians. There should be at least 3-4 at any time to support that many residents and students. - Main character syndrome - a well-run system should be able to function just fine without you. If it can't, then someone hasn't planned properly. Dr. Robbie and others should not feel the entire weight of the ED on their shoulders. They should be able to go home and assume their colleagues have things in hand. - Some of the social issues around insurance coverage, coming from a universal health care system, are just alien to me and hard to understand. Why would any society want to live like this? I'm thankful the Pitt was able to highlight a lot of the issues facing staff in a modern ER, though I feel tremendously sorry for anyone who does work in such a place and hope they can fix it or move elsewhere.

If there was one article you want to read as a clinician? Read this Via @jenna_taglienti - an absolutely stunning write in @JAMA_current "Medicine can have extraordinary meaning. But it cannot substitute for being present in your own life. The world may need us as physicians. But the people who love us need us as ourselves. And that is the role no one else can fill." Brilliant - and much love to you 'Time is Finite" jamanetwork.com/journals/jama/…

Study links long COVID in kids to worse grades, attention span, and social life. School-aged children with long COVID had more than double the risk of decreased academic performance than those without the condition. 📝 Read more: ow.ly/GKNm50YLc1s