Long COVID – Techso Mogro

Five COVID Shots, Two Bouts of the Virus, and About to Get My Sixth Shot – What Have We Learned and What Do We Still Not Know?

Mon, 30 Oct 2023 17:42:53 +0000

When the coronavirus known as COVID-19 or SARS-Cov-2 first emerged from Wuhan, China in 2019, the world changed dramatically. Not since the Black Death and Spanish Flu has the world seen such a disruptive pathogen inflict damage on humanity.

COVID-19 began its assault on us as a respiratory infection causing severe damage to lung tissue. The medical establishment applied the same technology and treatments as it had done in the past for severe pneumonia and other deadly lung infections. Detection of the virus was done by taking nose swabs.

When I got COVID-19 in April 2020, the tests didn’t detect the presence of the virus. I didn’t present initially with lung issues. It was several weeks before I began coughing, a common sign of the infection. Instead, my voice changed, not for tracheal or bronchial reasons, but because my heart had enlarged and was pressing on my larynx.

An emergency doctor who saw me was the first to describe what I was experiencing. COVID-19 had infected my heart muscle and caused the left upper chamber to swell. She said that they were seeing an increase in symptoms similar to mine in the emergency department which they were presuming were related to COVID-19 exposure.

What I thought was indigestion when I felt changes in my chest turned out to be arrhythmias. The electrical conduction pathways of my heart were being altered by the virus infecting the contractile muscle cells responsible for pumping blood through the circulatory system. An electrocardiogram (ECG) showed I was in atrial fibrillation with my heartbeat jumping all over the place. Wearing a portable ECG, a Holter Monitor, for two weeks showed I was experiencing episodes of tachycardia (racing heart), bradycardia (slower than normal heart) and occasional moments when the muscle stopped beating lasting up to five seconds. The latter happened when I was sleeping which was a frightening thing to learn. COVID-19 could have killed me in my sleep. Three years later, having had two procedures and taking blood thinners, and anti-arrhythmic twice daily, my heart muscle is back to its prior calm self.

A study published earlier this year in Nature Cardiovascular Research that from March 2020 to March 2022, the United States saw 90,160 excess cardiovascular deaths higher than expected. The spikes in heart-related mortality appeared from March to June 2020 during the first wave of COVID-19, and from June to November 2021, a second noted COVID-19 death peak. The little over 90,000 represented a small percentage when compared to the global death count which surpassed 18.2 million during the first two years of the pandemic.

The majority of these excess deaths happened in people 65 years old or older. This is consistent with population health studies that show those of that age or older or more likely to experience cardiovascular events. A significant number of deaths associated with the heart found the biggest spike, however, in young adults between the ages of 25 and 44. These included higher incidents of heart attacks, strokes and arrhythmias associated with COVID-19 with occurrences happening up to a year after the initial infection.

A 2022 Lancet study of 42 million U.S. medical records covering from January 2019 to March 2022 ended up recruiting over 4 million participants who had been tested for COVID-19. The study published in eClinicalMedicine revealed a much higher risk of heart-related diseases occurring in the year after having tested positive for COVID-19. Higher incidents of stroke, heart attacks, arrhythmias, myocarditis, ischemic cardiomyopathy, heart failure, hypertension and pulmonary embolisms appeared in these medical records.

Dr. Helene Glassberg, a cardiologist at the University of Pennsylvania Perelman School of Medicine, is quoted in a New York Times, September 7, 2023, article, stating “Early on, we saw the impact on the cardiovascular system during Covid illness…But now we’re seeing the long-term consequences in people who’ve had prior Covid.” Dr. Glassberg was not a participant in the Lancet study but concurs with what the data shows. Although there have been rare incidents of myocarditis occurring from vaccinated patients, something that vaccine skeptics like to point out, the risk of getting myocarditis from the virus is 28 times greater.

A Children’s Hospital of Philadelphia (CHOP) led research study published in Science Translational Medicine in August 2023 points to COVID-19-induced mitochondrial genetic changes as the possible agent leading to heart and other organ damage from the virus. The mitochondrion is an organelle found in every human cell. It has separate DNA and genes from the cell’s nuclear DNA.

Evidence shows the proteins found in COVID-19 have a fondness for mitochondrion. They bind with the organelle’s proteins to suppress mitochondrial gene expression. So, although the initial access for COVID-19 may be through our lungs, the damage to its mitochondria is temporary. Lung cells recover. That is not the case, however, in other organs, particularly in the heart, where damage is long-term.

States Douglas C. Wallace, Director of the Center for Mitochondrial and Epigenomic Medicine (CMEM) at CHOP, “We need to stop looking at COVID-19 as strictly an upper respiratory disease and start viewing it as a systemic disorder that impacts multiple organs. The continued dysfunction we observed in organs other than the lungs suggests that mitochondrial dysfunction could be causing long-term damage to the internal organs of these patients.”

Previous studies may have identified a mitochondrial function regulator that could lead to a new therapy for those suffering from Long COVID. Called microRNA 2392 (miR-2392), it could impede viral replication to stop long-term complications from COVID-19.

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The Loss of our Sense of Smell and Taste from COVID-19 May Soon be a Thing of the Past

Wed, 18 Oct 2023 19:40:07 +0000

In Japan, a new antiviral pill is helping COVID-19 sufferers to regain their sense of smell and taste. This was a problem for those who were infected in the virus’s first wave. When the Omicron variant became the most dominant strain, the symptomatic loss of sense of smell diminished. In the current COVID-19 XBB variants, the loss is even less.

But for those who were first infected in 2020 through 2021, between 40 and 50% with COVID-19 experienced loss of smell and taste which made food unpalatable. I never lost my sense of smell when I caught COVID-19 in 2020, but the painter we hired to do our Toronto apartment the next year described his experience stating everything tasted rotten to him. He described food as having a gun-metal smell. The only benefit, he stated, was he lost a lot of weight because food became so unappealing. He still hadn’t fully recovered his sense of taste when we met him.

Xocova which also goes by the name Ensitrelvir Fumaric Acid, was approved in Japan last November. It is administered in pill form and given once daily for five days. The drug suppresses viral replication by inhibiting 3CL protease, an enzyme that breaks down the proteins produced by the virus. In clinical trials in Japan, the drug has produced no serious adverse effects and more notably, has helped restore the sense of smell and taste of those infected rather quickly. By the third day of treatment, clinical trials report the loss of smell and taste to be diminished, and by day seven, the restoration is quite dramatic. In addition, Xocova shortens the duration of other COVID-19 symptoms including the most severe that would lead to hospitalization and death.

Stated Yohei Doi, an infectious disease researcher at Fujita Health University in Japan, notes that the recovery of these senses comes back over time, “But we know that some people have had long-term issues with smell and taste.”

That certainly has been the case in North America. A Harvard University study in the United States looked at almost 30,000 COVID-19 cases in 2021. That year 35.8 million Americans, representing 14% of the adult population of the country, got COVID-19. Of those 60% reported a loss of taste and smell. The severity of other COVID symptoms appeared to increase the duration of sensory loss.

Following the infection, 24% reported only partial recovery of their sense of smell, with 3% showing no recovery at all. The Harvard research estimates that 28 million Americans are still suffering from partial loss of sense of smell and taste from COVID-19 while 6 million have never got these senses back.

Xocova has yet to be approved for use in North America where Paxlovid remains the preferred pill for shortening the duration of COVID-19 infections in people who are most at risk. But Paxlovid hasn’t shown that it does much to restore the sense of smell and taste in patients who take it.

Laryngologists have had some success using a combination of fluticasone, a nasal spray and triamcinolone dental paste, noting significant improvement in smell and taste over a five-day course of treatment.

When Xocova comes to North America, you may find it under the Ensitrelvir name.

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The Mystery of Long COVID and Why We Still Don’t Fully Understand Its Human Impact

Sat, 02 Sep 2023 15:25:07 +0000

Why do so many who are first infected with the COVID-19 virus in its many forms, end up with long-term symptoms? What makes this coronavirus different from others like a predecessor that caused the SARS pandemic from 2002 to 2004?

Before we tackle this subject it would be good to have a definition. What is Long COVID? It describes COVID-19 symptoms that persist beyond 12 weeks. The average gestation for COVID-19 with resolution of symptoms lasts up to 4 weeks. But when symptoms persist without any alternative explanation, the individual who has had COVID is deemed to be suffering from Long COVID.

From a study on population groups, the U.S. National Institute of Health (NIH) has come up with a list of 37 discrete COVID-19 symptoms that include post-exertional malaise (the worsening of symptoms after physical or mental activity), fatigue, brain fog, dizziness, gut symptoms, heart palpitations, sexual problems, change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements such as muscle twitching or jerking. Of these 12 have appeared to be persistent in individuals suffering from what we call Long COVID.

These 12 break down into four categories that produce symptoms in different parts of the body such as:

Heart, kidney and circulatory problems.
Lung complications, sleep disruptions and anxiety.
Muscle pain, and nervous and connective tissue symptoms.
Digestive and respiratory symptoms.

Researchers have tried to create a method of scoring these various Long COVID symptoms to allow for differentiation. The NIH research shows that symptoms of Long COVID appear to be more common before the arrival of the Omicron variant of the virus, and in those who have never been vaccinated. And those in the Omicron era who have been infected again are also seen as more susceptible to Long COVID.

States Andrea Foulkes a doctor at Massachusetts General Hospital who has been a senior researcher at NIH, “One of the big takeaways is [that] long COVID is not just one syndrome; it’s a syndrome of syndromes.” Within the four clusters as described above are other Long COVID symptoms that include dry mouth, weakness, headaches, tremors, muscle and abdominal pain, fever, sweats, chills, and sleep disturbances.

Many studies over the last two years have identified immune cell abnormalities and tiny blood clots that persist beyond 8 months after an initial infection.

An Australian research study has identified persistent signs of inflammation associated with abnormal circulation.

A study out of Italy shows cells associated with blood flow appear to be damaged by the COVID-19 virus in patients suffering from long-term symptoms. States Danilo Buonsenso, a pediatric infectious disease doctor working at Italy’s Gemelli University Hospital, in assessing circulatory abnormalities in Long COVID, “In some patients, we have specific areas where no blood flow comes in.”

Now adding to our understanding comes research from the Children’s Hospital of Philadelphia (CHOP) and the COVID-19 International Research Team (COV-IRT) that shows the virus causes genetic impairments to the mitochondria in cells. Infected mitochondria in host cells when activating immune defences, cause malfunctions that can result in serious complications such as organ failure.

Mitochondria are organelles found in every living cell in our bodies. The genes responsible for them are contained within the DNA in the main cell body as well as separately within the mitochondria organelles themselves. Studies show COVID-19 proteins within infected cells bind to mitochondrial proteins which explains the malfunctions.

At CHOP, autopsies showed that mitochondria in lungs recovered from COVID-19, but normal function in the heart, kidneys and liver exhibited malfunctions. Long COVID even showed the suppression of normal mitochondrial function in the cerebellum even when COVID was not found in brain tissue.

Douglas C. Wallace, Director of the Center for Mitochondrial and Epigenomic Medicine at CHOP states that there is “strong evidence that we need to stop looking at COVID-19 as strictly an upper respiratory disease and start viewing it as a systemic disorder that impacts multiple organs…The continued dysfunction we observed in organs other than the lungs suggests that mitochondrial dysfunction could be causing long-term damage to internal organs.”

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Visible Activity Tracking App Being Tested for People with Long COVID and Other Chronic Illnesses

Thu, 22 Dec 2022 19:39:18 +0000

I am back with my wife from our disastrous adventure in Aruba where much of the vacation was spent quarantined in a hotel room after we both got COVID-19. After all the precautions taken, the five COVID-19 shots, the mask-wearing, and avoiding crowded indoor places, our first vacation in three years turned out to be our nemesis. Aruba was rated as a good bet with low-virus numbers. We bought premium seats for the flight so that we weren’t near anyone else. We thoroughly sanitized every surface in our seating area when we arrived on the aircraft. And we only removed our masks which were KN95s when we ate and drank. Halfway through the trip we put on fresh masks and kept them on when we landed and until we got to our hotel room. Four days later I got sick, followed by my wife a day later. So the likely infection source was on the airplane or at the airport.

In Aruba, we self-tested using the rapid antigen test kits we brought with us. I tested positive immediately within 12 hours of experiencing the first symptoms. My wife didn’t test positive the first time. But the second time the test results showed the presence of COVID-19.

Our hotel insisted we contact a local doctor who arranged a virtual consult. She advised us to stay isolated for five days and then regardless of repeat positive test results get on the airplane and go home on our departure date. Now we are back in Toronto and experiencing some of the lingering symptoms that include gastrointestinal upset, blocked sinuses and nasal congestion, rough throats and occasional coughs. We are continuing the isolation that started in Aruba.

Having experienced COVID before and with long-term symptoms, I know what Long COVID can feel like. My concern now is that this repeat infection, although Omicron rather than the original COVID-19 which I got in April 2020, will trigger prolonged symptoms that lingered with me for so many months the last time. That’s why when I read about a new app, called Visible, currently, in beta testing, it caught my interest.

Visible is a tracking platform focusing on people suffering from chronic illnesses. In other words, rather than a fitness app which is all the rage these days, this one is being developed by people who have lived the experience of Long COVID.

What does the app do? It collects daily data using heart rate variability as a primary measure of wellness. Heart rate variability is an easy way to predict when someone is experiencing fatigue, a common Long COVID complaint.

Visible creates a record of a person’s heart rate producing a score of between 1 and 10. A high score (8 to 10) means you are doing okay. A median score (4 to 6) suggests the need to take a break from daily routines. And a low score (1 or 2) indicates rest should be a priority. Visible co-creator, Harry Leeming, a Long COVID sufferer since September 2020, believes the app will give researchers a better understanding of Long COVID. The data is being shared with researchers at Imperial College London.

One Long COVID sufferer, Mike Clarke, a 44-year-old, has been living with the aftermath of the virus since October 2020. The strain on his heart on many days produces low Visible scores and he has used the data to tell him when he needs to be lying down. In an MIT Technology Review article, Clarke states “after two years of doctors telling me all medical tests showed that everything in my body was fine, I’ve felt more validated by the data from Visible in a week and a half of use.” He continued, “After two years with absolutely no progress, most people like me with Long COVID are desperate for someone or something to offer hope. To me, the Visible app provides me little glimpses of that.”

Today, more than 100 million are living with Long COVID and debilitating chronic conditions like Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome (ME/CFS). Visible with its wearable technology and telephone app may prove to be a way to make these once “invisible” chronic illnesses visible and give the profession the means to defeat them.

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