#pasc

[pandemic-info]

Why You Should Rest If You Have COVID-19 | Time

[myalgicencephalomyelitiscfstom]

Fascinating long Covid research study from the Netherlands published in early January. Image is from Guardian article: "Long Covid causes changes in body that make exercise debilitating – study. Experts say severe muscle damage, mitochondrial problems and microclots may explain impact of working out"

Full research paper can be read here: "Muscle abnormalities worsen after post-exertional malaise in long COVID"

"This study highlights novel pathways that help to understand the pathophysiology of post-exertional malaise in patients suffering from long COVID and other post-infectious diseases."

Press release:

Discussion thread on the Science for ME forum

Twitter thread by corresponding author:

Includes: "We are now seeing if something similar happens in patients with ME, and hope to include muscle biopsies from patients with severe ME as well in the near future"

"This collaboration between @amsterdamumc, @VUamsterdam , @VU_FGB, and @AMSmovement would not have been possible without the help of so many students, colleagues, and private funders. We also acknowledge the contribution of @PlzSolveCFS , Patient-Led Research Collaborative , and @ZonMw for future work! 2/m"

"Professor Steve Griffin, of Leeds University, said the study suggests “the approach to treating conditions such as long Covid, ME and CFS [myalgic encephalomyelitis and chronic fatigue syndrome] using graded exercise regimens is entirely flawed. Moreover, it appears that over-exercising under these circumstances is actually directly damaging”."

[covid-safer-hotties]

Specific persistent symptoms of COVID-19 and associations with reinfection: a community-based survey study in southern China - Published Sept 2, 2024

Background: Surveillance remains fundamental to understanding the changes in epidemiological patterns regarding post-COVID conditions and reinfections. Persistent symptoms and reinfection in previously infected individuals are increasing being reported in many countries, but their associations among general populations were seldomly reported. Understanding the association with persistent symptoms of COVID-19 reinfection is essential to develop strategies to mitigate the long-term health and socio-economic impacts of the post-COVID conditions. This study aimed to investigate the incidence of COVID-19 persistent symptoms among previously infected Chinese community residents and explore associations of specific COVID-19 persistent symptoms with reinfection and other factors.

Methods: A community-based survey was conducted in a southern city of China with about 20 million residents from August 3 to 24, 2023. Face-to-face questionnaires were distributed to a total of 1,485 residents to collect their information about COVID-19 infection, reinfection, specific ongoing persistent symptoms, and other COVID-19 related information. Multivariable logistic regression analysis was used to examine the association between specific persistent symptoms and reinfection of COVID-19, along with age, gender, and educational level.

Results: Of the 1,485 participants, 1,089 (73.3%) reported they had been infected with COVID-19. Among them, 89.1% reported having ongoing persistent symptoms and 14.2% reported had two or more times of infection. About 20% participants were infected 1 year or more since their initial infection. Fatigue, cough, and headaches were the top 3 symptoms being reported. Participants with reinfection were associated with a higher probability of reporting headaches (OR: 1.54, 95% CI: 1.06–2.25), loss of or change in smell and/or taste (OR: 1.90, 95% CI: 1.27–2.83), impaired sleep (OR: 1.55, 95% CI: 1.02–2.35), and brain fog (OR: 1.76, 95% CI: 1.12–2.76). Participants aged 45 and above and who had a bachelor’s or higher degree were more likely to report chest tightness or shortness of breath, impaired sleep, and brain fog.

Discussion: During the post-emergency period of COVID-19 pandemic, the incidence of ongoing persistent symptoms among Chinese residents remains high. Individuals whose initial infection was longer than 1 year have the highest probability of reporting having multiple symptoms. Reinfection may increase the risk of reporting headaches, loss of or change in smell and/or taste, impaired sleep, and brain fog. It is important to maintain routine syndromic surveillance among previously infected people and provide recommendations for clinical management of individuals with multiple ongoing symptoms.

[disasterhimbo]

This is super specific but ever since I had covid, I misspell homophones (like two/to/too and there/their/they’re) and this NEVER used to happen to me before, spelling has always come naturally to me, and basically I was just wondering if anyone else has had a similar experience?

Edit: I said two/to/two instead of two/to/too. I made the mistake in the fucking post.

[radiant-flutterbun]

What is the deal with Deella :O how long has she been doing what she does?

Deella's deal is she wants to make Sornieth a safer place by killing Shade entities and developing vaccines!

She's been doing vaccine research since she was a teen, but only joined the Shade Chasers sometime later as a young adult. She's only been their leader for the last five years

[longhaulerbear]

Recent trials studying IVIG as a treatment for acute COVID-19 have produced mixed results. IVIG is being explored as a potential treatment for PASC, with initial small cohort studies reporting beneficial results and clinical trials currently underway in larger cohorts. Interestingly, investigations probing the efficacy of IVIG in treating PASC have demonstrated conflicting results. Some studies have reported that IVIG may be efficacious in treating conditions associated with PASC (Boehm and Packer, 2022), while others have found no significant effect (Sakoulas et al., 2020, Tabarsi et al., 2021, Xiang et al., 2021). Research is ongoing to demonstrate the efficacy of IVIG in treating these conditions and further studies will be necessary to fully understand its mechanisms of action and optimal dosing regimen. Access to IVIG is often hindered by insurance coverage limitations and high treatment costs. Insurance criteria and restrictions can make it difficult for patients to obtain coverage for IVIG, often requiring pre-authorization forms or extensive documentation to approve IVIG administration. Meanwhile, the high cost of the treatment puts it out of reach for those who are refused full coverage. The biological mechanism underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), is not entirely clear. However, the link between ME/CFS and other autoimmune conditions is well established. Further, prior work suggests that, in some patients, there may be an autoimmune etiology for this condition, as in PASC (Sotzny et al., 2018). Multiple studies have demonstrated a rise in various B-cell phenotypes associated with ME. Tirelli et al. first reported increases in the number of CD19 + cells (Tirelli et al., 1994). In 2013, Bradley et al. demonstrated heightened numbers of naive and transitional B-cells (Bradley et al., 2013). Notably, elevated numbers in CD24 + cells, which are seen in other autoimmune conditions such as MS, rheumatoid arthritis, and systemic lupus erythematosus, have also been reported in ME/CFS (Mensah et al., 2016). The same study also found increased IgG levels in patients’ CSF. Finally, autoantibodies have been reported in patients with ME, including one study that found that 52 % of patients (n = 60) had antinuclear antibodies. (Konstantinov et al., 1996). In 2015, a phase II clinical trial demonstrated that B-cell depletion is efficacious in treating ME/CFS in over 50 % of patients (Fluge et al., 2015). Interestingly, IVIG was capable of depressing B-cell levels, with one study finding that IVIG can suppress B-cells in MS patients and another demonstrating that IVIG can induce selective B-cell depletion in patients with common variable immunodeficiency There is a wide spectrum of immunological disturbances associated with acute COVID-19. As IVIG can replenish IgG, inhibit the complement system, and prevent the formation of membrane attack complexes, as well as neutralize inflammatory cytokines and dampen macrophage and microglial activation (see Fig. 1), its use has been welcomed as an acute therapy in COVID-19, although trial results continue to be debated both ME/CFS and PASC share a potentially “autoimmune nature” that is not well characterized.

[theradicalscholar]

🌡️⚖️ Bacterial Pneumonia: Lessons from the Past, Relevance to COVID-19 🦠🔍

The 1918 influenza pandemic taught us about the significant role of bacterial pneumonia, overshadowing the primary viral infection. This knowledge remains relevant to COVID-19.

🧪 Unveiling the Evidence: Autopsy findings showed that secondary bacterial infections were the primary cause of death during the 1918 pandemic.

⚙️ Viral-Bacterial Interplay: Combining influenza viruses with bacteria led to severe disease, highlighting their synergistic effects.

💡 Pandemic Preparedness: Recognizing the importance of bacterial pneumonia is vital in preparing for future outbreaks. Preventing, diagnosing, and treating bacterial pneumonia should be prioritized.

😷 Finding Balance: While masks are essential in curbing the spread of COVID-19, excessive and indiscriminate usage may have drawbacks. Research has raised concerns about certain mask types potentially increasing respiratory infections.

💪 Navigating Complexity: We need a comprehensive approach that balances mask usage with overall health considerations to create a resilient society.

🌍🤝 Building a Healthier Future: By learning from history, we can prioritize public health, prepare for future pandemics, and minimize unintended consequences. Let's stay vigilant and #StopTheSpread.

[marbledaesthetics]

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pasc | 20 | she/they | bi | CST/CDT

hi! i'm pasc (short for pascale) and i write things sometimes. requests are open and responses are slow. i'm in nursing school during the standard fall/spring semesters, and i work full time on school breaks so i don't always have as much time or motivation to write as i'd like to

my asks and messages are always open, so come talk to me! i love talking to you guys sm! i leave my asks open even when requests are closed, so you can always reach out. please preface with content warnings if you are discussing sensitive topics (sa, si/sh, substance use, etc) i'm willing to talk about them but i need to prepare myself/be in a good headspace

All that being said, please just be nice. I’m willing to take criticism, but random hate is going to get blocked fast. On the blocking topic: racism, homophobia, transphobia, islamophobia, antisemitism, and other general bigotry is not welcome here. this blog supports a free palestine. if you’re being an dick, i’ll block you. if you look like a bot, i'll block you.

this is not a strictly 18+ account, but if you are a minor: please do not interact with any works labeled as smut or 18+. i try to tag all of these as "mdni" (minors: do not interact). i understand that you feel mature enough to consume sexual content. i also read smut before i was 18. that being said: interacting with sexual content in adult spaces will expose you to predators. it is a US crime to allow you to interact. if you don't have an age in your bio or pinned/are underage, you will be blocked.

if you are strictly a NSFW blog/have no interest in SFW content, please interact with/follow my nsfw sideblog: darkeraesthetics. strictly NSFW blogs following this account will be directed to my sideblog and blocked if they continue to follow here.

my works

i'm always cycling through fandoms so if you want to see something but you don't know if i watch it, feel free to ask! i no longer write for 5SOS or EST19XX (honestly i probably won't do most RPF anymore, it's just not my thing). current fandoms: mainly top gun/tgm, outer range (rhett), and some criminal minds. i've been rereading the pjo books and hunger games so i might chatter about them as well!

request guidelines:

note: the length of a fic pretty much always depends on how inspired i am. you can ask for thoughts/headcanons vs narrative/fic, but whether something ends up a blurb or a one-shot is up to me and the motivation goblin in my brain please preface with content warnings if you are requesting a sensitive topic (sa, substance use, sh/si, etc) hard limits (i will NOT write these, they may be mentioned in kink negotiations as hard no's for a character): scat, weaponry/threat play, incest, anything involving minors, sexual age play (i'll add as need) i will write about nonsexual age-regression (i personally age regress and combining this with explicit content makes me v uncomfy) any prompt lists i reblog are fair game! similarly, you can make a request with a custom prompt remember that responses will be sloooowwww

i currently only post with the username “marbledaesthetics” so please tell me if you see someone else reposting my work! (if you are looking to do any kind of translation or spin off piece, please message me first!) i edit all my longer pieces extensively before posting, but if there is a typo or a broken link somewhere, feel free to let me know so i can edit it. I want this to be a safe place for everyone, so if you ever need me to tag something or add a warning that I missed, please tell me!

[blindedbythedarkness]

Dear future me

It's New Years Eve 2023 right now, and I feel sad thinking about all the NYEs that have come before. For a few years, I saw in the new year via zoom with 2 close friends and we chatted well past midnight. This year, I haven't spoken to one of those friends in 6 months, and the other seems so distracted with their own things. And I know I certainly won't be able to stay up until midnight, I'll be pushing it after 9pm.

This year has been long and hard. I'm proud of myself for everything I've achieved, but it's not been without almost constant struggle. I smashed my med school exams, lived at the hospital for 6 months whilst on placement, and then was ultimately infected with SARS-COV2. That left me with worsened autonomic dysfunction, CCI, generalised hyperinflammation and neuroinflammation. And that sucks.

After making the most of Christmas, yesterday I spent the day horizontal in bed all day, save for eating and going to the toilet. I have a list of things I need to do, and a longer list of things I want to do, but I had to write off the whole lot. Again. Today, though there's a little improvement, I'd still say I feel like shit warmed up.

The world right now doesn't feel much more positive either. Covid JN1 is surging, and despite renewed recommendations from the WHO for healthcare facilities to bring back masks, the UKHSA is dragging its feet. There's no doubt anymore that they're not following the science. They get away with it though, as no lawyers are willing to fight the case (as I have found, time and again).

Everyone is ill with "the worst cold ever". There's so many stories about young people dropping dead. But people refuse to connect the dots, or connect them wrong and blame the vaccine. Public Health has abandoned us all to eugenics.

The final result? I dread going to visit my nearly 90 year old gran next month as either one of us could infect the other and finish them off. I know if I don't go though, I'll feel endlessly guilty (and be endlessly guilted). I live in a constant state of high stress.

This time last year, I don't think I had high hopes for 2023. I figured it would get worse before it gets better, but 2024 might see improvements. I was certainly right that it's got worse, but I'm less certain next year will be better- the world is so stubborn and unwilling to open its eyes. I think maybe by 2025? But who knows, maybe that's what I'll say now for every year of my life. Always "maybe the next year, maybe the next year".

Either way, I hope for me personally I'm in a better place by next New Year's. I hope my long covid is vastly improved and that I'm back on placement and coping well. I also hope I haven't been reinfected and I'm managing to stand my ground on any issues people take with me keeping myself safe. I hope that I am more hopeful.

That's all I will say for now, as honestly just writing this has tired me out! But me, I love you, you're doing the best you can and its a damn sight better than a lot of people. You can do this. Keep going. It's a marathon not a sprint.

C

[sonyapassesthebar]

I didn’t take the exam this time around.

I spent the day before with my husband. He was getting an MRI to look for pulmonary embolism.

I spent the day after with my husband. He was seeing a neurologist to seek treatment for his myriad neurological problems from Long Covid.

And I am having an IBD flare. But I didn’t get anywhere near my requested accommodations.

Maybe I can get the time extension by getting a new gynecologist (my gynes keep leaving their practice…)

Here is to hoping.

[lemmming]

I swear to god the fucking long covid clinics GOTTA be purposefully trying to not see patients at this point. I went to schedule with my doc, got my appointment cancelled 2 minutes before it started, told that the doc wants 40 min appointments instead of 20 and that's why (and also that she has to only do them on one certain day of the week for some reason???).

The long covid appointment is over 2 months out!!!!

Meanwhile her openings for tomorrow look like this :) And most other days are the same :)

[pandemic-info]

(via If we don't develop a treatment we're f*cked)

“Not to be a downer, but this is the result of a study researches led at the University of Toronto following SARS1 patients who were disabled by the virus initially and how they were doing 20 years later.“

Screenshot “from the presentation by; Prof. Daniel M. Altmann, Department of Immunology and Inflammation, Imperial College, Faculty of Medicine, London, UK at #UniteToFight2024 https://unitetofight2024.world/program/”

+ important comment:

“A study on SARS 1 survivors, if you're curious:

2023 study in The Lancet on SARS 1 survivors

Lots had femoral necrosis (bone death), osteoporosis, and long-lasting, possibly immunologically-based fatigue.

Just a reminder that while there are similarities, these are two different diseases. SARS CoV 1 hospitalized 70% of infected and killed 10% at the time of containment. They're similar in disease profile and in genetics, but they are NOT the same.

COVID-19 is much more infectious and less lethal, and the range of post-viral complications is different. Plus, we don't know what treatments will come out for Long COVID patients, but medicine is much more advanced and there is much more funding for Long COVID than there was for SARS CoV 1 survivors, who were infected in 2003, and never had access to a vaccine.”

[myalgicencephalomyelitiscfstom]

[covid-safer-hotties]

Also preserved on our archive

By Sabra Gibbens, MD

It wasn’t always lonely out here. I have been the only permanent doctor in my little country clinic north of Kingston for eight years now, and I previously felt tremendous camaraderie and connection with my hospital-based specialist colleagues and other family physicians in the area. But in the past two years, I have begun to feel alone.

My diagnosis of long COVID came in 2022, after months of investigations. The results of the bloodwork, pulmonary function tests, sleep study, head CT, Holter, and exercise stress tests all came back normal. When I met with a cardiologist to review my symptoms and the abnormal echocardiogram, she confirmed that the persistent shortness of breath, postexertion malaise, insomnia, headaches, and brain fog were caused by long COVID. She never attributed them to anxiety. I was grateful for the validation.

Thankfully, my symptoms have largely improved over the past two years, but because of this experience, I take prevention seriously. I am the weirdo who still requires masks or respirators for all staff and patients in the clinic. I am the outlier who has HEPA filters in the waiting room and exam rooms, who monitors CO2 with my air quality monitor, who cracks the windows, and who asks patients with respiratory symptoms to do rapid SARS-CoV-2 tests at home before they come in.

The primary focus of public health throughout the pandemic has been to prevent severe acute disease and to preserve hospital capacity. Prevention of long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), has always seemed like an afterthought, if it gets mentioned at all.

Why do emergency department reports and hospital discharge summaries not mention that my patient tested positive for SARS-CoV-2 (or had “a really bad cold” or “the worst flu ever”) 1 month before they presented to hospital with weakness, falls, confusion, dyspnea, heart failure, acute kidney injury, or non–ST-elevation myocardial infarction? Doesn’t that seem relevant? It does to me.

With the blessing of provincial medical officers of health and regional public health units, most institutions and the general public have adopted the “vax and relax” strategy, When it comes to COVID-19, most public health officials seem more concerned with meeting people where they are and with keeping people calm than with informing and guiding people about risks to their health. I wish I didn’t, but I now have doubts about the willingness of these officials to inform and guide physicians and the public about the next epidemic or pandemic.

The department of family medicine where I trained, as well as most family medicine clinics in my area, made masking and other precautions optional long ago. How quickly optional became rare, then peculiar.

In February 2023, I attended a recruiting event with dozens of local family physicians and residents. Rates of SARS-CoV-2 infections and wastewater levels were very high in our region at that time, so I wore a KN95 respirator. I did not expect to be the only one, but I was. Dang. Awkward.

Social media constantly reminds me that most of the medical community has moved on. It’s a steady stream of pictures of parties and crowded conferences and medical school classes with no one masking. My feed is occasionally interrupted by posts from similarly COVID-conscious physicians who are trying their best not to get COVID-19 or transmit it to patients under their care. Scattered across the Twitterverse, each one of us is a little island of perseverance.

I stopped attending in-person medical events because it is psychologically too difficult. I expect to be the only one masking in the movie theatre or grocery store, but among physician peers? Did they not get the memo? Did I not get the memo?

It wasn’t just one memo; 24 000 papers on the sequalae of COVID-19 have been published since the pandemic started.1 The British Medical Journal published an update on long COVID for primary care in September 2022, and guidance includes a time- and resource-intensive protocol for bloodwork, stress tests, pulmonary function tests, CT scans, and specialist consultations.2 Ontario Health published summary guidance for primary care regarding PASC in December 2022, but it has not been updated.3 The absence of any newer guidance suggests that interest in or funding for this topic has dwindled.

Anyway, I’m headed to a conference in a sunny place next week. It’s mostly an excuse to get away with my family while I brush up on some topics of interest. Of course, I am packing respirators, a CO2 monitor, and a portable HEPA filter. Weirdo? Outlier? Yep. Don’t care. Maybe I feel comfortable doing that for this conference because I’m unlikely to have any ongoing relationship with the other conference attendees. I care more about preserving my health so that I can continue practising medicine, taking care of my community, and enjoying my family than what others might think of me.

I do miss the camaraderie. What would it take to get that back? I had been hoping that the whole medical community would come together to advocate for clean-air standards, masking to protect against airborne pathogens, better vaccines, diagnostics, and therapeutics for PASC. I now realize this is unlikely to happen. I cannot wait for the world to change. I’ve got to find something in me, a mindset that will enable the reconnection, the old sense of belonging and shared purpose. I’m looking. I’ll keep looking.

References ↵Al-Aly Z. Long COVID puzzle pieces are falling into place — the picture is unsettling. The Conversation 2024 July 18. Available: theconversation.com/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759 (accessed 2024 July 25).

↵Greenhalgh T, Sivan M, Delaney B, et al. Long covid: an update for primary care. BMJ 2022;378:e072117. doi:10.1136/bmj-2022-072117.

↵Post-COVID-19 condition: guidance for primary care. Toronto: Ontario Health; 2022. Available: www.ontariohealth.ca/sites/ontariohealth/files/2021-12/PostCovidConditionsClinicalGuidance_EN.pdf (accessed 2024 Aug. 5).

[violetdisasterzone]

"I wish it was worse so I'd have an excuse to show it/ask for help" or maybe it's enough already. ANYTHING is enough. you don't need an excuse, you already have a reason. you should not be in pain at all and you do not deserve to suffer any amount that is preventable

[radiant-flutterbun]

🥑

🥑Show off your most underrated lore dragon, and talk about them!

Oof ok. The downfall of having a lot of dragons is that could apply to most of them.

Monachopsis is a dragon I rarely talk about so I'll give him some time to shine. He was born with a condition that causes acid to ooze from his scales. He cannot touch other dragons because of this.

He has found that the acid has great affect on killing Shade creatures, so he joined the PASC to aid them in their mission of eradicating the Shade.

Despite his appearance and job however, his personality is gentle and sweet, and most often he spends his time in the PASC keeping his teammate Evarado's violence in check.