Long covid resources

Hi! If you are here you are probably just like myself earlier, are looking for more knowledge around long covid to help yourself or your dear one. My name is Anastasia Mokienko, i live in Oslo Norway. I am a former researcher among other things I do. I have a PhD and I did a research on health care system in Norway. And I was so lucky and got long covid myself (LC). Since the disease is pretty novice, the health care providers across the world are still struggling to give any answers, at least in Norway they do, so I decided to update myself with the recent publications on the topic in hope to find something helpful for diagnostics and treatment. When I am thinking of diagnostics, I think about the root cause – why we get disautonomia, POTs, what happens to our blood, brain, cardio, vestibular, hormonal systems. The disease affects 75% women and as we know research on women has not been funded globally as much as it deserves. Most research projects were performed on men previously. Men as research subjects are easier to control, as there are no hormonal cycles. However those hormonal cycles and childbearing ability and autoimmunity is what some researchers believe, makes us, females, more prone to LC. Interestingly enough but the LC symptoms increase as well between ovulation and period. There is a theory that it could be connected to for example mast cell activation, oestrogen and reaction to histamine.

Below I have gathered a few articles that I found informative on different aspects of LC. It’s not complete yet, but you already may find something useful. And I keep adding more. You are welcome to dig in them and connect to me to discuss as well. It would be nice to make a research article in collaboration knitting things together.

Soon I will as well make a post about my own LC journey and symptoms, what helped me and what not. Keep tuned.

In this page I plan little by little to list out the research and articles that I find to be relevant and share links with you. The page will be open to public as I work on it. Since I have long covid myself i am working on it max 30 min a day, please come back later for the updates. You can also stay in touch through my instagram of fb pages. Feel free to write me say hi and leave your email to receive updates.

If you are a fellow researcher – please write me. I’d love to do something together.

As well I hope when I’m bit more recovered – I will do some short trainings for long COVID patients for activating parasympathetic nerve system. Stay tuned or ask me if it’s already out.

Links:

A must to read for every physician and patient- Review of long COVID findings:

«There are several hypothesized mechanisms for long COVID pathogenesis, including immune dysregulation, microbiota disruption, autoimmunity, clotting and endothelial abnormality, and dysfunctional neurological signalling. EBV, Epstein–Barr virus; HHV-6, human herpesvirus 6»

«Tests …such as total immunoglobulin tests, natural killer cell function tests, the tilt table or NASA lean test, the four-point salivary cortisol test, reactivated herpesvirus panels, small fibre neuropathy biopsy, and tests looking for abnormal brain perfusion96, should instead be prioritized.»

Long COVID: major findings, mechanisms and recommendations | Nature Reviews Microbiology

Hormons:

Hormonal trends in patients suffering from long COVID symptoms – PubMed

Females, estrogen, autoimmunity: Why are women more prone to long Covid?

https://www.theguardian.com/society/2021/jun/13/why-are-women-more-prone-to-long-covid

Estrogene, histamine: The Curious Link Between Estrogen, Mast Cells, and Histamine https://www.larabriden.com/the-curious-link-between-estrogen-and-histamine-intolerance/

Heart

Chronotropic incompetence (CI)

is generally defined as the inability to increase the heart rate (HR) adequately during exercise to match cardiac output to metabolic demands.

Chronotropic Incompetence: Causes, Consequences, and Management

POTs

«PoTS is diagnosed if your heart rate increases by 30 beats a minute (bpm) or more (40bpm in those aged 12 to 19) usually within 10 minutes of standing. This increase continues for more than 30 seconds and is accompanied by other symptoms of PoTS.»

Postural tachycardia syndrome (PoTS) – NHS

POTs: «We’ll review a groundbreaking new study funded by Dysautonomia International that found reduced cartilage and connective tissue biomarkers in POTS, as well as evidence of increased coagulation and inflammation.»

https://onlinelibrary.wiley.com/doi/10.1111/joim.13566

https://www.nature.com/articles/s41598-022-24729-x

“The current proposed pathology for POTS is an inability to regulate blood volume. Researchers suspect that vasomotor denervation causes dilation of the blood vessels, leading to reduced preload to the heart, which triggers an increase in the central sympathetic nervous system response. Resulting symptoms are likely related to inadequate blood circulation and overcompensation by the sympathetic nervous system.”

https://www.hopkinsmedicine.org/news/articles/on-the-heels-of-covid-19-influx-of-patients-with-pots-symptoms

Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies

Hyperandregernic pots

https://www.ahajournals.org/doi/10.1161/01.hyp.0000158259.68614.40?fbclid=IwAR0NA1_ud2qxaqV0Mb3NWHftMZBjhQRCEkZLSYcH06RcSOJD6G7YQRGbIok

Heart rate frequency

iwatch https://no.moyens.net/hvordan/hva-er-hjertefrekvensvariabilitet-hrv-i-apple-watch-og-hvordan-sjekker-jeg-det/

Interbeat Interval – an overview | ScienceDirect Topics

“hjertefrekvensvariasjonen registrerer spesifikke endringer i tid mellom påfølgende hjerteslag. Og tid mellom slag måles i millisekunder (ms) og er kjent som «RR-intervall» eller «inter-beat-intervall (IBI).”

“The sinus node discharge rate depends on a basic intrinsic or constitutional rate for that person as modulated by the speeding influences of sympathetic nervous system firing and the slowing influences of parasympathetic system (vagus nerve) firing upon the sinus node. Thus, a second-by-second recording of heart rate provides a second-by-second record of a balance between sympathetic and parasympathetic nervous system influences on the heart.”

Characterization of cardiac autonomic function in COVID-19 using heart rate variability: a hospital based preliminary observational study

“Reports using HRV to link autonomic dysfunction with infection. Proposed mechanisms of viral infection induced autonomic dysfunction include invasion of the central nervous system and the direct viral, toxin-mediated or immune-mediated involvement of the peripheral and autonomic nervous system

The vagus nerve seems to inform the brain about a peripheral inflammation. As a result, the production of cortisol (causing suppressing the inflammation) is activated through the hypothalamic–pituitary–adrenal axis. The Authors also pointed out that due to the descending efferent vagal-to-sympathetic neural conversion, a subclass of T-cells secrete acetylcholine and the production of inflammatory cytokines by splenic macrophages is limited. When the vagus activity is low, then the inflammatory response can even lead to a ‘cytokine storm’. However, in physiological response, the vagus ‘controls’ the inflammation process.

One of the clinical endpoints of the present study could be the development of a methodology for monitoring post-COVID patients, including the analysis of HRV performed by Holter monitoring. In order to validate the application of HRV measures, we suggest performing studies in groups of patients affected by COVID-19 several months after infection. In our report, the study group was characterized by a mild (or asymptomatic) course of the disease, which may indicate that the statistically significant HRV parameters are sensitive markers for a long-term monitoring of convalescent patients.”

HRV and COVID-19 in athletes. Is there a connection? – Myithlete

Data gathering and explanation

Frontiers | Reduction of Cardiac Autonomic Modulation and Increased Sympathetic Activity by Heart Rate Variability in Patients With Long COVID

“Our findings indicate that long COVID leads to sympathetic excitation influence and parasympathetic reduction. The excitation can increase the heart rate and blood pressure and predispose to cardiovascular complications. Short-term HRV analysis showed good reproducibility to verify the cardiac autonomic involvement.”

JCM | Free Full-Text | Cardiac Autonomic Function in Long COVID-19 Using Heart Rate Variability: An Observational Cross-Sectional Study

Free version of preprint is here: Cardiac Autonomic Function in Long COVID-19 Using Heart Rate Variability: An Observational Cross-Sectional Study[v1] | Preprints

Easy explained HRV: Heart Rate Variability | The Ultimate Guide to HRV | WHOOP

https://elitehrv.com/the-8-biggest-mistakes-made-when-measuring-hrv

Resting heart rate

https://ouraring.com/blog/heart-rate-during-sleep/

Tachycardia

Inappropriate sinus tachycardia in post-COVID-19 syndrome | Scientific Reports

Microclots

https://www0.sun.ac.za/researchforimpact/2022/11/20/breakthrough-work-on-microclots-may-explain-long-covid/?fbclid=IwAR0oG5XXdcIbeCnnTvOQVyCY4f7lIwavbI7cOZDjexgfdYll2W_hxaSJoik

Brain and long COVID

SARS-CoV-2 infection and persistence in the human body and brain at autopsy | Nature

Norsk forskning: Norwegian research project

Hjernehelse ved COVID-19 – Oslo universitetssykehus

Inflammation in the brain

• Inflammation in the brain and nerve cell damage are associated with symptoms of anxiety in long COVID-19 patients, a study finds.

• Both hospitalized and non-hospitalized COVID-19 survivors with symptoms of anxiety showed cognitive impairment and high levels of the biomarkers of brain inflammation.

• The evidence may help validate the experiences of people experiencing neurological symptoms of long COVID-19 and point towards better diagnostic strategies.

https://www.verywellhealth.com/brain-inflammation-long-covid-anxiety-5221661

Long covid diagnostics

Recommended tests:

“COVID EBV activation and load + complete blood count (CBC), electrolytes, metabolites, hepatic function panels, cardiac biomarkers, thyroid panels and D-dimer “ : (11 things doctors have learned about long COVID)

“The team found that blood vessels of those with presumed long COVID were changing rapidly after a confirmed COVID-19 infection. They also found that patients with long COVID had 14 elevated blood biomarkers associate with blood vessels. With the help of machine learning, they discovered that two biomarkers called ANG-1 and P-SEL could be used to classify long COVID with 96 per cent accuracy.”

Frontiers | Saliva antibody-fingerprint of reactivated latent viruses after mild/asymptomatic COVID-19 is unique in patients with myalgic-encephalomyelitis/chronic fatigue syndrome

Causes of long COVID

Treatments

WHO clinical guidelines

https://www.who.int/teams/health-care-readiness/post-covid-19-condition

HBOT

https://www.healthrising.org/blog/2022/12/27/hbot-hyperbaric-oxygen-chronic-fatigue-fibromyalgia-long-covid/

Anti COVID drug

https://www.sciencedaily.com/releases/2022/12/221207142207.htm

Paxclovir and T-cells

https://www.contagionlive.com/view/-long-covid-caused-by-hidden-viral-reservoirs

Norsk: Rehabilitering i Norge

https://www.sunnaas.no/regional-koordinerende-enhet/rehabiliteringstelefonen?fbclid=IwAR3fhaw4YoId4ZxpyNpcuBm0t5MmStLQ8iR-AtC4SiYw_D1h9ucZZV69-qw

Norsk: Korona medisin paxlovir

Coronamedisin snart tilgjengelig på apotekene – VG

Muscles and COVID

“…the progressive reports of aggressive skeletal muscle complications associated with COVID-19, mainly sarcopenia, cachexia, rhabdomyolysis, peripheral neuropathy, and Guillain-Barré syndrome. It is believed that these conditions are prompted predominantly by the cytokine storm triggered by SARS-CoV-2, but a few studies have also indicated an association with ACE2 downregulation, hypoxia, direct viral invasion into the skeletal muscle, and physical inactivity.”

https://www.frontiersin.org/articles/10.3389/fnut.2022.825629/full?fbclid=IwAR3wnl-n9vXRCmTuqZEGmHdnJlkEoU37Dq5EzpWdtJLGgMoV45VK35emzqo#:~:text=It%20has%20been%20determined%20that,rectus%20femoris%20muscle%20(8).

Viral provoked anxiety

https://www.moleculeralabs.com/anxiety-that-will-not-go-away/

Lungs – OBS!

People with long-lasting symptoms of breathlessness after COVID-19 infection may have damage to their lungs that does not show up using routine diagnostic scans, according to a small UK study.

https://pharmaphorum.com/news/new-diagnostic-finds-hidden-lung-damage-in-long-covid/

Fatigue

Supplements and mitochondria

Clinical trials have shown the utility of using oral replacement supplements, such as l-carnitine, alpha-lipoic acid (α-lipoic acid [1,2-dithiolane-3-pentanoic acid]), coenzyme Q10 (CoQ10 [ubiquinone]), reduced nicotinamide adenine dinucleotide (NADH), membrane phospholipids

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566449/

Cold and mitochondria

Exercise and cold exposure promoted increased expression of mitochondrial biogenesis- related genes in soleus muscle.

The effects of exercise and cold exposure on mitochondrial biogenesis in skeletal muscle and white adipose tissue

Mitochondria and D-Ribose

If the mitochondria aren’t receiving enough oxygen, then mitochondrial enhancers might not make a difference. If a hydrogen sulfide imbalance is the issue, then that will have to be dealt with. If free radicals are a problem, then enhancing the mitochondria – the source of many free radicals in the body – could make things worse

D-Ribose levels decline during the low oxygen states which may be present in ME/CFS and FM. When those conditions are present, cells turn to bringing two ADP molecules together to form ATP. The AMP left over is washed out – leaving the cell depleted in purines. Bob Naviaux found reduced purines in ME/CFS.

D-Ribose is able to enhance purine levels. Two non-placebo blinded studies from Dr. Teitelbaum suggest the D-Ribose may be helpful in a number of ways.

https://www.healthrising.org/blog/2020/12/18/5mitochondria-coq10-d-ribose-fibromyalgia-chronic-fatigue-syndrome/

Sound sensitivity

Vestibular Hyperacusis – Vestibular Disorders Association

Detox

Copper

https://revealingfraud.com/2022/04/health/how-to-detox-mercury-with-copper-zinc-selenium/

Podcasts Jason Hommel on his new book, The Copper Revolution

https://podcasts.apple.com/no/podcast/the-ideal-day-podcast/id1457973622?i=1000556262664

Koder i Norge

Fra 2023: «For å markere at noe er en følgetilstand etter en infeksjon skal man som regel bruke en kode fra gruppen Følgetilstander etter infeksjonssykdommer og parasittsykdommer (B90-B94). For covid-19 er det imidlertid innført en egen kode, U09.9 Postinfeksiøs tilstand etter covid-19.
Eksempel: vedvarende hodepine etter vaksinasjon: Kode 1: R51 Hodepine
Kode 2: U09.9 Postinfeksiøs tilstand etter covid-19»

https://www.ehelse.no/kodeverk-terminologi/regler-og-veiledning-for-kliniske-kodeverk-i-spesialisthelsetjenesten-icd-10-ncsp-ncmp-og-ncrp/_/attachment/download/bdcfc750-5ee5-4390-b7a1-cfbce1a7ea29:1d85f0a05967de415ec75c6f83c2057cfebb695a/Kodeveiledning%202023.pdf#page154

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