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#LongCovid

116 posts74 participants9 posts today
medRxiv · Brainstem Reduction and Deformation in the 4th Ventricle Cerebellar Peduncles in Long COVID Patients: Insights into Neuroinflammatory Sequelae and "Broken Bridge Syndrome"Post-COVID Syndrome (PCS), also known as Long COVID, is characterized by persistent and often debilitating neurological sequelae, including fatigue, cognitive dysfunction, motor deficits, and autonomic dysregulation (Dani et al., 2021). This study investigates structural and functional alterations in the brainstem and cerebellar peduncles of individuals with PCS using diffusion tensor imaging (DTI) and volumetric analysis. Forty-four PCS patients (15 bedridden) and 14 healthy controls underwent neuroimaging. Volumetric analysis focused on 22 brainstem regions, including the superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP), periaqueductal gray (PAG), and midbrain reticular formation (mRt). Significant volume reductions were observed in the SCP (p < .001, Hedges' g = 3.31) and MCP (p < .001, Hedges' g = 1.77), alongside decreased fractional anisotropy (FA) in the MCP, indicative of impaired white matter integrity. FA_Avg fractional anisotropy average tested by FreeSurfer Tracula, is an index of white matter integrity, reflecting axonal fiber density, axonal diameter and myelination. These neuroimaging findings correlated with clinical manifestations of motor incoordination, proprioceptive deficits, and autonomic instability. Furthermore, volume loss in the dorsal raphe (DR) and midbrain reticular formation suggests disruption of pain modulation and sleep-wake cycles, consistent with patient-reported symptoms. Post-mortem studies provide supporting evidence for brainstem involvement in COVID-19. Radtke et al. (2024) reported activation of intracellular signaling pathways and release of immune mediators in brainstem regions of deceased COVID-19 patients, suggesting an attempt to inhibit viral spread. While viral genetic material was detectable, infected neurons were not observed. Matschke et al. (2020) found that microglial activation and cytotoxic T lymphocyte infiltration were predominantly localized to the brainstem and cerebellum, with limited involvement of the frontal lobe. This aligns with clinical observations implicating the brainstem in PCS pathophysiology. Cell specific expression analysis of genes contributing to viral entry (ACE2, TMPRSS2, TPCN2, TMPRSS4, NRP1, CTSL) in the cerebral cortex showed their presence in neurons, glial cells, and endothelial cells, indicating the potential for SARS-CoV-2 infection of these cell types. Associations with autoimmune diseases with specific autoantibodies, including beta 2 and M 2 against G protein coupled alpha 1, beta 1, beta 2 adrenoceptors against angiotensin II type 1 receptor or M1,2,3 mAChR, among others, voltage-gated calcium channels (VGCC) are known (Blitshteyn et al. 2015 and Wallukat and Schminke et al. 2014). These findings support the "Broken Bridge Syndrome" hypothesis, positing that structural disconnections between the brainstem and cerebellum contribute to PCS symptomatology. Furthermore, we propose that chronic activation of the Extended Autonomic System (EAS), encompassing the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, may perpetuate these symptoms (Goldstein, 2020). Perturbations in this system may relate to the elevation of toxic autoantibodies AABs (Beta 2 and M 2), specific epitopes of the COVID virus's SPIKE protein and Cytokine storm of IL-1, IL-6, and IL-8 in their increased numbers (1,000->10,000) Further research is warranted to elucidate the underlying neuroinflammatory mechanisms, EAS dysregulation, and potential therapeutic interventions for PCS. Keywords: Long COVID, Brainstem, Cerebellar Peduncles, Diffusion Tensor Imaging, Neuroinflammation, Broken Bridge Syndrome, Extended Autonomic System (EAS) ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by OTTO Research Group ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: 2022-100867-BO-ff 1. Ethics approval was granted by the Ethics Committee of the Hamburg Medical Association, Germany, on September 5, 2022, under the title "MRI Biomarkers in Chronic Fatigue," by Prof. Dr. Rolf Stahl. 2. The project complies with the ethical and professional requirements. The Ethics Committee approves the project. The Ethics Committee operates on the basis of German law and professional regulations, as well as in accordance with ICH-GCP. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors All data produced in the present work are contained in the manuscript

This is the longest I’ve ever gone without publishing an article, and the stress of not having anything ready is weighing heavy on my heart

It’s ironic considering how often I write about the importance of resting and listening to your body when it needs a break.

I’m so grateful for the Disabled Ginger community, but my body and brain clearly need a break.

I sit down to write everyday, and so far all I have is 30+ drafts with titles, a few images and (at best) two lines of actual content.

This is the harsh reality of chronic illness. It doesn’t matter how much you WANT to do something… if your body says “No”… Its a No.

You can’t try harder your way out of it. You can’t play through the pain.

The more you try to fight your body, the harder and longer the crash.

If you’re struggling to rest right now, take this as a sign to unplug. Relax. Recharge. Give your body what it’s crying out for and do it without the guilt.

We will all be here for you when you’re ready.

Sharing my article on radical rest from the archives, because I need the reminder & maybe so does someone else:

disabledginger.com/p/its-time-

The Disabled Ginger · It's Time to Throw Away the 'Coulda, Woulda, Shouldas' and Practice Radical RestBy Broadwaybabyto

I understand wanting to go 'back to normal'. Pandemics are traumatizing and scary. Of course people want to forget them.

But they don't end when we decide we've had enough. The threat doesn't go away because we have 'Covid fatigue' or because we’re sick of masking.

We must stop denying the reality that Covid is still with us, still killing and still disabling people.

We must work on our collective trauma and push for common sense measures like masks in healthcare, free respirators and tests and clean air in public spaces.

“Back to normal” isn’t working. It’s a mirage. The comfortable lie.

But we can move towards a new normal together. One where everyone is safer and healthier. It’s not too late.

"Cards2Warriors has a special program called Happy Mail, where they send snail mail cards to those [who are ill] who need encouragement & cheer"

Links:
cards2warriors.org/
cards2warriors.org/happy-mail

Image from Institute for Neuro-Immune Medicine e-bulletin

#chronicillness @chronicillness
@spoonies
#chroniclife
#Spoonielife
#hiddenillness
#invisibleillness
#ChronicIllnesses
#Spoonies
#Spoonie
#ChronicallyIll @mecfs
#MEcfs @longcovid
#LongCovid @fibromyalgia
#Fibromyalgia #Fibro #FMS #FM

Replied in thread

@UP8 @llPK It sounds like you are working through your issues, but what the actual fuck? What I study and practice in my “social movements … in disability, pain, suffering, and marginalization” is how to live a happy life despite my disability, how to reduce my pain and suffering, and how to fight back against the marginalization from ablists. Whether it is my autism, long covid, or osteoarthritis, the first step towards a better life was recognizing clearly the challenges I face. This then enabled me to make the changes I need to make to overcome those challenges. Still working on that part, but I could not have come as far as I have without the support of other #actuallyAutistic people and others with #LongCovid.

New US research:

Identifying commonalities & differences between EHR representations of #PASC & ME/CFS in the RECOVER EHR cohort

nature.com/articles/s43856-025

"These findings suggest symptom management approaches to these illnesses could overlap"

@mecfs
#MyalgicEncephalomyelitis #ChronicFatigueSyndrome #MEcfs #CFS #PwME @longcovid
#LongCovid #PwLC #postcovid #postcovid19 #LC #Covidlonghaulers #longhaulers #COVIDBrain #NeuroPASC
@covid19 #Coronavirus
#COVID19 #COVID #COVID_19 #COVIDー19 #SARSCoV2

Covid is no worse than the flu?

I know, I have now led dozens of posts over the past few years with this sarcastic question. But now, with the pandemic officially declared over by the politicians and the majority of the public behaving as though Covid19 is no longer a threat, it seems particularly apropos in light of the reasons for declaring the pandemic over: to get people back to work and back to consuming. Yet, as the data from this study show, Long Covid has had an enormous negative impact on the income and quality of life for millions of Americans, particularly the poor and working class, and particularly for African Americans and women.

*Nearly 1 in 7 working-age adults in the U.S. had experienced Long Covid by the end of 2023
*Socially disadvantaged adults were 152% more likely to suffer from Long Covid
*Groups with higher risk for Long Covid include being Black, LGBTQ, Hispanic, Female, or low income
*In 2022, people with Long Covid lost $211 billion in wages
*In 2023, people with Long Covid lost $218 billion in wages

One reason for the disproportionate effect of Long Covid on marginalized communities, particularly BIPOC and poor people, is that these groups suffer disproportionately from chronically elevated levels of the stress hormone, Cortisol, due to the stress caused by racism, sexism, homophobia, and poverty. Elevated Cortisol levels are also associated with increased risk of heart disease, hypertension, and diabetes, as well as impaired immune function.

For a really good documentary on the Social Determinants of Health and the relationship between racism and poverty on stress/cortisol levels and negative health outcomes, please see the Unnatural Causes video series

cidrap.umn.edu/covid-19/studie

CIDRAPStudies: 1 in 7 US working-age adults report long COVID, with heaviest burden on the poor

A #LongCOVID question for people who might know.

A friend has had a very dramatic drop in iron level over the past few months. Has had #COVID19 at least 3 times. She is chronically tired. The iron level was picked up on routine blood test. She doesn't have any change in bowel habit/bleeding & is post menopausal.

I recall links between iron levels and #LongCOVID; have searched for articles, but if anyone has anything they consider worth sharing with me, it would be appreciated.

Thank you.