One of my extended adult chosen family has contracted COVID. He’s fit, healthy, but a Gen X old (approximately) like the rest of us. Perhaps too fit, because he hates hearing that as far as we know, Some of the best ways to avoid Long COVID are to take a 6 week break from any strenuous activity after “recovering” from COVID. This is an attempt to summarize, organize, and make accessible, a roundup of the Twitter threads and journal-published papers, and newspaper coverage I’ve seen that are about our (humanity’s) attempts to understand the group of issues currently understood as “Long COVID”.

I am by no means a doctor, nor am I an epidemiologist, or any kind of medical specialist. I have a technical science degree, Mom was a nurse, Dad another scientist, and I am well-read – able to read and understand most medical journal published papers, especially statistics heavy ones, but also run of the mill papers, as long as I have a good medical dictionary handy. Recently, I got a stem cell transplant to treat leukemia, and am in remission. I hope I don’t have to tell you that being an active cancer patient, actively involved in your own treatment, means you have to pay a lot of attention, and learn medical concepts on the fly. There’s lots of room for good self-advocacy during cancer treatments.

I also follow an uncanny number of Health Care Workers on Twitter, so some of these links will just be Twitter threads by various medical professionals.

I’ll mark my own observations/notes in [] brackets.

• General Resources
  • Summary: The theory right now seems to be that Long COVID is related to a long-term inflammation response related to the mechanisms Sars-Cov-19 triggers while you’re sick with it.
  • In general, advice is to avoid strenuous exercise (anything that gets your heart rate up) for as long as 6 weeks after “recovering” from the flulike symptoms of initial infection (by testing negative in PCR and antibody tests).
  • We still don’t have a LOT of Long COVID studies or data, but articles and studies are beginning to come out.
  • Possible Mechanisms:
    • Oxidative Stress and Hyper-Inflammation as Major Drivers of Severe COVID-19 and Long COVID: Implications for the Benefit of High-Dose Intravenous Vitamin C (Frontiers in Pharmacology, 29 April 2022) [Vitamin C!? Again?]
    • Neurokinin-1 Receptor as a potential drug target for COVID-19 treatment (Biomedicine and Pharmacotherapy, November 2021)
    • Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study (The Lancet, 23 April 2022) [Top correlations seem to be fibrosis and gastrointestinal epithelial inflammation.]
  • New Therapies:
    • Stem Cell Therapy: The Latest Contender in Pharma’s Fight Against Long COVID (BioSpace, 2 May 2022) [Also mentions Pfizer’s Paxlovid.]
    • Alterations in microbiota of patients with COVID-19: potential mechanisms and therapeutic interventions (Nature, 29 April 2022) [fecal microbiota transplantation – FMT]
    • Epipharyngeal Abrasive Therapy (EAT) Has Potential as a Novel Method for Long COVID Treatment (Viruses [journal name], 27 April 2022)
  • Summaries, Round-up Threads:
    • Eric Feigl-Ding, @DrEricDing (Twitter, 27 April 2022)
  • Patient Anecdote:
    • mynamesleurah, @mynamesleurah (Twitter, 26 April 2022)
    • Willow, @__Granuaile__ (Twitter, 1 May 2022)
    • Emma James, @jmojames (Twitter, 3 May 2022)
    • Dame Sa, @LongCovidHell (Twitter, 4 May 2022)
• Cardiovascular Risks and Complications:
  • The COVID Heart—One Year After SARS-CoV-2 Infection, Patients Have an Array of Increased Cardiovascular Risks (JAMA, 2 March 2022)
• Central Nervous System Dysfunction:
  • Covid: 67% of people with long Covid are developing this nervous system disorder (Oh! mymag, 4 May 2022) [‘Dysautonomia is the umbrella term for autonomic nervous system disorders that can cause problems regulating the heart rate and blood pressure, resulting in lightheadedness, palpitations, fainting, debilitating fatigue, cognitive dysfunction, exercise intolerance, headaches, and more.’]
• Cognition and Cognitive Impacts:
  • Superthread by Putrino Lab @PutrinoLab (Twitter, 1 May 2022)
• Inflammation Responses:
  • Hypercoagulability, endotheliopathy, and inflammation approximating 1 year after recovery: Assessing the long-term outcomes in COVID-19 patients (American Journal of Hematology, 28 April 2022)
• Heptatitis:
  • Mysterious Cases of Severe Hepatitis Outbreaks in Children Continue to Rise (Medriva, 28 April 2022)

Feel free to drop me a line with questions. Still looking for the older threads I read that talked about exercise, inflammation, and the possible worsening of Long COVID, which runs counter old medical lore about how good exercise always is to recover from colds and flus. It seems likely not the case with COVID. Epidemiologists and Pulmonologists seem to agree.

(Photo by Pixabay: https://www.pexels.com/photo/bubbles-chemistry-close-up-color-220989/)