Analysis of fat oxidation capacity during cardiopulmonary exercise testing indicates long-lasting metabolic disturbance in patients with post-covid-19 syndrome
Post-COVID-19 Syndrome (PCS) is characterized by symptoms including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. The mechanisms underlying the onset and severity of PCS point to mitochondrial dysfunction as significant contributor. This study examined fat oxidation as a function of mitochondrial capacity during exercise.
Methods
Single-center prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and assessment of fatigue using questionnaires were performed at admission and discharge. Detailed spirometric breath-by-breath data were used to calculate substrate oxidation rates.
Results
Patients (N = 187; 38 % women; 49.7 ± 11.4 years) were referred to rehabilitation 253.4 ± 130.6 days after infection. Lead symptoms included fatigue/exercise intolerance (79.9 %), shortness of breath (77.0 %), and cognitive dysfunction (55.1 %). Fat oxidation capacity was disturbed in PCS patients overall (AUC: 11.3 [10.7–11.9]) compared to healthy controls (p 0.0001), with hospitalization during acute infection predicting the level of disturbance (p 0.0001). Low exercise capacity and high fatigue scores resulted in reduced fat oxidation (both p 0.0001). In particular, younger males were affected by significantly reduced fat oxidation capacity (sex: p = 0.002; age: p 0.001). Metabolic disturbance was significantly improved during exercise-based rehabilitation (AUC: 14.9 [14.4–15.4]; p 0.0001), even for the group of younger impaired males (+44.2 %; p 0.0001). Carbohydrate oxidation was not impaired.
Conclusions
PCS-specific restrictions in fat oxidation may indicate persistent mitochondrial dysfunction. Clinical assessment of PCS patients should include detailed breath-by-breath analysis during exercise to identify metabolic alterations especially in the group of younger males identified in this report. Exercise-based rehabilitation results in improved exercise capacity and fat oxidation and thus likely mitochondrial function. Clinical Trials: NCT06468722.
Alice in Wonderland Syndrome in children with SARS-CoV-2 infection: a case series of two patients in an Italian hospital
Alice in Wonderland Syndrome (AIWS) is a disorienting neurological condition that affects human perception to the senses of vision, hearing, touch, se…
In vitro analysis suggests that SARS-CoV-2 infection differentially modulates cancer-like phenotypes and cytokine expression in colorectal and prostate cancer cells
Scientific Reports - In vitro analysis suggests that SARS-CoV-2 infection differentially modulates cancer-like phenotypes and cytokine expression in colorectal and prostate cancer cells
Post-acute COVID-19 syndrome: prevalence of peripheral microvascular endothelial dysfunction and associations with NT-proBNP dynamics
Post-acute COVID-19 syndrome (PACS) has been linked to microvascular endothelial dysfunction as a potential underlying pathomechanism and can manifest even following a mild course of the initial infection. Prevalence of microvascular endothelial dysfunction and circulating natriuretic peptides in such PACS patients remains unknown.
Methods and results
This prospective, cross-sectional cohort study enrolled 92 patients (82% females, median age 48 years) with PACS. Reactive hyperemia index (RHI) was evaluated with peripheral arterial tonometry where 1.67 was defined as microvascular endothelial dysfunction, 1.67-2.0 impaired- and 2 normal endothelial function, on average 31 months after the acute infection. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were collected at two different time points within over 1-year span. In total, 41% of PACS subjects had microvascular endothelial dysfunction and 20% had impaired RHI. No major differences in clinical characteristics, routine chemistry laboratory testing or symptom burden were observed across the groups. Only subjects with microvascular endothelial dysfunction and impaired endothelial function had a significant increase in NT-proBNP levels over time and those with larger increase in NT-proBNP had significantly lower RHI. There was a significant correlation between relative or absolute increase in NT-proBNP and RHI, which remained significant in a multivariable adjusted linear regression.
Conclusions
Peripheral microvascular endothelial dysfunction was prevalent in a symptomatic PACS population long after recovery from a mild acute infection. Increases in NT-proBNP levels were associated with microvascular endothelial dysfunction, suggesting a link between and providing a foundation for future studies on post viral microvascular endothelial dysfunction in PACS.
Efficacy of Air Cleaning Units for preventing SARS-CoV-2 and other hospital-acquired infections on medicine for older people wards: A quasi-experimental controlled before-and- after study
Nosocomial infections are costly and airborne transmission is increasingly recognised as important for spread. Air Cleaning Units (ACUs) may reduce transmission but little research has focused on their effectiveness on open wards.
Aim
Assess whether ACUs reduce nosocomial SARS-CoV-2, or other, infections on older adult inpatient wards.
Methods
Quasi-experimental before-after study on two intervention-control ward pairs in a UK teaching hospital. Infections were identified using routinely collected electronic health records data during one year of ACU implementation and the preceding year (“core study period”). Extended analyses included 6 months additional data from one ward pair following ACU removal. Hazard ratios (HR) were estimated through Cox regression controlling for age, sex, ward and background infection risk. Time the ACUs were switched on was also recorded for intervention ward 2.
Findings
ACUs were initially feasible but compliance reduced towards the end of the study (average operation in first vs second half of ACU time on intervention ward 2: 77% vs 53%). 8171 admissions 48hrs (6112 patients, median age 85yrs) were included. Overall, incidence of ward-acquired SARS-CoV-2 was 3.8%. ACU implementation was associated with a non-significant trend of lower hazard for SARS-CoV-2 infection (HR core study period 0.90, 95% CI 0.53, 1.52; extended study period 0.78, 95% CI 0.53, 1.14). Only 1.5% of admissions resulted in other notable ward-acquired infections.
Conclusion
ACUs may reduce SARS-CoV-2 infection to a clinically-meaningfully degree. Larger studies could reduce uncertainty, perhaps using a cross-over design, and factors influencing acceptability to staff and patients should be further explored.
This is the 5th year of the pandemic in the Let It Rip Kingdom of Sweden. Everyone is constantly reinfected w/ the immune damaging SARS-CoV-2.
Respiratory virus/bacteria infections like Rhino/Enterovirus, Adenovirus, Mycoplasma pneumoniae or Pertussis are skyrocketing.
🧵1/
— Joanna Teglund🕊️🍉Human life is sacred😷 (@JoannaTeglund)
Why do People Stop Masking After They Get Covid…and How Should These Changes Inform Our Own?
Lately, I’ve been seeing a lot of posts on social media that ask “why do people who were masking suddenly stop after having covid?” This is definitely “a thing” – one that I’ve seen occur among man…
What about the mRNA vaccines—they produce a spike protein, so can they also cause this problem? Nope!
The spike design used in the vaccines has a couple of tweaks to make it more stable, and those changes prevent it the vaccine-based spike protein from causing cell fusion!
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— Nick #RespiratorsFilterPathogens😷 Anderegg (@NickAnderegg)
Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia
Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acut...
Der Krankenstand in Rheinland-Pfalz ist insgesamt im ersten Halbjahr weiter gestiegen. Laut AOK ist als bemerkenswerter Aspekt festzustellen, dass die AU-Fälle der Atemwegserkrankungen in Rheinland-Pfalz seit dem ersten Halbjahr 2021 bis 2024 um beachtliche 17,2 Prozentpunkte angestiegen sind. Atemwegserkrankungen verursachen mehr als ein Viertel aller AU-Fälle und haben sich in den vergangenen drei Jahren knapp verdreifacht.
HOW CAN WE BLOCK SARS-CoV-2 INFECTION (treatments) ?
In this mega-thread🧵, you'll discover various treatments, including some still under investigation for their potential to stop infections.
— Emmanuel (@ejustin46)
Brain Frontal-Lobe Misery Perfusion in COVID-19 ICU Survivors: An MRI Pilot Study
Post-acute COVID-19 syndrome (PCS) is highly prevalent. Critically ill patients requiring intensive care unit (ICU) admission are at a higher risk of developing PCS. The mechanisms underlying PCS are still under investigation and may involve microvascular damage in the brain. Cerebral misery perfusion, characterized by reduced cerebral blood flow (CBF) and elevated oxygen extraction fraction (OEF) in affected brain areas, has been demonstrated in cerebrovascular diseases such as carotid occlusion and stroke. This pilot study aimed to examine whether COVID-19 ICU survivors exhibited regional misery perfusion, indicating cerebral microvascular damage. In total, 7 COVID-19 ICU survivors (4 female, 20–77 years old) and 19 age- and sex-matched healthy controls (12 female, 22–77 years old) were studied. The average interval between ICU admission and the MRI scan was 118.6 ± 30.3 days. The regional OEF was measured using a recently developed technique, accelerated T2-relaxation-under-phase-contrast MRI, while the regional CBF was assessed using pseudo-continuous arterial spin labeling. COVID-19 ICU survivors exhibited elevated OEF (β = 5.21 ± 2.48%, p = 0.047) and reduced relative CBF (β = −0.083 ± 0.025, p = 0.003) in the frontal lobe compared to healthy controls. In conclusion, misery perfusion was observed in the frontal lobe of COVID-19 ICU survivors, suggesting microvascular damage in this critical brain area for high-level cognitive functions that are known to manifest deficits in PCS. Physiological biomarkers such as OEF and CBF may provide new tools to improve the understanding and treatment of PCS.
Zero-covid advocacy during the COVID-19 pandemic: a case study of views on Twitter/X
Monash Bioethics Review - During the COVID-19 pandemic, many advocacy groups and individuals criticized governments on social media for doing either too much or too little to mitigate the pandemic....
Resonant breathing improves self-reported symptoms and wellbeing in people with Long COVID
Introduction Long COVID involves debilitating symptoms, many of which mirror those observed with dysautonomia, and care must be taken with traditional autonomic rehabilitation to avoid post-exertional malaise/post-exertional symptom exacerbation. Resonant breathing exercises require less exertion and can potentially improve autonomic function. The objective of this work was to report on the impact of a resonant breathing program on self-reported symptoms and wellbeing in people with Long COVID. Methods A retrospective analysis of de-identified data was completed in a convenience sample of people with Long Covid, who participated in the Meo Health (formerly known as Stasis HP) resonant breathing program. Participants completed baseline and follow up surveys. Results Data were available for 99 participants. Most measures of symptoms and wellbeing improved at follow up, with the largest differences per participant seen in sense of wellness (47.3%, p
COVID-19 and Carcinogenesis: Exploring the Hidden Links
The COVID-19 pandemic caused by the SARS-CoV-2 virus has been studied predominantly in terms of its immediate respiratory and systemic effects. However, emerging evidence suggests possible long-...
Cohort study of cardiovascular safety of different COVID-19 vaccination doses among 46 million adults in England
Nature Communications - COVID-19 vaccines have been associated with rare cardiovascular and thrombotic complications. Here, the authors use population-based longitudinal electronic health record...
Changes in memory and cognition during the SARS-CoV-2 human challenge study
These results support larger cross sectional findings indicating that mild Wildtype SARS-CoV-2 infection can be followed by small changes in cognition and memory that persist for at least a year. The mechanistic basis and clinical implications of these small changes remain unclear.
