Long COVID the Answers

Professor David Putrino is a physiotherapist with a PhD in Neuroscience. He is currently the Director of Rehabilitation Innovation for the Mount Sinai Health System, and a Professor in the Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai. Professor Putrino recently opened the Mount Sinai Cohen Center for Recovery from Complex Chronic Illness in New York also known as (CoRE) and serves as CoRE’s Family Director and is also a member of PolyBio’s Long COVID Research Consortium.Today we talk about the pathophysiology of Long COVID in the context of describing research into targeted treatments for the disease.REFERENCES1 Proal AD, VanElzakkerMB, Aleman S, Bach K, Boribong BP, Buggert M, Cherry S, Chertow DS, Davies HE, Dupont CL, Deeks SG. SARS-CoV-2 reservoir in post-acute sequelae of COVID-19(PASC). Nature Immunology. 2023 Oct;24(10):1616-27.2 Klein J, Wood J,Jaycox JR, Dhodapkar RM, Lu P, Gehlhausen JR, Tabachnikova A, Greene K, Tabacof L, Malik AA, Silva Monteiro V. Distinguishing features of Long COVID identified through immune profiling. Nature. 2023 Nov 2;623(7985):139-48.3 Long COVID low-dose Rapamycin clinical trial4 Lumbrokinase LongCOVID & ME/CFS clinical trial5 Silva J, Takahashi T, Wood J, Lu P, Tabachnikova A, Gehlhausen JR, Greene K,Bhattacharjee B, Monteiro VS, Lucas C, Dhodapkar RM. Sex differences insymptomatology and immune profiles of Long COVID. medRxiv. 2024 Mar 2:2024-02.6 VanElzakker MB, Bues HF, Brusaferri L, Kim M, Saadi D, Ratai EM, Dougherty DD, Loggia ML. Neuroinflammation in post-acute sequelae of COVID-19 (PASC) as assessed by [11C] PBR28 PET correlates with vascular disease measures. Brain, Behavior, and Immunity.7 Fernández-CastañedaA, Lu P, Geraghty AC, Song E, Lee MH, Wood J, O’Dea MR, Dutton S, Shamardani K, Nwangwu K, Mancusi R. Mild respiratory COVID can cause multi-lineage neural cell and myelin dysregulation. Cell. 2022 Jul 7;185(14):2452-68.

Professor Nancy Klimas is interviewed about the mechanisms behind how a nebulised medication caused a remarkable recovery from symptoms of ME/CFS and Long COVID in a small group of individuals and her objective to gain the ability to extend this research into a larger population of people with the hope of finding a viable treatment for these diseases.REFERENCES1 Gil A, Hoag GE, Salerno JP, Hornig M, Klimas N, Selin LK. Identification of CD8 T-cell dysfunction associated with symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID and treatment with a nebulized antioxidant/anti-pathogen agent a restropective case series.2 Long COVID the Answers Episode 6:“PEM, Long COVID & It’s Management featuring Professor Todd Davenport”3 Appelman B, Charlton BT, Goulding RP, Kerkhoff TJ, Breedveld EA, Noort W, Offringa C,Bloemers FW, van Weeghel M, Schomakers BV, Coelho P., Wüst Rob.C Muscle abnormalitiesworsen after post-exertional malaise in long COVID. Nature communications. 2024Jan 4;15(1):1-54 Oldham WM, Lewis GD, Opotowsky AR, Waxman AB, Systrom DM. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing. Pulm Circ. 2016 Mar;6(1):55-62. 5 Joseph P, Arevalo C, Oliveira RKF, Faria-Urbina M, Felsenstein D, Oaklander AL, Systrom DM. Insights From Invasive Cardiopulmonary Exercise Testing of Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Chest. 2021 Aug;160(2):642-651. 6 Singh I, Joseph P, Heerdt PM, Cullinan M, Lutchmansingh DD, Gulati M, Possick JD, Systrom DM, Waxman AB. Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing. Chest. 2022 Jan;161(1):54-63. 7 Joseph P, Pari R, Miller S, Warren A, Stovall MC, Squires J, Chang CJ, Xiao W, Waxman AB, Systrom DM. Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Placebo-Controlled Trial of Pyridostigmine. Chest. 2022 Nov;162(5):1116-1126. 8 Open Medicine Foundation: Dr. David Systrom Discusses OMF's LIFT Clinical Trial

Dr David Lyons Kaufman is interviewed about Mast Cell Activation Syndrome. Dr Kaufman is a working member of the U.S. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Clinical Coalition and part of the Guideline Committee. He is a founder and practising physician of the Center for Complex Diseases based in Seattle and California, USA which has a focus on patients suffering from Complex Chronic Disease such as Mast Cell Activation Syndrome ME/CFS & Long COVID.REFERENCEAfrin LB, Ackerley MB, Bluestein LS, Brewer JH, Brook JB, Buchanan AD, Cuni JR, Davey WP, Dempsey TT, Dorff SR, Dubravec MS. Diagnosis of mast cell activation syndrome: a global “consensus-2”. Diagnosis. 2021 May 1;8(2):137-52.

Gina Assaf & Letícia Soares are interviewed about the work they do as part of the Patient-Led Research Collaborative. In this episode we do a deep dive into their latest publication.REFERENCES1 Soares L, Assaf G, McCorkell L, Davis H, Cohen A, Moen J, Shoemaker L, Liu L, Lewis D, Robles R, McWilliams C. Long COVID and associated outcomes following COVID-19 reinfections: Insights from an InternationalPatient-Led Survey.