Ⓜⓤⓛⓡⓔⓨ ⓂⓒⒾⓝⓣⓨⓡⓔ

Operation Incognito

[Dr. Jennifer Irwin @drjenirwin]

Long-term neurological & cognitive impact of COVID-19: systematic review & meta-analysis in over 4 million patients

Findings included:
fatigue 43.3%
memory disorders 27.8%
cognitive impairment 27.1%
sleep disorders 24.4%
concentration impairment 23.8% https://t.co/Mldydwj5M3

[Kathryn @kadamssl]

This incredible human crossed the stage this week to accept her high school diploma.
4 years.
N95. Every. Day.
The only masked face in her yearbook.

Her senior quote?
“Strength does not make one capable of rule; it makes one capable of service.” - Teft, Way of Kings (1/x)

🧵

[Conor Browne @brownecfm]

Outstanding point in an excellent thread.

'If this signal holds, we will have run an uncontrolled neurodegeneration experiment on the whole population and called it returning to normal'.

This is why I mitigate against infection.

[Hiroshi Yasuda (保田浩志) @Yash25571056]

FYI, "The reactivation of latent herpesviruses has been associated with sustained immune dysregulation for long periods of COVID-19.
The reactivation process refers to the mechanism by which the latent viruses [(e.g. EBV and Varicella Zoster Virus (VZV)], which remain dormant in B lymphocytes and epithelial cells following initial infection, become active and enter their replication cycle.
The reactivation of these dormant viruses can be triggered by concurrent infections, physical or psychological stress or immunosuppression..
For instance, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has been linked to LC..
Furthermore, dysautonomia, a condition observed in several post-viral infections, has also been reported in LC patients..
these viruses (EBV and VZV) can remain latent within the host and can be reactivated by a stressor such as another serious viral infection (e.g. SARS-CoV-2), leading to chronic inflammation and neurological disorders..
EBV infects B lymphocytes and epithelial cells, potentially triggering autoimmune disorders such as multiple sclerosis, Systemic Lupus Erythematosus (SLE), and rheumatoid arthritis.. Association between EBV reactivation and SARS-CoV-2 infection has been demonstrated by several studies.."

Stay relaxed in clean air.

'Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination'
https://t.co/wsoj2Jg0NF

[tern @1goodtern]

Me: Oh, this honeysuckle smells amazing.
Him: How can you smell it with that mask on?
Me: Some smells are gas-phase molecules that can get through this kind of mask. Doesn't it smell amazing?
Him: I don't know. I haven't been able to smell anything for six years.
Me: Really?
Him: Yeah. My first covid infection. It's got worse too. The other day our dinner was on fire, and I couldn't smell the smoke. The first I knew was when my eyes started watering, then the alarm went off.
👀

[Eric Topol @EricTopol]

Yet another study shows a 24% reduced risk of dementia after the Shingles vaccine. This one in over 500,000 participants with a recent skilled nursing facility stay, adding to 4 huge natural experiments in 4 countries (US, Canada, Wales, and Australia)
https://t.co/TmYqwTB7IT @AnnalsofIM

[Barry Hunt @BarryHunt008]

😢

Sigh 😔

It would be so easy to install Upper Air UV - schools were the first place they were used - IN THE 1930s!!!

New modern louvreless fan assisted designs are quiet, unobtrusive & 2 orders of magnitude more efficient than dilution ventilation or air purifiers

🤷‍♂️

[Ⓜⓤⓛⓡⓔⓨ ⓂⓒⒾⓝⓣⓨⓡⓔ @Mulrey75]

💯

[Conor Browne @brownecfm]

With the strong caveat that this is purely anecdotal, I have to say that over the past months it's been increasingly difficult to ignore the sheer number of mistakes people have been making. There's a kind of endemic sloppiness and I think part of it is cognitive dysfunction.

[Hiroshi Yasuda (保田浩志) @Yash25571056]

From a study of 349 children and adolescents in Mexico,
"The prevalence of long COVID was 11.8%.
For “persistence”, the most frequent symptoms were cough (50%) and rhinorrhea (15.4%); for “post-COVID conditions”, the most common symptoms were myalgia (33.3%), asthenia and irritability (26.7% each), and constipation (20%)..
the associated factors for individuals aged over 8 years were a history of reinfection (OR 9.7) and BMI at the time of the survey (1.1), while for those aged under 8 years, the associated factor was male sex (4.7)."

Be aware of reinfection, kids.

'SARS-CoV-2 reinfection: a possible contributing factor to long COVID in children and adolescents'
https://t.co/yGYlT1WrnH

[MaskTogetherAmerica @TogetherWeMask]

Congrats to @drDavidKeegan appointed to chair Public Health Agency of Canada’s National Advisory Committee on Preventive Health Services.

Read
@MsJulieSLam’s interview of Dr. Keegan who sees #LongCOVID patients.

https://t.co/bGy1aNrOLS

https://t.co/t2MI4kTXGr

[Jess @MeetJess]

New study shows metformin given during acute COVID-19 infection reduced risk of clinician-diagnosed long COVID by 50%
https://t.co/noDfQK7Cx9

[Mike Hoerger, PhD MSCR MBA @michael_hoerger]

😷 BREAKING🚨

Canada launches a new National Advisory Committee on Preventive Health Services.

It will be chaired by Dr. David Keegan, a leading advocate for masks in healthcare and on airplanes who filed human rights litigation on both fronts.

[World Health Network @TheWHN]

WHN Voices Magazine is a community publication created by and for people who care about public health, clean air, Long COVID, disability justice, and building a safer future.

We're looking for articles, personal stories, poetry, artwork, interviews, reviews, and creative submissions from voices across our community.

Whether you're COVID-cautious, COVID-curious, a healthcare professional, researcher, advocate, artist, caregiver, or simply someone with a story to tell, we'd love to hear from you.

Submit your work to: [email protected]

Read the latest issue and explore past editions here: https://t.co/P3UpbHHWwK

Together, we can share knowledge, amplify lived experiences, and help others feel less alone.

#LongCOVID #PublicHealth #COVID19 #CleanAir #DisabilityJustice

[Conor Browne @brownecfm]

I know I've said this many times before on this platform, but the moment I learned anosmia was a symptom of Covid-19 was the moment I decided I was going to do everything possible to avoid getting it. I knew anosmia was an early prodromal symptom of Parkinson's Disease.

[Jess @MeetJess]

Pretty sure we all know what it is

[Dr Rae Duncan @Sunny_Rae1]

@hannahspierMD 1/Hannah, we have now almost 500,000 peer reviewed published research into long covid now. “Fatigue”, “post exertional malaise (PEM)” “Brain Fog” “difficulty concentrating” are not psychiatric symptoms. They have a pathological basis and clear demonstrable abnormalities 1/

[Ⓜⓤⓛⓡⓔⓨ ⓂⓒⒾⓝⓣⓨⓡⓔ @Mulrey75]

@AwhatsN @noahjacobmama @JPWeiland Moldex respirators are also great for MRIs and contain no metal. I’ve used them repeatedly with no issues, but have brought along paperwork from the manufacturer just as a backup. Have never had pushback. Good luck!

[Jess @MeetJess]

Oh hi 👋🏻

Have you met @fitterhappierAJ ??

In case you haven’t, he’s been warning us about this exact thing …

[Liesl McConchie @Liesl4CleanAir]

This! ⬇️

Both, And.

Clean surfaces.

Clean the air.

Thank you @cvspharmacy for understanding dominant forms of transmission.

💉

[Biff #SARSisAirborne 🍉 @Biff234523]

🚨💊HUGE news: @US_FDA has finally granted approval to @ShionogiUS’s Xocova (Ensitrelvir), a 2nd-generation antiviral targeting SARS-CoV-2.

The approval is for the indication of “post-exposure prophylaxis of COVID-19 following contact with an individual who has COVID-19”. However, just like with any drug, it can obviously also be used off-label (e.g. treatment of both acute COVID or Long COVID).

In Japan, Xocova received Emergency Use Authorization for the treatment of acute COVID all the way back in November 2022, received full approval in March 2024, and an expansion to include post-exposure prophylaxis in March 2026.

The post-exposure prophylaxis indications are based on the SCORPIO-PEP trial (https://t.co/Dxv0lhS2CM), where Xocova reduced the incidence of COVID-19 after household exposure by 67%, from 9.0% down to 2.9%.

Mechanically, Xocova is the same class of drug as Paxlovid - a 3C-like protease inhibitor that inhibits viral replication. From our best understanding, Xocova is probably slightly more potent than Paxlovid, but the more definitive advantage is that it comes with less side effects and less drug interactions (which are caused by the Ritonavir component of Paxlovid, added to boost the concentration of the actual antiviral, Nirmatrelvir).

Xocova should be useful for lowering viral load during an acute infection, especially if taken within a couple or days of symptom onset, which may help shorten the duration of acute symptoms. Will it do anything to prevent long-term damage or the development of Long COVID? Almost certainly not, just like Paxlovid, but I’d be more inclined to tell people that it’s worth trying if we’re no longer dealing with the side effect profile of Paxlovid.

Where it makes the most sense to use Xocova, just like with Paxlovid, is as a component of polytherapy for Long COVID driven by viral persistence. The big issue there, however, is that you need a longer course of these antivirals than most physicians are willing to prescribe and/or most insurance companies are willing to cover. And they’re generally not very effective as a monotherapy, you need to pair these oral antivirals with other therapies for better coverage and tissue penetration (eg. monoclonal antibodies and Nuvaxovid, and potentially even a 2nd antiviral like Remdesivir).

All in all, this is a very important and long overdue approval. It’s not a game-changing silver bullet, and notably, nobody should really be expecting to use or rely on Xocova in a way that they wouldn’t be open to using or relying on Paxlovid in the present. But there are plenty of applications for it, and Xocova should absolutely be seen as another Swiss cheese layer / tool in the toolbox for COVID conscious community members and any allied medical providers.