Draza Holmann

[Draza Holmann @holmannka]

Covid vs. mozek

[WesElyMD @WesElyMD]

1/🧵Your brain “on COVID”🧠

Let’s integrate >20 studies on #LongCOVID neuropathology

My 24 y/o patient explained: “I don’t have a future because I can’t think anymore.”

Let’s talk:
Autopsy Studies
Viral persistence
Brain Size & Disability
Recovery & Hope

H/T pic 👁️ tw 13

[Draza Holmann @holmannka]

Zcela náhodně na jedné z fotek (škoda horší kvality) setkání užovky a paní šídlové🤣

[Draza Holmann @holmannka]

@broucek_t Díky, u vody toho člověk potká hodně a hady mám v oblibě, ale jsou dost plaší a rychlí (tedy na mě a na zaostřování foťáku), takže se mi málokdy podaří udělat nějakou pěknou fotku.

[Draza Holmann @holmannka]

Třeba někomu chyběla trocha té fauny z východu Čech😉

[Iniciativa Sníh @SnihIniciativa]

Při čištění zubu a jídle musím ležet.
https://t.co/z5lTLVKtlS
Nejtěžší stupně ME/CFS a long covidu znamenají být upoután na lůžko 24 hodin denně. Bez přehánění. To je bohužel realita části nejvážněji zasažených pacientů.
@longcovidportal

[Iniciativa Sníh @SnihIniciativa]

Jemný dotek jako bodnutí, závrať bez příčiny – a dosud žádná léčba. Holandský tým přenesl protilátky od 34 pacientů s long covidem do zdravých myší a vyvolal trvalou přecitlivělost na bolest. Tři další studie ukazují stejným směrem.
https://t.co/D2Zq0SdFtT

[Draza Holmann @holmannka]

@infektolog A budete tedy tlačit na nějaká preventivní opatření, včetně např. bariérové ochrany dýchacích cest? Nebo je v pohodě nechat populací stále šířit covid a další infekce bez "povšimnutí"? To povšimnutí dávám do uvozovek, protože si všichni všímají, že je populace stále nemocnější.

[Iniciativa Sníh @SnihIniciativa]

Česká asociace pro long covid založila kampaň “Nevidíte nás, ale ještě jsme tady”
Příběhy lidí, kteří jsou pro okolní svět neviditelní.
Na https://t.co/8UIce1925U můžete také podepsat výzvu za lepší systémovou péči o pacienty s long covidem.
#jestejsmetady2026 #longcovid

[Draza Holmann @holmannka]

@_Klein___ Oni to řešit nebudou, když sami mají stejný problém jako jejich pacienti...

[Iniciativa Sníh @SnihIniciativa]

Březen je celosvětově uznáván jako měsíc povědomí o long covidu. Cílem iniciativy je upozornit na tato chronická onemocnění COVID-19, která postihují miliony lidí po celém světě, a bojovat za lepší výzkum, léčbu a podporu pacientů.
#LongCovid #Postcovid #Podpora #ProVylecene

[Harry Spoelstra @HarrySpoelstra]

Audiovestibular Dysfunction Related to Long COVID-19 Syndrome: A Systematic Review of Characteristics, Pathophysiology, Diagnosis, and Management

🔥Interesting international review article that synthesizes the current knowledge on audiovestibular dysfunction related to long COVID-19 syndrome. Vestibulocochlear nerve (Cranial Nerve VIII)

➡️Their review data:
- Acute COVID-19: auditory symptoms 21.9%, vestibular symptoms 34.9%,

- Persistent at 6 months: auditory dysfunction 1.99%, vestibular dysfunction 3.99%,

- In long COVID (various follow-ups): tinnitus 30–39% (most common auditory symptom), hearing loss 11–15%, vertigo/unsteadiness 34–60% (often central origin),

- ~15% combined hearing loss + tinnitus, with ~1/5 of affected patients report severe symptoms,

- Higher in females but occurs in both adults and children,

- May be underestimated (even in asymptomatic cases!),

- Pathophysiology (hypothetical):
Direct inner ear/vestibulocochlear nerve invasion (ACE2/TMPRSS2/FURIN), microthromboembolic events, central auditory gain increase, reduced cortical GABA, neuroinflammation,

- Diagnose:
Standard pure-tone audiometry often insensitive, better tools include extended high-frequency audiometry, TEOAE/DPOAE, ABR, VEMP, vHIT, P300,

- Treatment:
No specific trials, Multidisciplinary care, vestibular rehabilitation, steroids, hyperbaric oxygen (limited evidence),

- And there you have it: Reinfection prevention critical(cumulative damage)!

- Prognosis: most resolve within 6 months, but some persist >12 months, with a high quality of life impact.

- The review does not examine vaccination effects in depth.

➡️Conclusion:
Long COVID can silently inflict lasting inner-ear and central auditory damage in up to 60% of patients, risking permanent sensorineural hearing loss, debilitating tinnitus, and chronic vestibular disability. Early screening and intervention are essential to prevent irreversible harm.
And as mentioned in this review: AVOID REINFECTIONS!
https://t.co/RGhVxbLfDX

[David Lingenfelter, PhD @dlingenfelter]

SARS-CoV-2 variants are showing resistance to key antiviral drugs like Paxlovid and Xocova due to global mutations in the virus’s main protease.

A multi-drug cocktail strategy is proposed to reduce cross-resistance and improve treatment durability. (1/2)🧵

[Vipin M. Vashishtha @vipintukur]

COVID-19 may leave a lasting mark on the brain — even after “full recovery.”

➡️ Advanced MRI shows detectable changes in tissue microstructure and neurochemistry in people months after infection. 1/

[Vipin M. Vashishtha @vipintukur]

➡️ Preclinical data suggest aspirin may modulate early SARS-CoV-2–host interactions, not only through anti-inflammatory/antithrombotic effects but also via spike protein modulation.

(Ref: Frontiers Immunol. 2025;10.3389/fimmu.2025.1706997)

➡️ Mechanism: Aspirin alters SARS-CoV-2 spike protein properties, reducing ACE2 binding in cell models, suggesting a direct interference with viral entry.

https://t.co/xLNdPTBVaX

➡️ Pulmonary effects: In preclinical lung injury models, aspirin appears to attenuate inflammation, endothelial damage, and fibrosis associated with spike protein exposure.

https://t.co/vCiywTRWxt

➡️ Clinical translation: Effects likely depend on timing (early infection). However, large RCTs such as RECOVERY showed mixed or modest benefits without consistent mortality reduction.

https://t.co/Wl0KLGOYeI

👉 Conclusion: Aspirin’s role in COVID-19 remains adjunctive and hypothesis-generating. Mechanistic insights justify focused trials, but preclinical effects do not support routine clinical use for COVID-19 outside established indications.

[Vipin M. Vashishtha @vipintukur]

Why does #LongCOVID cause persistent GI symptoms?

➡️ New mechanistic work shows that intestinal SARS-CoV-2 reservoirs impair epithelial repair, identifying the gut as a key local driver of LongCOVID GI pathology.

➡️ Mechanism uncovered:

Viral persistence disrupts very-long-chain fatty acid (VLCFA) metabolism, suppressing PPAR signaling and peroxisome abundance, leading to defective intestinal stem-cell differentiation and epithelial regeneration.

➡️ Therapeutic insight:

FDA-approved drugs sodium phenylbutyrate & fenofibrate restored epithelial repair, reduced diarrhea, inflammation & dysbiosis — highlighting the VLCFA–PPAR–peroxisome axis as a promising treatment target for GI LongCOVID.

H/T: @CatchTheBaby

https://t.co/8WTIlfqQMj

[Draza Holmann @holmannka]

@HuJirui Děkuji, to je milé, ale vypadat stejně dá pořád větší práci, s každým rokem😅

[Draza Holmann @holmannka]

Tak jedna dnešní z čekárny u doktora😉

[Vipin M. Vashishtha @vipintukur]

New study shows that people with #LongCOVID and neurological symptoms had a ~59% increase in plasma #pTau-181 — a phosphorylated tau protein linked to Alzheimer’s pathology — compared with their pre-COVID levels. 1/

[Eric Topol @EricTopol]

Real time video of tumor infiltrating lymphocytes attacking cancer cell https://t.co/BHtvuqid8m

[AJ Leonardi, MBBS, MPH, PhD @fitterhappierAJ]

The hygiene hypothesis is being eroded

Infections at a young age correlate with severe infections later in life, few infections in youth correlate with less infections in adulthood

Where was the “strengthening of kids immune system” from infections?

https://t.co/f7rjcBOxvK

[Jon Douglas @atranscendedman]

Researchers analyzed genetic data from nearly 1.4 million people and found a causal link between blood clot risk and long COVID, regardless of how severe the initial infection was.

https://t.co/l1Yw9gH5OV