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It's so beautiful to see those interactions. What a sea change from even a year ago.

I was a bit unsure about the Stop Rest Pace campaign since it's very direct and prescriptive, with ME still in a place where our advice is taken but with a lot of hesitation, people still hope this isn't ME. But it's the physios who are using it the most. Incredible difference it all makes.

Sad that it takes so many people to suffer this for change to happen but I doubt it would have happened any other way.
 
Maybe there's a better thread for this but it suggests a possible mechanism for long-term symptoms that seems to reflect prior ME research. Obligatory: in mice.


Diverse Functional Autoantibodies in Patients with COVID-19

https://www.medrxiv.org/content/10.1101/2020.12.10.20247205v2

We found that COVID-19 patients exhibit dramatic increases in autoantibody reactivities compared to uninfected controls, with a high prevalence of autoantibodies against immunomodulatory proteins including cytokines, chemokines, complement components, and cell surface proteins. We established that these autoantibodies perturb immune function and impair virological control by inhibiting immunoreceptor signaling and by altering peripheral immune cell composition, and found that murine surrogates of these autoantibodies exacerbate disease severity in a mouse model of SARS-CoV-2 infection.



 
Some information from research in France on Long Covid. Nothing ground-breaking but it aligns with early data, which is always useful. Lots of data and stats. More interest on neurological than is typical, which is very nice. Some discussion of ME, not bad overall. A national study, named COCOLATE, has been officially launched. The 20-40 peak is maintained, which is REALLY interesting considering it has been consistent for ME.

Article: https://www.lejdd.fr/Societe/Sante/...-sur-les-formes-longues-de-la-maladie-4011338.
Translation: https://translate.google.com/transl...-sur-les-formes-longues-de-la-maladie-4011338.

Alternative URL from The Conversation: https://theconversation.com/covid-1...it-on-des-formes-longues-de-la-maladie-142929.

Thread:



Some emphasis that this is not psychological, which is unfortunately necessary. Not much awareness of dysautonomia.
 
From the article above:

During the persistent phase or relapses, the symptoms observed could differ from those which had initially appeared. The most predominant of them was fatigue. Often extreme (asthenia), this forced a large part of the patients to interrupt their work again which they had been able to resume after the disease. This asthenia was often increased by the slightest exertion, both physical and intellectual.
 
They keep associating long covid with ME because of fatigue but that is all wrong. If the BPS crew had not introduced CFS with its 6 months of fatigue before diagnosis it would be clearer to see the association.

ME never had a requirement for fatigue and certainly not 6 months of it before diagnosis. It happened when people became ill during different epidemics then discovered that either they did not recover or they thought they were better then kept relapsing. They had neurological symptoms and problems in many other body systems but especially were made worse by exercise.

Many experienced fatigue but with what we know now that was most likely payback for exertion. Fatiguability where you are fine then suddenly stop is common as it is in the convalescence for many viral illnesses.

Oh and it was not considered hysteria for many years.

Being starved of research money means the mechanism for disease is not known but the idea that it is another name for the symptom of fatigue has to be soundly stamped out.

Personally, I was able to walk miles for years after I became ill though I could not run or play sports, probably because it never caused me to reach my anaerobic threshold.
 
COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Settings

https://www.acpjournals.org/doi/10.7326/M20-5926

Of 30 557 persons tested in Geneva during the study period, 18.1% tested positive (n = 5534); 22.2% of these were hospitalized (n = 1229), and 703 enrolled in COVICARE follow-up. Out of the initial cohort, 669 persons were ultimately included (Figure 1). The mean age was 42.8 years (SD, 13.7); 60% of included patients were women, 24.6% were health care workers, and 68.8% had no underlying risk factors.
Ooof on the bolded part.
At 30 to 45 days (mean, 43 days) from diagnosis, at least 32% of the 669 originally included patients reported 1 or more symptoms. Fatigue, dyspnea, and loss of taste or smell were the main persistent symptoms. Participants not reached between days 30 and 45 (n = 159) had similar characteristics to those reached in that period
Coronavirus disease 2019 can persist and result in prolonged illness. Our study shows persistence of symptoms in a third of ambulatory patients 30 to 45 days after diagnosis even if we assume that those lost to follow-up were all asymptomatic. Fatigue, dyspnea, and loss of taste or smell were the main persistent symptoms. These results are in line with a recent study of 274 participants that reported the persistence of symptoms 14 to 21 days after diagnosis (2).

m205926ff2.jpeg
 
Maybe there's a better thread for this but it suggests a possible mechanism for long-term symptoms that seems to reflect prior ME research. Obligatory: in mice.

Diverse Functional Autoantibodies in Patients with COVID-19

https://www.medrxiv.org/content/10.1101/2020.12.10.20247205v2




https://www.theguardian.com/science...may-be-driving-severe-covid-cases-study-shows

'Autoantibodies' may be driving severe Covid cases, study shows
Scientists find aberrant immune system in patients with virus could also be cause of ‘long Covid’

Dramatic levels of “friendly fire” from the immune system may drive severe Covid-19 disease and leave patients with “long Covid” – when medical problems persist for a significant time after the virus has been beaten – scientists have said.

Researchers at Yale University found that Covid-19 patients had large numbers of misguided antibodies in their blood that targeted the organs, tissues and the immune system itself, rather than fighting off the invading virus.

The scientists compared immune responses in patients and uninfected people and discovered scores of aberrant antibodies in the former.These blocked antiviral defences, wiped out helpful immune cells, and attacked the body on multiple fronts, from the brain, blood vessels and liver to connective tissue and the gastrointestinal tract.
 
How to manage post-viral fatigue after COVID-19
Post-viral fatigue is when you have an extended period of feeling unwell and fatigued after a viral infection.

Fatigue is a normal part of the body’s response to fighting a viral infection such as COVID-19. Fatigue is likely to continue for some time after the infection has cleared. It can make you sleep more, feel unsteady on your feet, make standing for long periods difficult, as well as affecting your ability to concentrate and your memory.
https://www.rcot.co.uk/node/3540

@PhysiosforME , you probably have seen this but just in case.
 
This webinar is a patient-led discussion on how Long Covid is depicted in the media and in research, and how health services should respond to meet people’s needs. The panel of experts by experience address some of the myths that currently surround the experience of Covid infection before answering questions on the variation of service provision, education for healthcare professionals and outstanding research questions.
Code:
https://youtu.be/wZ_ipmf0s-Q
 
I think a large proportion of people with long covid will recover within a year as I think a large number of people with PVF do. That's why I would prefer that ME/CFS was diagnosed after a year and it remained PVF to that point.

If ME had never been degraded down to the single symptom of fatigue there would not be the diagnostic confusion. CFS was invented by people called "lumpers" who saw fatigue as a spectrum where ME was just at the extreme end (as opposed to "splitters" who saw everything as a different disease)

ME is like MS in that fatigue is important to the individual but does not define the disease.

Before I had every heard of ME my husband took a bad post viral and he was ill for almost a year. It never occurred to us that he might have the same illness I had. Dr Ramsay said that someone who feels fatigued all the time without the variability of symptoms over time that are part of ME is unlikely to have it.

There may well be a middle section of overlap where people with PVS go on to develop ME, but I believe that it should be possible to diagnose ME after a few weeks. ME may be curable with rest in the early days so there might be some confusion there but when a diagnostic test is found or even a proper understanding of what ME actually does to the body there will be no need for months of delay.

The multisystem damage with neurological involvement is there from the beginning.
 
The Atlantic - How Science Beat the Virus - And what it lost in the process - Ed Yong

From chapter 4:

Even after the COVID‑19 pandemic, the fruits of the pivot will leave us better equipped for our long and intensifying war against harmful viruses. The last time a virus caused this much devastation—the flu pandemic of 1918—scientists were only just learning about viruses, and spent time looking for a bacterial culprit. This one is different. With so many scientists observing intently as a virus wreaks its horrible work upon millions of bodies, the world is learning lessons that could change the way we think about these pathogens forevermore.

Consider the long-term consequences of viral infections. Years after the original SARS virus hit Hong Kong in 2003, about a quarter of survivors still had myalgic encephalomyelitis—a chronic illness whose symptoms, such as extreme fatigue and brain fogs, can worsen dramatically after mild exertion. ME cases are thought to be linked to viral infections, and clusters sometimes follow big outbreaks. So when SARS‑CoV‑2 started spreading, people with ME were unsurprised to hear that tens of thousands of COVID‑19 “long-haulers” were experiencing incapacitating symptoms that rolled on for months. “Everyone in my community has been thinking about this since the start of the pandemic,” says Jennifer Brea, the executive director of the advocacy group #MEAction.

ME and sister illnesses such as dysautonomia, fibromyalgia, and mast cell activation syndrome have long been neglected, their symptoms dismissed as imaginary or psychiatric. Research is poorly funded, so few scientists study them. Little is known about how to prevent and treat them. This negligence has left COVID‑19 long-haulers with few answers or options, and they initially endured the same dismissal as the larger ME community. But their sheer numbers have forced a degree of recognition. They started researching, cataloging their own symptoms. They gained audiences with the NIH and the World Health Organization. Patients who are themselves experts in infectious disease or public health published their stories in top journals. “Long COVID” is being taken seriously, and Brea hopes it might drag all post-infection illnesses into the spotlight. ME never experienced a pivot. COVID‑19 might inadvertently create one.

ETA:
Anthony Fauci hopes so. His career was defined by HIV, and in 2019 he said in a paper he co-wrote that “the collateral advantages of” studying HIV “have been profound.” Research into HIV/AIDS revolutionized our understanding of the immune system and how diseases subvert it. It produced techniques for developing antiviral drugs that led to treatments for hepatitis C. Inactivated versions of HIV have been used to treat cancers and genetic disorders. From one disease came a cascade of benefits. COVID‑19 will be no different. Fauci had personally seen cases of prolonged symptoms after other viral infections, but “I didn’t really have a good scientific handle on it,” he told me. Such cases are hard to study, because it’s usually impossible to identify the instigating pathogen. But COVID‑19 has created “the most unusual situation imaginable,” Fauci said—a massive cohort of people with long-haul symptoms that are almost certainly caused by one known virus. “It’s an opportunity we cannot lose,” he said.
 
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