News from the Visegrád Countries - Czech Republic, Poland, Slovakia and Hungary

Wyva said:
I was asked by the editor-in-chief of the health website InforMed to write an up-to-date article on ME/CFS. InforMed is a smaller health news website written by doctors for patients (but it definitely has some traffic because the "ask a doctor" section seems pretty busy with questions). It is also quite old, started more than 20 years ago and in general is seen as a reliable health website as it is operated by doctors themselves.

So here is my article, translated to English with Google translate:
What we know today about chronic fatigue syndrome

And here is the original Hungarian version: https://www.informed.hu/betegsegek/...a-kronikus-faradtsag-szindromarol-246732.html

The Google translation might sound a bit weird, as always. I tried to be as conservative in my statements and as close to what my sources say as possible, in order to show a high degree of credibility. The editor-in-chief asked about me after publishing the article, so I hope that the fact that I am a patient will be alright and the article will remain regardless (this info about me is openly available on my website, I'm not hiding anything).
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Excellent that you have been able to get the idea of PEM to a medical audience.
 
Wyva said:
I was asked by the editor-in-chief of the health website InforMed to write an up-to-date article on ME/CFS. InforMed is a smaller health news website written by doctors for patients (but it definitely has some traffic because the "ask a doctor" section seems pretty busy with questions). It is also quite old, started more than 20 years ago and in general is seen as a reliable health website as it is operated by doctors themselves.

So here is my article, translated to English with Google translate:
What we know today about chronic fatigue syndrome

And here is the original Hungarian version: https://www.informed.hu/betegsegek/...a-kronikus-faradtsag-szindromarol-246732.html

The Google translation might sound a bit weird, as always. I tried to be as conservative in my statements and as close to what my sources say as possible, in order to show a high degree of credibility. The editor-in-chief asked about me after publishing the article, so I hope that the fact that I am a patient will be alright and the article will remain regardless (this info about me is openly available on my website, I'm not hiding anything).
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Excellent work, Wyva. You hit on all the important points while keeping the article concise.
 
Looks good to me. :thumbup:

Only problem I have, which could just be a simple translation issue, is with this:

What can be done is "pacing", i.e. the scheduling and allocation of the patient's energy,​

The Hungarian word it was translated from may have a different meaning. But in English that is a word I would definitely avoid in relation to pacing. It means more-or-less the opposite, certainly in this context.

Pacing means symptom determined, and scheduling means time determined.
 
Sean said:
Looks good to me. :thumbup:

Only problem I have, which could just be a simple translation issue, is with this:

What can be done is "pacing", i.e. the scheduling and allocation of the patient's energy,​

The Hungarian word it was translated from may have a different meaning. But in English that is a word I would definitely avoid in relation to pacing. It means more-or-less the opposite, certainly in this context.

Pacing means symptom determined, and scheduling means time determined.
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Yeah, I meant something like "breaking up into smaller pieces, not doing everything all at once" by that but I can see how it can also be interpreted in other ways, especially if someone is not familiar with the concept of pacing. I haven't thought of that, to be honest, but I'll try to avoid this kind of wording and describe it differently instead.
 
Portfolio, a finance news site and one of the most visited websites in Hungary, published a series of articles about the potential long-term negative side effects of the covid vaccines.

Here are the links to the Google translated articles in English for those interested:

Part 1: Katalin Karikó: there were those who said that they got pregnant from the vaccine against the coronavirus

The journalist asked Katalin Karikó, Hungarian-American researcher who played a key role in developing the mRNA vaccine technology used by Pfizer in this part but also a virologist commented. The journalist also asked other experts who declined to comment.​

Part 2: Light has been shed on the side effects of vaccines: what can the vaccine against the coronavirus cause?

This article talks about the situation of the covid vaccines and their potential negative side effects in Australia, Germany and how those states handle this (people from those countries on the forum may confirm if this is accurate or not). POTS is mentioned as something that has become 5 times more prevalent after the covid vaccines.​

Part 3: Corona virus: There may be vaccine-injured people in Hungary, but no one pays them

This article describes two Hungarian cases, their symptoms and experiences in detail. One of these people mentions having CFS now, but she seems to talk about it as a symptom (while also mentioning many other symptoms she has), so this may just mean chronic fatigue here.​
 
Bad title but good article (and the photo is a picture from a Millions Missing protest, not a sleepy secretary in front of her computer at work):

People who get stuck in fatigue for months, years - and there is hardly any hope for change

The article appeared on HVG, which is a well-known news site here. It is paywalled but I subscribed just to be able to read it because this site has a history of publishing articles promoting psychosomatic views (not about us though).

So the article has some minor flaws, inaccuracies but in general it is OK and seems to be mostly based on the German situation, Scheibenbogen and her clinic are mentioned, that ME/CFS is often misdiagnosed as something psychosomatic and that the disease can be very severe etc. CCC is mentioned as the best way to diagnose patients.

So it is actually a pretty good article, conveying a lot of good info in a relatively short text. I suspect it was probably based on some German article from 12th May. It is very rare that someone writes an article about ME/CFS here, so I'm happy that this is actually a good one (which is even rarer here).
 
This is just an abstract from a conference (31st Meeting of the European Society of Paediatric Clinical Research) but I'm putting it here in case anyone is interested. From Semmelweis University.

Long COVID syndrome in children: the dysfunction of neutrophilic granulocytes as a possible pathological explanation

Fanni Kovács1,2, Eszter Zsáry1,2 , Tamás Posvai3 , Vivien Herczeg1,2 , Réka Garai1,2 , Ferenc Zoltán Kolonics3 , Péter Krivácsy1,2, Roland Csépányi-Kömi3

1 Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest, Hungary 2Department of Pediatrics (Bókay Street Unit), Semmelweis University, Budapest, Hungary 3Department of Physiology, Semmelweis University, Budapest, Hungary

Background: COVID-19 disease is an upper airway infection caused by the SARS-CoV-2 virus. Long COVID syndrome (LCS) is one of its complications, when the symptoms of the illness persist, or new symptoms occur after 4 or more weeks of the infection. Even children, whose acute illness is mostly mild, suffer from long COVID syndrome in about 10-25% of all cases. The symptoms of the disease are diverse and fluctuating, usually more organ systems are affected, and the quality of life is impaired. The need for aimed diagnosis and therapy is vital, still, the pathophysiology is not clear yet.

Aims: We purposed to discover the possible pathological role of neutrophilic granulocytes in long COVID syndrome, by examining the phagocyte functions and the cytokine environment of the cells.

Methods: Between April 2021 and April 2023 we examined 27 children suffering from LCS (LCS Group) and 24 children without LCS symptoms (Control Group). We compared the data of the clinical details, acute COVID-19 infection, long COVID symptoms, and quality of life and functioning of the two groups. We isolated serum and neutrophilic granulocytes (PMN) from the peripheral blood of the children and examined the superoxide production and the phagocytosing capacity of the PMNs, as well as the IFN-γ, IL-8, and IL-6 levels in the serum. We correlated the clinical parameters and the neutrophil function.

Results: The average number of symptoms and the quality of life and functioning were significantly worse in the LCS Group. There was a significant difference in the level of serum IL-8 of the resting and Zymosan stimulated cells. The phagocytosing capability of the LCS group was significantly worse than the control group’s. The superoxide production in resting conditions was significantly lower in sick children. After stimulating the superoxide production with phorbol ester (PMA) or Zymosan, the neutrophilic granulocytes of the LCS Group were significantly more hyperactivated than those of the control group. We revealed a negative correlation between the number of symptoms and superoxide production of the sick children.

Conclusions: According to our results, immunological dysregulation may be part of the immunopathogenesis of pediatric long COVID syndrome, with impaired superoxide production and phagocytosing capability of the neutrophil granulocytes. This could be a complication of the disease or part of a predisposing phenotype.
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One of the very few articles from Hungary where a doctor talks about long covid (so the article is not a translation of some foreign article about long covid, which is much more common, but original stuff - the latter is really rare). The doctor in the article is Gábor Markó, a neurologist and the website is a well-known women's magazine. ME/CFS is not mentioned and it is mostly about general brain fog but I think it is interesting how a neurologist sees this term or talks about it.

Google translate:
What causes brain fog?

Difficult to describe dullness, lethargy, feeling of insecurity - this would be the condition known as brain fog, which many people only heard about for the first time during the coronavirus epidemic. What can cause such a feeling, and how can it be alleviated or eliminated?
The phenomenon called brainfog in English became the focus of attention during the coronavirus epidemic, many people suffered from it in the weeks and months after the disease. It is not a medical term, but it is also used by doctors, it was called by this name long before the epidemic. The pandemic only brought about a change in the fact that this name has become widespread among lay people, for which there is no official Hungarian equivalent - apart from the fact that it means brain fog in a literal translation - and its meaning can only be described in long sentences.

– Brainfog is a complex of symptoms that is hard to grasp. It is characterized by fatigue, lethargy, dullness, and a feeling of insecurity. When it occurs, thoughts do not come as quickly as they used to. Cognition deteriorates, the exact meaning of which is also difficult to define, since the basic concept itself is not so graspable. We mean the thinking process encompassing perception, reasoning and memory, which also become weaker in brainfog. However, the degree is a key issue here: brainfog is the mildest form of cognitive dysfunction, the deterioration is not at the same level as, for example, in the case of dementia or other neurological diseases. This state is more similar to when jet lag occurs after long flights, or, for example, after a pig slaughter, the company starts feasting, and then everyone becomes lethargic and dull, they would prefer to go to sleep right away. Brainfog also feels like this, but it typically lasts longer, says Dr. Gábor Markó is a specialist in neurology.

Dullness after large meals is due to the fact that the blood circulation is rearranged. The reason behind this is that the digestive system needs a lot of blood for proper digestion, so the body draws blood from other areas. This leads to the relative - which does not cause serious problems and cannot be measured in any meaningful way - cerebral blood circulation disorder and lack of oxygen, which causes lethargy.

It was made public by Covid

– A similar feeling exists with brain fog that occurs after a coronavirus infection, where there is also no measurable cause, for example cerebral circulation disorder, blockage or inflammatory process, no changes that can be verified by imaging studies or functional tests. We only know from research that the virus can affect the brain in several ways, it can be present in the central nervous system and cause some kind of change there. However, the symptoms are very subjective, we cannot relate them to anything. While so-called cognitive tests are useful for dementia, for example, we don't go far with them here. For this reason, brainfog is more suitable to help diagnose problems such as long Covid, taking into account other symptoms and previous illnesses, says the neurologist.

This condition occurs in ten to fifty percent of cases after the coronavirus infection, the scale is very wide according to the literature. Dullness and fatigue can also occur after other viral infections - such as the flu - for a few days, weeks or months. During the pandemic, this was only so spectacular because Covid affected many people at the same time, so the brain fog that may exist after the disease also developed in many people. in time. On the other hand, Covid-19 was so new that we paid attention to every detail. A good example of this is the temporary loss of smell, which may have developed earlier in upper respiratory diseases, but we did not attach any particular importance to it, and often did not even notice it.

A storehouse of reasons

In addition to viral infections, brainfog can follow or accompany other diseases or conditions. A classic example of this is when a patient who has just had a stroke feels dull and lethargic. But as an example, we could cite spring fatigue, which can also be associated with brainfog, but we didn't call it that before.

– It can also occur as a side effect of drugs, and it can be caused by hormonal effects, whether during adolescence, pregnancy or menopause. By the way, it is interesting, because these conditions were also found when the literature tried to define what the person who complains of brain fog feels after Covid. Multiple sclerosis is also mentioned as an example, because patients suffering from it also have slight cognitive differences that cannot yet be detected by tests - points out Dr. Gábor Markó.

Brain fog can also be caused by heart failure, since in this case the amount of blood pumped from the heart every minute does not ensure the body's normal oxygen and nutrient needs, and because of this, the brain does not work well either. This can lead to fatigue among other symptoms. Brainfog can also occur in chronic obstructive pulmonary disease (COPD) due to a lack of adequate oxygen supply. The only difference is that in this case the problem is caused only by the lack of oxygen, while in the case of problems of cardiac origin, the insufficient amount of other nutrients delivered by the blood is also present. At the same time, it is important to know that in such diseases, cognitive problems appear only as one of the many symptoms, since the body does everything to ensure that the brain is supplied with oxygen and nutrients - even at the expense of other organs.

It should not be trivialized

If brainfog occurs due to some specific, well-definable reason, then the key issue is its appropriate treatment, but if there is no such thing, or if the lethargy remains as an after-effect after some illness, then other methods can also be considered. In such cases, the protocols recommend aerobic type of movement - this includes, for example, walking, running, swimming and cycling - as they increase oxygen consumption, thus prompting you to breathe more deeply and speed up your heart rate. Everything that is good for nerve cells is useful in this case, including the Mediterranean diet and sleep hygiene that helps you sleep restfully. The latter also includes going to bed and getting up at the same time every day, thus avoiding sleep debt. Drug treatment is out of the question for brainfog, it may only be necessary for diseases, such as specific dementias or multiple sclerosis, which go far beyond this condition. These problems must always be separated from simple brainfog, which fortunately can be done with tests and examinations. While brain fog does not require medical intervention and does not pose any dangers, diseases attributed to it and left untreated as a result do. Neurodegenerative diseases (e.g. Parkinson's disease or Alzheimer's disease) should be highlighted separately, which can be indicated if the brainfog worsens. If this is the case, an investigation and appropriate therapy are always required.
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Neúnavní joins the World ME Alliance to represent the Czech Republic

"We are thrilled to announce the newest member of the World ME Alliance: Neúnavní. This Czech charity is dedicated to supporting individuals living with Myalgic Encephalomyelitis (ME) in the Czech Republic. Neunavní has been at the forefront of raising awareness, providing resources, and advocating for better care and understanding of ME within their country."

https://worldmealliance.org/2023/06...-me-alliance-to-represent-the-czech-republic/
 
Recently I sent a letter to the Department of Quality Improvement and Methodology (a department under the Secretary of Health) about the ME/CFS situation in Hungary. I don't really have too much time right now but this is the answer I have just received (Google Translate):

Dear Ágnes Szarvas!



The Department of Quality Improvement and Methodology contacted the Departments of the Health Professional College (hereinafter: ESZK) involved in the topic, the Departments highlighted that the interpretation of myalgic encephalomyelitis/chronic fatigue syndrome (hereinafter: ME/CFS) and some basic principles of treatment have changed significantly in recent years. In WHO-11, instead of the main group of Mental, behavioral and neurodevelopmental disorders (6), it is found in the group of diseases of the nervous system (8 main groups, subgroup 8E4: other diseases of the nervous system).

Increasing knowledge is of great importance, because early detection and management of patients, preventing the development of chronic complications can improve the physical and mental well-being of patients, and their uninterrupted social participation, which in the long run can also result in a reduction of healthcare expenses. The etiology of ME/CSF is clearly not clear, and no medical therapy is available for the cause. The diagnosis is based on symptomatology: no specific biomarker that can be used in clinical practice is known. According to international recommendations, diagnosis and treatment are the task of a specialized professional team covering several fields, even in the most modern protocols - including the NICE 2021 recommendation - lifestyle and psychological intervention elements dominate.



The Department of Internal Medicine, Endocrinology, Diabetes and Metabolic Diseases, the Department of Family Medicine, the Department of Clinical Immunology and Allergology, and the Department of Psychiatry of the ESZK supports the establishment of an interdisciplinary working group, where the domestic situation can be reviewed and proposals related to the topic can be formulated. With adequate time spent, reviewing the international classification criteria and recommendations and building a domestic consensus based on them is a joint task. ESZK Sections recommend the adaptation of the modern approach to ME/CSF, the development and application of guidelines in accordance with best practice and up-to-date evidence.



The Department of Quality Development and Methodology coordinates and methodologically supports the development of healthcare professional guidelines. Based on the provisions of the EMMI decree on the uniform rules for the development and editing of examination and therapeutic procedures, as well as the conduct of professional consultations concerning them, a healthcare professional guideline can be prepared during adaptation or self-development, and the department/departments of the ESZK representing the given profession are entitled to initiate the development of the guidelines.



On behalf of Dr. Beáta Sebestyén, Head of Department,



Sincerely:



Krisztina Kerek

MINISTRY OF THE INTERIOR
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Hutan said:
Am I right in thinking that sounds promising for the development of fairly reasonable clinical guidelines @Wyva? Do you think you could get on an 'interdisciplinary working group'? (don't feel you need to answer)
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Yes, looks like they want to develop a guideline. We don't currently have any such thing for ME/CFS, so it will be interesting to see what direction this will actually go in the end, how reasonable it will be. I'm happy to see that Internal Medicine and Immunology are interested in this, not just Psychiatry (although I kind of expected Immunology to be one of these, as my personal observation is that immunologists seem to be more interested in ME/CFS than say neurologists elsewhere in the world too).

It is good that they are acknowledging the recent changes in other guidelines. I made some quick observations in a members only forum for Hungarian advocacy if anyone is interested in those.

The letter states that recommendations/suggestions will be welcome for the interdisciplinary group but I'm not sure if that can involve me as a random person too. I'm going to ask this in my reply.

It was a while ago when I checked how guidelines are developed and from what I remember patient organizations can be involved somewhat but when I randomly checked actual guidelines (eg one for autism where I expected some patient involvement) they were never involved, so I'm not sure this is common in practice. And I'm not even a patient org, just a random person with a website and a FB group. I've wanted to create a patient org but it is a lot of work and you actually need at least 10 people for setting one up and I don't know 10 people who are 1) available for this 2) are knowledgeable enough about the scientific literature of the disease apart from personal experience. I know a few but not enough. This whole ME/CFS advocacy is still very new in Hungary unfortunately, even the availability of post-IOM info for patients is quite new.

So anyway, we'll see to what extent I can get involved or not. I would like to be of course.
 
To sum up the situation in the Czech Republic (from what I understand and my understanding probably doesn't give the full picture).

The patient organization wanted the new NICE guidelines to be adapted for the Czech Republic. They put a lot of work in it but the process was unfortunately stopped by the Czech Medical Association last year. In the end the patient organization decided to suspend their activities after this as they were too ill to continue.

In the meantime another Czech patient organization seems to have emerged, the one linked by @Andy just a few posts above this one. They chose a cute smiling sloth as their symbol. I'm not sure how I feel about that but maybe they are trying to make pwME look more harmless/innocent/sympathetic/relatable with such a cartoon character type of symbol.

Anyway, the actual point of my post is that this new organization posted this on Facebook: "Communication with the Ministry of the Czech Republic regarding ME/CFS diagnostics in the Czech Republic successfully launched!"

So I checked their website and this is what I found from February (Google Translate):

Indefatigable met the Ministry of Internal Affairs and Communications for the first time
Posted by —17 February 2023

In recent months, the Foundation has focused its efforts on implementing changes in the health sector and raising awareness. A petition and appeal by hundreds of patients and family members resulted in a meeting with the Ministry of Labor and Social Affairs, however the Ministry of Health continues to ignore patients.

The challenge under the title "Help chronic fatigue syndrome does not rob them of their lives!" signed by more than 400 patients and their relatives. The aim of the initiative was, already several times, to warn the Ministry of Health and the Ministry of Labor and Social Care that although the approach to chronic fatigue syndrome abroad has long since changed, in the Czech Republic care and support from the state is still unavailable for patients and is still subject to unfounded denial and belittling by the Czech Medical Society JE Purkyně.

Following the call, we received support from the chairman of the Patient Council or the National Association of Patient Organizations. Furthermore, on February 17, 2023, there was a personal meeting with representatives of the Ministry of Labor and Social Affairs. "Even though they understood the patients' situation to a large extent, the conclusion remains that changes must first of all take place in the health department," said Šimon Procházka, one of the founders of NF Neunavní.

During the meeting, we gave representatives of the Ministry of Internal Affairs and Communications an overview of developments in countries such as Great Britain, the Netherlands, Scandinavian countries and Germany. In all these states, studies were conducted under the leadership of professional societies, which confirmed the assumptions of patient organizations about the insufficient quality of medical and social care, and a resolute decision was made to include the diagnosis of chronic fatigue syndrome in the system of clinical recommendations there. Despite a certain complexity of detection, a set of symptoms has been developed that sufficiently confirms the presence of ME/CFS in a patient. In the Czech Republic, we consider a similar development to be inevitable, as well as the inclusion of ME/CFS in the decree on recognition of disability.

At the same time, we tried to refute the arguments of ČLS JEP regarding the necessity of defining chronic fatigue syndrome in the International Classification of Diseases of the World Health Organization. From the statement of MUDr. Miroslav Zvolský (head of the Department of Clinical Classifications of the DRG, ÚZIS CR), it follows that this classification "serves to identify and classify conditions, diagnoses and syndromes for the collection and statistical evaluation of the collected information. ICD-11 is not responsible for defining these states.” The same argumentation was chosen by the Ministry of Internal Affairs and Communications in 2020 in response to the interpellation of Minister Maláčová, who stated that "at the same time, it is necessary to state that the ICD is not an "assessment tool", but primarily serves statistical purposes for collecting data from the field of health."

The position of the Ministry of Internal Affairs and Communications regarding the recognition of disability and social care remains unchanged and considers the current system to be sufficient and does not consider the absence of an official diagnosis to be problematic. According to the Ministry of Health, the system does not take into account individual diseases, but rather the impact of health restrictions on the functioning of the individual as such. Ministry representatives therefore advise patients to always clearly define the individual's level of activity reduction and the impact of ME/CFS on their involvement in daily life with their treating physicians.

The Ministry of Health and Welfare also believes that patients with ME/CFS who apply for disability are not falling through the social care network. There was an internal review of the cases of all patients who participated in the call from May last year, and all those concerned were awarded at least first-degree disability. Although it is possible to agree with this conclusion, it is only one piece of the puzzle. First, patients with ME/CFS almost exclusively receive support in the form of a disability pension based on the so-called comorbidity and not on the basis of the primary cause of their medical condition. Second, the impact of chronic fatigue syndrome on an individual's activity is in most cases so severe that the first degree of disability is completely disproportionate to the severity of the situation and insufficient for the patients' lives.

In the following months, NF Neunavní plans to:

  1. Collect anonymous cases of individual patients, on the basis of which it would be possible for the Ministry of Internal Affairs and Communications to show that there is no adequate assessment of the situation.
  2. Put even more pressure on the Ministry of Health. At the moment, it is not clear what process will follow the Clinical Guidelines project, nor why the Ministry of Health does not consider the opinions of the ČLS JEP to be appropriate.
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Just an abstract from the PhD Scientific Days at Semmelweis University but the authors are Johanna Takács and Ákos Koller, who are two of the people doing LC research here

Impairments of Verbal Working Memory in Young Females in Post-COVID-19 Condition: Vaccination Prevents Cognitive Impairments
Johanna Takács1, Akos Koller2,3,4
1 Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
2 Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
3 Research Center for Sport Physiology, Hungarian University of Sports Science, Budapest
4 Institute of Translational Medicine, Faculty of Medicine, Semmelweis University, Budapest

Text of the abstract
Introduction: One of the most commonly reported symptoms of post-COVID-19 condition (PCC) is cognitive dysfunction. There are only few studies examining long-term cognitive symptoms (LTCS), but they are restricted to adults/older adults and lack a control group. We hypothesized that cognitive dysfunctions occur in young females in PCC, and vaccination has a preventive role even after reinfection.

Aims: To assess LTCS in PCC after a mild infection, and examine the preventive role of vaccination in cognitive impairments.

Method: 15 months after the COVID-19 infection, cognitive assessment was conducted with Vienna Test System Neuro, measuring attention and executive functions as well as response inhibition. 74 young female adults aged between 18 and 34 (M=20.6±3) participated in the study. Test results are interpreted in percentile ranks (PR) and frequencies.

Results: 64.9% of the young females had mild acute COVID-19 illness; 27.1% reported long COVID symptoms (LC). The rate of reinfection was 29.2%, mostly after vaccination. Attention functions and inhibition response showed non-significant differences between the LC, infected (IG) and control CG (CG) groups. However, in divided attention, the rate of below-average performance (<25PR) was higher in LC (61.5%) and IG (62.9%) than in CG (34.6%). In verbal working memory, there was a significant difference between the groups (F(2,70)=4.731, p=0.012, η2p=0.12). LC showed lower working memory performance (MPR=28.6±5.4) than IG (MPR=46.5±3.3) and CG (MPR=47.5±3.8). 69.2% of LC showed below-average performance; this was 20% in IG and 26.9% in CG. Non-reinfected (MPR=44.4±3.6) and after-vaccination reinfected (MPR=41.2±5.2) females showed better verbal working memory performance than those reinfected before vaccination (MPR=26.1±9.8).

Conclusion: In young females COVID-19 infection elicits long-term mild cognitive impairments, especially in verbal working memory. Vaccination helps to prevent cognitive dysfunctions in verbal working memory even after reinfection. Thus, the follow-up would be necessary to control the progression of cognitive impairments with/without subjective complaints, especially after reinfection.

Funding. ÚNKP-22-4 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.
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I posted an interview with them here earlier: https://www.s4me.info/threads/news-...slovakia-and-hungary.15709/page-7#post-423109
 
I found this in the Hungarian-language media of the Hungarian minority in Slovakia, but this article is about a Slovak person. Warning: the content may be disturbing!

Google translate: The terminally ill Slovak actress chose euthanasia

Katarína Paveleková decided that she wanted to end her pain forever. Two years ago, she developed serious health problems, reports Topstar.noviny.sk.

She could not live with her illness, so she visited a Swiss clinic specializing in assisted suicide. Two months before that, she went on vacation to Hurghada, Egypt, and she was not really well at that time.

The Hollywood model and actress posted her last Instagram post on June 1, announcing that she was ending her life. She wrote about her diagnosis of chronic fatigue syndrome, which involves muscle pain and inflammation of the brain and spinal cord. He added that she also suspected amyotrophic lateral sclerosis (ALS). It is a rare neurological disease that affects the motor neurons that control voluntary muscle movement.

She linked her illness to a booster dose of the covid vaccine.

"The booster shot I received more than a year ago has completely ruined my health, my body and my life. There is no other way to end my suffering. This disease has crippled me, made it impossible to work, socialize and even I can't enjoy life. My breathing has become more and more difficult and painful, and my lung function has also deteriorated."

- can be read in the post. Paveleková thanked her friends and loved ones for their support over the past year.

One of the good friends of the late actress was actress Lucia Oškerová, who will soon become parents with her partner, actor Michael Anthony Hall. Two months ago, Katarína was also there at their "baby shower" before the birth, and she was also very much looking forward to her friend's baby. It is not known what happened to her in the course of a few weeks.

Katarína played a minor role in several films, and also appeared in the film Paradise of Fools.
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Another article (Google translated) about the vaccines, this time on a pretty well-known news site. I only copy here the part that an immunologist said about what he believes to be the reason why these symptoms some people attribute to the vaccines are so similar to long covid:

Academician Dr. András Falus , Széchenyi Prize-winning immunologist, professor emeritus of Semmelweis University also confirmed to 24.hu that vaccinations can have side effects, and serious complaints can occur in a small proportion. "However, I do not agree at all that this would call into question the importance of vaccines," the expert told our newspaper.

(...)

As the specialist also pointed out, all medical or medicinal interventions have side effects, but a strange coincidence can be observed with coronavirus vaccines: the complaints seem to show a large overlap with post-covid symptoms. "Prolonged Covid affects about a fifth of those infected, and the symptoms are extremely similar to many of the suspected side effects," he explained.

It is difficult to assess the correlation
What became clear by the middle of 2022: vaccines do not protect against infection, but against a serious course that requires hospital treatment. In Hungary, even a vaccinated person can get sick, even without knowing it. According to András Falus, this may even partly explain some of the supposed side-effect cases that show similarities with post-covid.


It is not impossible, for example, that what a patient believes to be malaise after a vaccination is actually the result of an unidentified infection. Thanks to the protection, the patient does not need treatment, but in the long term, the virus or its bacterial superinfection can trigger, among other things, myocarditis. "This is similar to post-covid symptoms," the expert told our newspaper.

It is a serious problem in getting to know the situation precisely that it is not easy to reveal the cause-and-effect relationships, especially if we are examining individual cases. Looking at the big picture, statistics can help, for example, you can count how many people received the vaccine and how many of those people later developed symptoms, but the pandemic itself, the infections of the unvaccinated and the vaccinated complicate the picture.

The study should probably be carried out on a longer time scale, including the period before the pandemic, but the professor cautions here as well. The pandemic was an unprecedented event for our species, which seriously affected the human psyche with anxiety, restrictions, and isolation, and this can also distort the data.

As for the individual level: the immunologist is skeptical.

"All in all, I don't think it can be proven with a very correct scientific method that the particular after-effect was actually caused by the vaccine.

It is not at all certain that the complaint that appeared after the vaccination was really a consequence of the vaccination, as it could have been caused by some chronic infection. Genetically, we are not the same, someone can develop post-covid even after three doses," he told 24.hu.
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Veterinarian and virologist professor Miklós Rusvai frequently talks about covid in the media, here is an article where he also mentions long covid (Google Translate):

- But as long as the acute epidemic is at rest, long-term covid cases and problems caused by vaccination must be dealt with. The latter can be just as unpleasant as long Covid - he noted. According to Miklós Rusvai, it's worth being aware of the symptoms it causes, the complications it can cause (e.g. diabetes, circulation problems, endocrine disorders), and what it causes. It is also worth investigating whether the post-Covid or long-Covid phenomenon could also be the consequence of the tamed virus, he pointed out. According to the virologist, the examination of long Covid primarily requires statistical processing, and it is also important that general practitioners and hospital doctors have an interface where they can report their observations. As he said it is advisable to start this research as soon as possible, since the acute epidemic itself has passed, so in a few years it will no longer be possible to carry out such a precise investigation as now, when sixty to seventy percent of the domestic population has been infected.

Miklós Rusvai finally indicated: the harmful effects of smoking could only be proven with statistical data collected over decades. - Although smoking can be traced back hundreds of years, its harmful effects were only discovered fifty years ago. In addition, it took another thirty years for this to be clearly accepted by the medical community. In other words, only statistics will prove whether certain diseases (e.g. mental problems, psychological disorders) occur more often in people who have been infected with the coronavirus than in those who have not or only in a mild form, the specialist explained.
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Just an abstract from the 14th Congress of the Hungarian Society of Human Genetics and Genomics.

Google Translate:

Single-cell transcriptomic and immunomic mapping of T-cell immune dysfunction in long-COVID syndrome

Júlia Erhardt1, Ferenc Árpád Kovács1, Ágnes Németh1, Márta Ranák1,
Nóra Fekete2, Kamilla Li Luca1, Sándor Kovács1, Tünde Abonyi1, Bence Nagy2,
György Fekete1, Edit Buzás2, Éva Pállinger2, Gábor Kovács1
1 Semmelweis University, Department of Pediatrics, Tűzoltó Street, Budapest
2 Semmelweis University Genetics, Institute of Cell and Immunobiology, Budapest

Introduction: after SARS-CoV-2 infection, the long-COVID syndrome that develops in some children is associated with a significant impact on the quality of life. T-cells are the main elements of the adaptive immune system, they are organically involved in the development of both cellular and humoral immunity, and they play an important role against viral infections.

Objective: to systematically assess the symptom spectrum of the long-COVID syndrome among children with molecularly confirmed acute SARS-CoV-2 infection, and to investigate the role of T-cell-mediated immune dysfunction based on organ involvement.

Materials and methods: Patients (N=250) examined at the long-Covid outpatient clinic on Tűzoltó Street of Semmelweis University's Pediatric Clinic between 08.01.2021 and 06.01.2023 were classified according to their symptoms, and 30 people were included for detailed T-cell immunophenotyping. From the control group (N=54), we examined 10 age-adjusted samples. In addition to the detailed mapping of relevant clinical data, T-cell mediated immunity was assessed by flow cytometry, single-cell transcriptomics and immunomics.

Results: CD3+CD4+ T cells were decreased in children with long-COVID syndrome (CNS and chest symptoms 895 ± 268 cells/µL vs. chest symptoms 685 ± 232 vs. control 1107 ± 573 cells/µL group). The proportion of central memory T cells (thoracic 21.81 ± 12.37 vs. control 11.15 ± 4.1% group) increased, while the proportion of regulatory T cells decreased (central nervous system and thoracic 3.59 ± 3, 23 vs. control 9.35 ± 6.46% group). The proportion of NSP3 epitope-specific SARS-CoV-2-specific T cells (thoracic 5.26 ± 7.4% vs. control 10.96 ± 5.9% group) decreased, while the S epitope-specific SARS-CoV-2 T -cell ratio (central nervous system and chest 26.8 ± 12.8% vs control 17.7 ± 5.2% group) increased in long-COVID syndrome.

Conclusion: The number of CD3+CD4+ T cells changes significantly in Long-COVID syndrome, and the proportion of T cells also changes characteristically depending on the symptom spectrum. The proportion of memory T cells specific for the different SARS-CoV-2 epitope pattern suggests a dysfunction of T-cell immunity. Based on our preliminary results, T-cell-mediated immune dysfunction probably plays a significant role in the pathomechanism of the long-COVID syndrome.

Funding: Hungarian Academy of Sciences, MTA PC2022-9/2022
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