Long Covid Enigma?

Time to put the finger on it.

“Lack of Ontario long COVID strategy risks care: ministry documents” (CBC, 2023.05.03):

Long COVID is not yet well understood, but the current and likely rising volume of patients will have an effect on Ontario's recovery and may place added pressures on emergency rooms, say the documents obtained under a Freedom of Information request.

Between 10 and 20 per cent of people who have had COVID-19 still experience symptoms 12 or more weeks post-infection, the documents note. Researchers estimate 1.4 million Canadians are living with long COVID.

Not well understood? After 3 years? Maybe we don’t want to know?

According to another CBC article from Jan. 2023, “the most common symptoms include deep-rooted fatigue, brain fog, heart palpitations, insomnia and mood disorders like anxiety and depression.”

Sounds like neurological disturbances to me. Let’s look at heart palpitations first. “Are Heart Palpitations Normal?”(Abbott, June 2018):

The vagus nerve is one of the nerves responsible for controlling your heart rate. This important nerve passes through your neck and thorax to your abdomen and has an extensive distribution throughout your body. Stimulation of the vagus nerve with the Valsalva manoeuvre can help control heart palpitations.

Yet, there may be other nerves damaged that result in arrhythmia, .e.g. “Cardiac autonomic nerve distribution and arrhythmia”(Neural regen Res., Dec. 2012):

The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance, and symptoms of arrhythmia.

This same article points out the markers that can help diagnose the causes of arrhythmia (“The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution.”) Why isn’t it widely done? Likely because we don’t want to know?

“B.C. doctors push back against company offering 'long-COVID testing'“ (CTV News, 2023.05.04): “Canada’s biggest testing and diagnostics company is offering “various diagnostic tests” for long COVID to British Columbians, even though the national health agency clearly states the condition isn’t detectible via testing. The Public Health Agency of Canada, however, is clear that ‘there are currently no diagnostic tests or treatments for post-COVID-19 condition.’ The president of Doctors of BC agrees with the national public health agency, and pointed out the testing recommended is so broad – it’s essentially useless. https://www.doctorsofbc.ca/”

As we all know by now, the Covid vaccines are known to cause inflammatory autoimmune nerve damage, as manifested by incidents of GBS and others, e.g. “Covid-19: Regulators warn that rare Guillain-Barré cases may link to J&J and AstraZeneca vaccines”(BMJ, July 2021).

Yet, we have just scratched the surface of “Long Covid”. There’s more!

“CU School of Medicine Researcher Identifies Potential Cause of ‘Long COVID’” (Feb. 20203):

The results led Palmer and his research team to theorize that post-acute sequelae of COVID (PASC) symptoms are being driven by the immune system, which is ramping up inflammation in response to the COVID virus that remains hidden in the body post-initial infection.

“We took these blood cells, and we incubated them with little parts and pieces of the virus. Then we looked at the frequency of two types of T cells — CD4 and CD8 — that respond by producing cytokines,” Palmer says. “The cells that responded to the viral parts were specific for SARS-CoV-2.

“We found a very pronounced high frequency of cytotoxic CD8 T cells in the individuals with PASC,” he adds. “These responses were up to 100 times higher in the PASC group than in the individuals who didn’t have long-term, persistent symptoms.”

Palmer, who also studies HIV infection, was astonished to see that a few people six months out from their initial infection had nearly 50% of their T cells directed against COVID-19. “That’s an amazingly high frequency, much higher than we typically see in HIV, where you have ongoing viral replication all the time,” he says. “These responses were in most cases higher than what we see in HIV.”

We are back to the chronic inflammatory responses, and this time we have the clear culprit - CD8+ T cell overabundance.

And here’s a Nature article from Jul. 2021 exactly on this subject: “Rapid and stable mobilization of CD8+ T cells by SARS-CoV-2 mRNA vaccine”:

Fully functional vaccine-elicited early memory CD8+ T cells patrol the periphery for SARS-CoV-2 at least within the first months. The functional capacity of spike-specific early memory CD8+ T cells is similar after vaccination and natural infection up to 3–4 months after boost or symptom onset. Compared with natural infection, however, the early memory pool of spike-specific CD8+ T cells after vaccination exhibits a different memory T cell subset distribution that may affect long-term maintenance characteristics. …our data provide insights into the protective mechanisms that underlie bnt162b2 vaccination.

Fig. 1: Vaccine-elicited epitope-specific CD8+ T cells: a, Calculated ex vivo frequency indicated at baseline (BL), dpp and dpb for spike-specific CD8+ T cells. Detection limit: 5 × 10−6. b, Percentage of CD38, Ki-67 and T-BEThi expressing spike-specific non-naive CD8+ T cells. c, Diffusion map showing flow cytometry data for A*02/S269-specific CD8+ T cells in relation to dpp (shades of red) and dpb (shades of grey) in one individual. Expression levels of CD38, T-BET, TOX and BCL-2 are plotted on the diffusion map (blue denotes low expression; red denotes high expression). d, e, Calculated ex vivo frequencies of non-naive spike-specific CD8+ T cells expressing CD127 or TCF-1 for spike-specific CD8+ T cells. Line indicates median. P values determined by two-way ANOVA with main effects only comparing the effect of the different epitopes (Pe) and of time course (Pt:).

You can see that CD8+ S spike specific T cells stay elevated well into 4 months post “vaccination”. Which hashes well with the fact that S spike mRNA stays functional and keeps producing S spikes for at least that long. Considering that people are encouraged to top up on S spike every 6 months (in the form of boosters), the widespread continuous inflammatory condition (e.k.a. “Long Covid”) should come as no surprise.

So, while the expects stay baffled as to what Long Covid actually is, we have some pretty solid clues.

I’ll stop right there lest I am labeled as the vaccine misinformation spreader. That is the worst that can happen to anyone these days?

But I encourage the readers to share their perspectives in the comments below.

For the reference: “Treatment for Long COVID Patients” (cornerstonephysio.com, Toronto, ON, Canada)