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We should take some of the most replicated findings in #MECFS and study them in #longCOVID patients. Some of these findings, if also present in #longCOVID, *could* potentially imply avenues for symptom management or therapeutic treatment.
Here are a few that might be interesting:
Low serum carnitine: https://me-pedia.org/wiki/Carnitine
Low natural killer cell function: https://me-pedia.org/wiki/Natural_killer_cell
Elevated lactate (blood, brain): https://me-pedia.org/wiki/Lactic_acid
Cerebral hypoperfusion: https://me-pedia.org/wiki/Brain#Blood_flow
Low serum carnitine: https://me-pedia.org/wiki/Carnitine Low natural killer cell function: https://me-pedia.org/wiki/Natural_killer_cell Elevated lactate (blood, brain): https://me-pedia.org/wiki/Lactic_acid Cerebral hypoperfusion: https://me-pedia.org/wiki/Brain#Blood_flow
Low AMPK activation: https://me-pedia.org/wiki/List_of_abnormal_findings_in_chronic_fatigue_syndrome_and_myalgic_encephalomyelitis#Muscular_system https://twitter.com/SimonBreidert/status/1353766519826763776?s=20
Increased mast cell populations: https://pubmed.ncbi.nlm.nih.gov/27362406/ 
Elevated muscarinic and B2-adrenergic receptor autoantibodies (also found in #POTS): https://me-pedia.org/wiki/Acetylcholine#In_human_disease
Intestinal dysbiosis: https://me-pedia.org/wiki/List_of_abnormal_findings_in_chronic_fatigue_syndrome_and_myalgic_encephalomyelitis#Gastrointestinal_tract
Peripheral endothelial dysfunction: https://onlinelibrary.wiley.com/doi/full/10.1002/ehf2.12633
Low cardiac output/pre-load failure: https://me-pedia.org/wiki/List_of_abnormal_findings_in_chronic_fatigue_syndrome_and_myalgic_encephalomyelitis#Heart11. Small heart syndrome: https://me-pedia.org/wiki/Small_heart_syndrome
12. Elevated IgA (corresponds to illness severity): https://me-pedia.org/wiki/Immunoglobulin_A
13. Low red blood cell magnesium: https://me-pedia.org/wiki/Magnesium
14. Impaired pyruvate dehydrogenase expression: https://me-pedia.org/wiki/Pyruvate_dehydrogenase
15. Increased glycolysis (anaerobic respiration): https://me-pedia.org/wiki/Glycolysis#Glycolysis_and_myalgic_encephalomyelitis
13. Low red blood cell magnesium: https://me-pedia.org/wiki/Magnesium
14. Impaired pyruvate dehydrogenase expression: https://me-pedia.org/wiki/Pyruvate_dehydrogenase
15. Increased glycolysis (anaerobic respiration): https://me-pedia.org/wiki/Glycolysis#Glycolysis_and_myalgic_encephalomyelitis
16. Reduced liver volume: https://www.tandfonline.com/doi/abs/10.1080/21641846.2018.1488525
17. Increased risk of death from heart failure (average age, 58.7, conditional on having heart failure): https://pubmed.ncbi.nlm.nih.gov/16844674/
18. Cytokine dysregulation: https://me-pedia.org/wiki/Cytokine
17. Increased risk of death from heart failure (average age, 58.7, conditional on having heart failure): https://pubmed.ncbi.nlm.nih.gov/16844674/
18. Cytokine dysregulation: https://me-pedia.org/wiki/Cytokine
19. Persistent infection (enteroviral): https://me-pedia.org/wiki/Enterovirus#Evidence_for_enterovirus_infection_in_ME.2FCFS
20. Neuroinflammation: https://me-pedia.org/wiki/Brain#Inflammation
20. Neuroinflammation: https://me-pedia.org/wiki/Brain#Inflammation
There is so much more than this. Here is a partial list: https://me-pedia.org/wiki/List_of_abnormal_findings_in_chronic_fatigue_syndrome_and_myalgic_encephalomyelitis (many findings aren’t even on MEpedia yet, let alone this page—but anyone can contribute, so have a go!)
I want to underline the importance of #longCOVID researchers doing thorough reviews of the #MECFS, #POTS, #EDS, #MCAS, #fibromyalgia and #PTLD literatures so they can cite relevant research and compare and contrast their findings, embedding them within 50+ years of context.
I also want to underline the history of 75+ outbreaks ( https://me-pedia.org/wiki/Epidemic_myalgic_encephalomyelitis), which resulted in a % of those infected developing the attached symptoms, many of which should look...awfully familiar to anyone who has #longCOVID or treats people who do.
As well as the importance of recognizing the many possible comorbidities and overlapping syndromes that #longCOVID patients may be developing or are at risk for. https://me-pedia.org/wiki/Comorbidities_of_Myalgic_Encephalomyelitis
Here’s how I think about this in the context of #MECFS: https://twitter.com/jenbrea/status/1352675184038166529?s=20
Here’s how I think about this in the context of #longCOVID (as well as #MECFS): https://twitter.com/jenbrea/status/1353372183456702467?s=20
Almost completely unstudied in #MECFS, but I believe of eminent importance, are mast cells ( https://me-pedia.org/wiki/Mast_cell ) and connective tissue ( https://me-pedia.org/wiki/Collagen ).
I think they help explain the “multi hit” hypothesis of #MECFS, which should be a hypothesis in #longCOVID, too.
I think they help explain the “multi hit” hypothesis of #MECFS, which should be a hypothesis in #longCOVID, too.
Here’s a bit more on the multi-hit hypothesis/equifinality: https://medium.com/@jenbrea/onset-part-iii-connections-65269f41b861 (skip to the second half or read Parts I & 2).
Finally, it is estimated that 50% of #MECFS patients meet criteria for #hEDS or #HSD, https://me-pedia.org/wiki/Ehlers-Danlos_syndrome#ME.2FCFS
Enough physicians are seeing connective tissue disease in #longCOVID, there’s a new ICD code for it: https://twitter.com/AlisonSbrana/status/1350273115285147650?s=20
Enough physicians are seeing connective tissue disease in #longCOVID, there’s a new ICD code for it: https://twitter.com/AlisonSbrana/status/1350273115285147650?s=20
Inflammatory connective tissue damage, at multiple sites, causing a dizzying array of possible pathologies unique to each patient, that some patients *will ‘spontaneously’ heal from with time, but others will not, with an overlay of #MCAS, might just be was pathogens can do...
If you got to the end, congrats!! What are other major findings/areas of inquiry in #MECFS #POTS #EDS #MCAS #fibro #PTLD that you think #longCOVID researchers and clinicians should know about?
Also gonna leave these links here...
US ME/CFS Clinician Coalition: https://mecfscliniciancoalition.org
#longCOVID and #MECFS: Understanding the connection: https://www.meaction.net/long-covid-me-understanding-the-connection/
US ME/CFS Clinician Coalition: https://mecfscliniciancoalition.org #longCOVID and #MECFS: Understanding the connection: https://www.meaction.net/long-covid-me-understanding-the-connection/
...and copy in some cool folks in research & medicine. Please share with any colleagues who might be interested. I think engaging with this literature is so important. @evolutionarypsy @ahandvanish @YoniFreedhoff @ScottGottliebMD @ShannonOMac @Dr2NisreenAlwan @trishgreenhalgh
@MatthewMarkert @WesElyMD @acweyand @arghavan_salles @VirusesImmunity @ErinSandersNP @choo_ek @janevandis @DocElovitz @uche_blackstock @meganranney @RanaAwdish @Cleavon_MD
@AlanLevinovitz @AlanaKinrich @EricTopol @BendyBrain @DrOniBee @drjessigold @amarkelkar @LeahNTorres @sczerwas @AdvocacyMD @drnatalietv @daniel_kraft @NINDSdirector @DrEReinhold
Do any of these findings surprise you?
