Vagal cholinergic denervation of the gastric mucosa in Long-COVID-19

https://www.ijidonline.com/article/S1201-9712(26)00608-9/fulltext

by thenerdhead • 11 days ago

104 48 11 days ago

kranke1555• 11 days ago

hopefully we will get somewhere with these studies. The lack of solid research on a disease that affects millions (likely a good percentage undiagnosed) is really tough for patients - and myself really, as I've found i likely suffer from this.

Finding out about autonomic dysfunction and small fiber neuropathy as I researched my own fatigue and finding out I likely have this has been very challenging.

zx8080• 11 days ago

It's probably more profitable to treat symptoms.

jambalaya83• 11 days ago

Hard to treat symptoms with immunological conditions. I mean, there are vitamins and supplements, but noone is gonna generally hand out economy-sized bottles of controlled substances for exhaustion, etc.

These sorts of conditions are systemic, and the causes and ways of dealing with the accompanying syndromes are probably always going to be different from individual to individual (well, likely the exact physiological causes anyway).

J0nL2• 11 days ago

It's true, this is why there are so many government agencies focused on healthcare. The medical field lacks a healthy profit motive. Healthcare CEOs use their fiduciary responsibilities as an excuse and say they'll get sued if they don't exploit situations.

There was a SARS vaccine as far as back 2016 which could have changed everything but was ignored. Pharmaceutical execs told them they were, "waiting to see if it comes back yearly" first

PaulKeeble3• 11 days ago

So far all the trials attempting to do so have failed. Its not that people aren't trying this, it just doesn't work for most of the symptoms.

naturalmovement3• 11 days ago

as I researched my own fatigue and finding out I likely have this

Please don't do this. It's the medical equivalent of copy/pasting shit you don't understand from Stack Overflow.

Go see a doctor who has a degree and training.

hombre_fatal• 11 days ago

If there's no test for it, then what is the doctor going to do for something as nebulous as long covid?

derektank• 11 days ago

As someone who has gone in to doctors for issues with fatigue, it’s incredibly draining (both emotionally and financially) to be batted around between a PCP and specialists that are unable to provide you with a diagnosis. I don’t blame anyone for just sitting down and trying to learn whatever they can by reading.

I agree with your general thrust of course, you’re much more likely to incorrectly diagnose yourself doing this than correctly, and walking around with a false belief is worse than walking around with uncertainty. But simply saying, “go see a doctor,” is rarely helpful. I’ve never heard of someone who tried to diagnose themselves without first presenting the issue to a physician.

ksenzee2• 11 days ago

Autonomic neurologists are the relevant specialists. I invite you to look for one in your local area and see how rare they are. The last I checked, the Seattle metro area (and in fact the whole state of Washington) had precisely one board-certified autonomic neurologist. Diagnostic delay is, unsurprisingly, around six years. Combine that with the fact that all the equipment you need to do a basic POTS test is a pulse oximeter and a blood pressure cuff, and yeah, you're going to have people self-diagnosing, for good reason.

kranke1555• 10 days ago

I did see a doctor. I’m mid diagnosis / testing.

jph00• 11 days ago

Wow mucosal innervation was around half in long covid patients - that's super worrying and would have nasty symptoms in practice.

The findings also support the hypothesis that SARS-CoV-2 may cause structural nerve damage, which is perhaps the even bigger worry. :(

RandomTisk• 11 days ago

What kind of symptoms? I have insane stomach issues since early 2021 that only this year started to largely subside.

PaulKeeble3• 11 days ago

Any Long Covid patient can tell you its damaged their nerves, they can feel it. Nerve pain all over and various weird zaps and shakes etc, the nervous system is clearly damaged/being damaged across the entire body.

kranke1555• 10 days ago

This is I believe one of the markers for small fiber neuropathy which is now increasingly being found in association with long covid and related syndromes.

fragmede2• 10 days ago

All the B12 and gabapentin in the world won't reverse the damage, but at least there's hope.

peab• 11 days ago

i noticed a thing with headlines like these: "x may cause y". Whenever it's "may" or "might", it's almost always meaningless

shiggydump• 11 days ago

Only the Sith deal in absolutes.

thenerdhead6• 11 days ago

small study yes, meaningless no

Fomite2• 11 days ago

There has been a shift - an understandable one, and one I by and large support (absent some edge cases) - to move away from causal language for observational studies.

flextheruler• 11 days ago

8 people as the entire control group... yeah I'd say "may" is the operative word in the title. My takeaway from long covid is that it's probably as severe as the much more deadly pandemic of the Spanish Flu. Considering there's now a newfound interest in "long flu", I think a spotlight has now been placed on the impact of severe respiratory illness. Whether that illness be covid or one of the any other respiratory illnesses.

jambalaya83• 11 days ago

Yeah, twelve patients and eight in the control group isn't really a study.

thenerdhead6• 11 days ago

is a small proof of concept study not a study anymore? gastric biopsies aren’t exactly easy to obtain at scale.

thenerdhead6• 11 days ago

severity is only one factor in developing long covid.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

naturalmovement3• 11 days ago

Funny that reactive arthritis has been around for decades but no one dares call it "long chlamydia" I guess it doesn't sell YouTube clicks as well.

dmix• 11 days ago

Usually they add “chronic” like chronic Lyme disease https://en.wikipedia.org/wiki/Chronic_Lyme_disease

fsckboy• 11 days ago

wikipedia:

Reactive arthritis, previously known as Reiter's syndrome,[1] is a form of inflammatory arthritis[2] that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease.[3] By the time a person presents with symptoms, the "trigger" infection has often been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis);[8] however, it also can happen after group A streptococcal infections.[9][10]

remarkEon2• 11 days ago

Is there a test for long covid?

thenerdhead6• 11 days ago

not quite. A grab bag of biomarkers being validated in research labs across the USA though

PaulKeeble3• 11 days ago

Nothing you can order from your doctor yet but plenty of abnormal findings in almost every aspect of the body. As far as I know none of the findings yet is found in every sufferer, a combination can often get to ~95% but its very heterogenous and that has made it very hard to come up with a single test.

nradov• 11 days ago

There's no such thing as "long COVID" specifically. Any serious viral infection has the potential to cause sequalae in susceptible patients for reasons that are still not well understood. Some of those are detectible in lab tests to an extent but there's no single clear diagnostic test.

thenerdhead6• 11 days ago

they are pretty well understood now with growing evidence of viral persistence in the gut and immune cells, and immune dysfunction causing autoantibodies.

they are also distinct from other conditions like ME/CFS or other sequelae although they may share overlapping symptoms. A lot of research is going into different PAIS post acute infection syndromes

J0nL2• 11 days ago

It's long as in persistent viral colonization, often in immune privileged areas where the virus can hide from the immune system.

One theory is that the immune system doesn't always produce a strong enough antibody response to flush the virus from all these areas but the truth is that's likely only a subset of total cases.

remarkEon2• 11 days ago

Interesting, then I guess the obvious next question is … is there a test for being a susceptible patient? We’ve been talking about long COVID for years now. Surely there’s some commonalities amongst the people who suffer from it.

LorenPechtel2• 11 days ago

Think of AIDS before the immune system dysfunction was found. That's where we are with Long Covid. One cause, a myriad of apparently unrelated effects--that's not how biology tends to work. Rather, there's something deeper we haven't found. And we certainly can't test for what we haven't found.

naturalmovement3• 11 days ago

This is nothing like AIDS.

tsoukase• 11 days ago

Firstly the term 'long' is not good. Better is post-COVID syndrom, because the virus has been eliminated and not staying for long but the situation remains post infection.

Secondly, the majority of burden is caused by CNS/brain dysfunction, especially a form of neurotransmitter depletion, and not due to peripheral autonomous imbalance. And the former is a much more difficult therapeutic target: in my experience incurable for ever but also quite more rare that it is shown in the media.

Vagal cholinergic denervation of the gastric mucosa in Long-COVID-19

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