Coronavirus Tidbits #276, January 7, 2024

Muscle abnormalities worsen after post-exertional malaise in long COVID

We find a skeletal muscle alterations in patients with #longcovid, which worsen with exercise.

we confirmed the lower exercise capacity in patients with #longcovid, which can partly be explained by changes in skeletal muscle structure and function 2/n

We next wanted to find out if skeletal muscle abnormalities contribute to the feeling of muscle pain, and fatigue one day after an exercise test on a bike. We found that in some #longcovid patients there was extensive muscle damage, but also signs of repair

Skeletal muscle mitochondrial function and metabolism were altered in patients with #longcovid, and this worsened after induction of post-exertional malaise (PEM). Intense exercise is not good for patients with long COVID!

Blocking of capillaries by amyloid-containing deposits (or microclots) could reduced exercise capacity. We found these deposits in muscle tissue, but surprisingly not inside capillaries. They were located in between fibers, were higher in patients, and went up after exercise

We tested whether viral persistence contribute, and screened muscle biopsies for the N-protein. We saw equal amounts in patients and healthy controls (who recovered after COVID). No viral particles were inside cells, so we assume remnants and not active viral particles

This study contributed to our understanding of muscle pain, fatigue and weakness in patients, and provides a biological substrate for the disease. It doesn’t directly point to the cause of the disease, but highlights that exercise can worsen symptoms in patients

To reduce the skeletal muscle abnormalities (reduction in mitochondrial function, muscle damage and more microclots), we can only recommend to avoid strenuous exercise for now. Every patient likely has a different threshold for induction of post-exertional malaise.

https://www.nature.com/articles/s41467-023-44432-3

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Some hospitals reinstating mask requirements amid rise in COVID

As COVID-19 and other respiratory infections rise across the country, some major health systems are bringing back mask requirements to stop the spread of infections.

This week, Mass General Brigham, the largest health system in Massachusetts, said it will require masking for health care staff who interact directly with patients in clinical care locations starting Jan. 2.

Patients and visitors will be “strongly encouraged” to wear a facility-issued mask. Masks will not be required for staff in hallways and common areas.

[JS: How does this make sense? Covid is airborne. So not masking in hallways, nurses stations, waiting rooms, etc., makes ZERO sense...Pity they are setting standards for the rest of the country. Also, using surgical masks, and not N95s.

And their policy is still that HCWs can refuse to mask, even if a vulnerable patient requests it]

The health system in a statement said its policy is based on the percentage of patients presenting to emergency departments or outpatient clinics with symptoms of respiratory illness.

Once this figure exceeded 2.85 percent for two consecutive weeks, the masking requirement took effect. It will end once the level falls below 2.85 percent for a week.

https://thehill.com/policy/healthcare/4380733-hospitals-reinstating-mask-requirements-rise-covid/

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Pets and Covid

Canadian government recommends that if you have Covid symptoms and want to be around your pet, you should use an N95. The recommendations say to only use a surgical mask if N95s aren’t available.

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/animals-covid-19.html