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TRAstonDrs @castltrastondrs.bsky.social · 13m

By comparing these 🔑 areas, this pilot study could provide early evidence suggesting common physiological pathways between #LongCOVID & ME/CFS & help researchers:
Refine larger-scale studies.
Target specific mechanisms for potential treatments.
Improve diagnostic methods for both conditions.

TRAstonDrs @castltrastondrs.bsky.social · 14m

@nature.com
www.nature.com/articles/s41...

www.rdash.nhs.uk/services/lon...

pmc.ncbi.nlm.nih.gov/articles/PMC...

www.uclh.nhs.uk/patients-and...

pubmed.ncbi.nlm.nih.gov/38562097/

pubmed.ncbi.nlm.nih.gov/32140630/

The Autonomic Nervous system is a part of our nervous system which controls bodily functions. It does this without the need for us to consciously control it - unlike if we tried to move our arms or say something. Lots of bodily functions are influenced by the autonomic nervous system: including temperature control, heart rate, blood pressure, digestion, breathing etc.

Normally, the autonomic nervous system is kept balanced by two different branches. The sympathetic branch (you may know as the ‘fight or flight response’) and the parasympathetic (also referred to as ‘rest and digest’).

These 2 branches keep your bodily functions in balance and adjust depending on what requirements your body needs. For example, if you need to run fast, the sympathetic branch will cause your heart rate to increase to increase blood flow and oxygen delivery to your muscles. Once you stop running, the parasympathetic nervous system acts to slow the heart rate, returning to a resting state.

Cleveland clinic

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TRAstonDrs @castltrastondrs.bsky.social · 28m

Study indicates that many #LongCOVID experience symptoms that overlap ME/CFS, suggesting shared underlying physiological mechanism.
@cellpress.bsky.social
www.cell.com/cell-reports...

@pnas.org
www.pnas.org/doi/pdf/10.1...

bmjopen.bmj.com/content/bmjo...

www.frontiersin.org/journals/med...

Frontiers | ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Some patients remain unwell for months after “recovering” from the acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted ...

www.frontiersin.org

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TRAstonDrs @castltrastondrs.bsky.social · 41m

#Medsky🧪 #IDsky #immunosky #neurocovid #publichealth
The pilot study likely investigated similarities in autonomic phenotyping, brain blood flow control & cognitive-motor integration between #LongCOVID & ME/CFS.

www.sciencedirect.com/science/arti...

pdf.sciencedirectassets.com/272142/AIP/1...

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Reposted by TRAstonDrs

Mike Honey @mikehoney.bsky.social · 3d

With the NB.1.8.1.* "Nimbus" and XFG.* "Stratus" variants carving up dominance around the globe, it is time to ponder which variant might drive the next wave.

The leading contender at this point is PY.1.1.1.

#COVID19 #SARSCoV2 #PY_1_1_1 #XFG_1_1
🧵

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TRAstonDrs @castltrastondrs.bsky.social · 1h

@thelancetinfdis.bsky.social
Pdf version
www.thelancet.com/action/showP...

www.thelancet.com/journals/lan...

Antiviral efficacy of oral ensitrelvir versus oral ritonavir-boosted nirmatrelvir in COVID-19 (PLATCOV): an open-label, phase 2, randomised, controlled, adaptive trial

Both ensitrelvir and nirmatrelvir accelerate oropharyngeal SARS-CoV-2 viral clearance. Ensitrelvir is an effective alternative to currently available antivirals in treating COVID-19. Although COVID-19...

www.thelancet.com

TRAstonDrs @castltrastondrs.bsky.social · 2h

Additionally, ensitrelvir offered a simpler once-daily dosing & a better tolerability profile in the PLATCOV trial. Consequently, the study authors concluded that ensitrelvir is an effective alternative to currently available antivirals.

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TRAstonDrs @castltrastondrs.bsky.social · 2h

Both #ensitrelvir & #paxlovid are potent & well-tolerated antiviral treatments for early COVID . While paxlovid showed slightly faster #viralclearance, #ensitrelvir demonstrated similar efficacy.

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TRAstonDrs @castltrastondrs.bsky.social · 2h

Both antivirals significantly accelerated viral clearance in acute #COVID, with ensitrelvir being slightly less potent in this specific measure.
@thelancetinfdis.bsky.social
pubmed.ncbi.nlm.nih.gov/41082886/#:~...

pmc.ncbi.nlm.nih.gov/articles/PMC...

pmc.ncbi.nlm.nih.gov/articles/PMC...

The head-to-head comparison was conducted in the PLATCOV open-label, Phase 2, randomized, controlled, adaptive trial between March 2023 and April 2024.

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TRAstonDrs @castltrastondrs.bsky.social · 2h

These should be initially assessed in pharmacometric platform trials assessing viral clearance.
Results from the PLATCOV trial revealed that oral ensitrelvir is an effective alternative to oral #Paxlovid for treating #COVID.

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TRAstonDrs @castltrastondrs.bsky.social · 2h

While COVID is now generally mild in vaccinated individuals, it still causes substantial morbidity, particularly in vulnerable groups. New variants or other #coronaviruses could still emerge with pandemic potential, highlighting the need for safe, effective & affordable antivirals.

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TRAstonDrs @castltrastondrs.bsky.social · 2h

#Medsky🧪 #IDsky #immunosky #episky #pharmsky #publichealth
Both #ensitrelvir & #Paxlovid accelerate oropharyngeal #SARSCoV2 #viralclearance. Ensitrelvir is an effective alternative to currently available antivirals in treating outpatients with #COVID.

The Lancet Infectious Diseases @thelancetinfdis.bsky.social · 1d

New Research

Antiviral efficacy of oral ensitrelvir versus oral ritonavir-boosted nirmatrelvir in COVID-19 (PLATCOV): an open-label, phase 2, randomised, controlled, adaptive trial

www.thelancet.com/journals/lan...

Antiviral efficacy of oral ensitrelvir versus oral ritonavir-boosted nirmatrelvir in COVID-19 (PLATCOV): an open-label, phase 2, randomised, controlled, adaptive trial

Both ensitrelvir and nirmatrelvir accelerate oropharyngeal SARS-CoV-2 viral clearance. Ensitrelvir is an effective alternative to currently available antivirals in treating COVID-19. Although COVID-19...

www.thelancet.com

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Reposted by TRAstonDrs

Ian Weissman, DO @drianweissman.bsky.social · 4h

Americans headed to pharmacies for COVID-19 vaccines are running into roadblocks and confusion due to new U.S. guidance that abandoned broad support for the shots, contributing to the lowest vaccination rates since they were introduced.
www.reuters.com/legal/litiga...

New US COVID guidelines add confusion, complications for Americans seeking shots

Americans headed to pharmacies for COVID-19 vaccines are running into roadblocks and confusion due to new U.S. guidance that abandoned broad support for the shots, contributing to the lowest vaccination rates since they were introduced.

www.reuters.com

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TRAstonDrs @castltrastondrs.bsky.social · 9h

Should we say all : N-95 m😷 , #COVID19vaccines, yearly vaccinations for children & pregnant women, biannual vaccinations for older & immunocompromised individuals

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TRAstonDrs @castltrastondrs.bsky.social · 9h

OMG

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TRAstonDrs @castltrastondrs.bsky.social · 10h

provided there are no specific contraindications.
- Consider potential drug interactions: Clinicians should be aware of potential Rx - Rx interactions with other #COVID therapies, such as ritonavir-boosted antivirals & monitor patients accordingly.

TRAstonDrs @castltrastondrs.bsky.social · 10h

Therefore, statins should not be started solely for this purpose.

d-nb.info/1352495597/3...
- Continue existing statin therapy: Patients already taking statins for cardiovascular indications should continue their medication during hospitalisation,

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TRAstonDrs @castltrastondrs.bsky.social · 10h

Based on the available evidences &clinical practice
- Do not initiate statins to treat COVID : There is no consensus from randomised controlled trials demonstrating a clear benefit of statins for treating COVID .

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TRAstonDrs @castltrastondrs.bsky.social · 10h

Concurrent administration of other Rx used to treat #COVID such as ritonavir, can interfere with statin metabolism & increase the risk of liver toxicity.
The systemic inflammation from #COVID could theoretically ⏫️ the risk of myalgia & elevated liver enzymes, similar to known statin side effect

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TRAstonDrs @castltrastondrs.bsky.social · 10h

The 2025 meta-analysis found a small but significant increase in #myopathy (0.6% vs. 0%) but no significant difference in liver enzyme abnormalities (1.0% vs. 1.4%).
Older meta-analyses & systematic reviews also reported no significant increase in ⏫️ liver enzyme levels associated with statin use

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TRAstonDrs @castltrastondrs.bsky.social · 10h

www.thrombosisresearch.com/article/S004...

pmc.ncbi.nlm.nih.gov/articles/PMC...

pmc.ncbi.nlm.nih.gov/articles/PMC...

pmc.ncbi.nlm.nih.gov/articles/PMC...

The reviewed studies suggest that statins have an excellent & generally favourable safety profile in hospitalized #COVID patients

Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations

Statins have been widely advocated for use in COVID-19 based on large favorable observational associations buttressed by theoretical expected benefits. However, past favorable associations of statins ...

https://pmc.ncbi.nlm.nih.gov/articles/PMC10380486/#:~:text=We%20demonstrate%20that%20massive%20“healthy,21%2C22%2C23%5D

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TRAstonDrs @castltrastondrs.bsky.social · 10h

Observational studies, which have shown positive associations with #statin use & outcomes, are prone to confounding factors, such as the healthy user effect, which RCTs are designed to avoid.
It is also possible that different variants of #SARSCoV2 & variations in statin dosage affect outcomes.

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TRAstonDrs @castltrastondrs.bsky.social · 10h

pmc.ncbi.nlm.nih.gov/articles/PMC...
www.annsaudimed.net/doi/full/10....
Differences in included trials, patient populations & study characteristics may contribute to the conflicting findings.

Effects of statin therapy in hospitalized adult COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials

COVID-19 is associated with endothelial activation and systemic inflammation; consequently, statins can be used in its treatment as they have anti-inflammatory, antithrombotic, and profibrinolytic pro...

pmc.ncbi.nlm.nih.gov

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TRAstonDrs @castltrastondrs.bsky.social · 10h

Other meta-analyses published in 2023 & 2024, including one that incorporated data from the large REMAP-CAP study, found no significant difference in all-cause mortality, length of hospital stay, or need for MV between patients treated with statins & those receiving standard care or placebo

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TRAstonDrs @castltrastondrs.bsky.social · 10h

www.sciencedirect.com/science/arti...
#statins Effectiveness for hospitalized #COVID patients . In 3 RCTs involving 3,882 statin-naive patients. It found that statin therapy was associated with a significant reduction in 30-day all-cause mortality (OR: 0.82, 95% CI 0.70–0.96; P = 0.01).

Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials

Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospi…

www.sciencedirect.com

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