18 ms·

Antiplatelet and anticoagulant therapy resolves long covid in 24 patients

233 points by tcamde 5y ago

swayvil 5y ago
Could covid not actually be just a disease? Maybe it's a disease + chronic unhealth. Due to age, pollution, obesity, bad diet, sitting on yr butt too much and/or etc
- ciphol 5y ago
  Nearly all diseases are worse if you're in bad health to begin with. That doesn't make them "not just diseases".
  - swayvil 5y ago
    Well if they have no symptoms then they aren't really diseases, right? And there are a thousand species of varmint that inhabit our body without helping or hurting anyway. So yes, massive unhealth can definitely spell the difference there.
    - SketchySeaBeast 5y ago
      I'm not following. For some people a cold can have basically no symptoms and can even spread asymptomatically, and for most people it's just an irritation, but for the especially vulnerable it can kill. Would you argue that the common cold is also not a disease?
      - swayvil 5y ago
        The key word here is "for some". If nobody gets a symptom then it isn't a disease. If only a very few get a symptom then maybe we call it a disease and maybe we call it something else. A disease requires some minimum proportion of the infected to feel it. Otherwise it's just commensalism or something. Therefore, as the general health shifts, so does what we call our relationship with that varmint.
        SketchySeaBeast 5y ago
        I'm still confused, because I don't know how that connects to your question "Could covid not actually be just a disease?", because it clearly is as it's affecting people. If we assume that the cold is a disease so is COVID, by the same criteria. Is the cold not just a disease? If so, what is just a disease?
        swayvil 5y ago
        It's a pretty simple idea. I'm having doubts about this "confusion".
        SketchySeaBeast 5y ago
        Fair enough. I think you're throwing a weird "disease" distinction and then moralizing angle into COVID which doesn't make any sense. We didn't just hit some sort of health critical mass for illness. COVID is its own beast and it's hurting a ton of people and implying it's people's fault for eating junk is bizarre.
        swayvil 5y ago
        The moral trip is all yours.
invitrom 5y ago
How risky is this therapy?
- aborsy 5y ago
  Anticoagulants and anti-platelets increase the chance of hemorrhage in the brain. So while they prevent ischemic stroke and help with circulation, they might cause hemorrhagic stroke. The dose and time duration has to be carefully adjusted. It’s a slippery slope in dealing with cerebrovascular accidents. Anti platelets (specially Aspirin 80 and Clopidogrel) are less risky than anticoagulants (such as heparin or warfarin).
- haroldskavar 5y ago
hammock 5y ago
- axel6665 5y ago
- SketchySeaBeast 5y ago
  Just for my own curiosity I clicked on your link. The I-MASK+ protocol also currently recommends Ivermectin (and if you don't have ivermectin, use black cumin seed), mouthwash, and a half dozen different vitamins for prevention and early treatment.
  - nradov 5y ago
    There is some clinical evidence to support curcumin as a prophylactic or treatment for COVID-19. The evidence so far is weak, but it's cheap and has no real side effects at normal dosage so from a risk versus reward standpoint it may be worth a look. https://www.frontiersin.org/articles/10.3389/fphar.2021.669362/full https://www.frontiersin.org/articles/10.3389/fphar.2021.6693...
    - SketchySeaBeast 5y ago
      Fair enough, but outside of the ivermectin misinformation, it feels a lot like busywork, giving people agency and a feeling of having done something when they haven't.
      - nradov 5y ago
        Where is the busywork? Other than ivermectin, the other recommended interventions also have at least some clinical evidence and no major negative side effects for those that choose to use them. Have you actually analyzed each of them within a risk versus reward framework?
        SketchySeaBeast 5y ago
nicoburns 5y ago
Huh. This is interesting. I also have some fatigue, but my most obvious long-covid symptom is heart pain/strain which is aggravated by either an elevated heart rate or dehydration. I'm no expert, but intuitively this would seem to provide a good explanation of those symptoms.
- runnerup 5y ago
  I'm hopeful that research into whatever "long covid" syndrome is/isn't leads to excellent new medical knowledge that applies to much more than just COVID edge-cases. I suddenly got similar symptoms since getting a nasty version of strep throat last October. Notably I had an elevated fever (>102F) for quite a few days straight. I've never had COVID but I did get the mRNA vaccines + booster. Since that fever, my heart goes into light arrhythmia all too frequently. It used to be maybe once or twice a year I'd notice 1-3 seconds of "off-beat" heart pattern. All of of a sudden it's a few times a week. I'm also getting older (entering mid 30's now), live in some of the worst air quality in the US (next to a bunch of chemical plants which are frequently releasing quantities of ethylene oxide/mercaptans/styrenes/acrylates/etc), and haven't been exercising much at all the past few years (largely due to air quality issues). My diet isn't the best either, but I incorporate a lot of fresh salmon which keeps my blood pressure down, triglycerides low, and HDL really quite high. There's probably more I could do to help myself using just current medical knowledge, but additional knowledge and medical practices are always, always welcome IMO.
  - superbaconman 5y ago
    Tell your doctor about your symptoms and then ask for an ECG. You want to know if you have an underlying heart condition. Depending on what you find, there may be options that will eliminate your arrhythmias.
    - dmichulke 5y ago
      Anecdotally, I also had arrhythmia and after a few months and visits to doctors I figured out it was the type of coffee I drank. Changed back (from Espresso so standard) and the arrythmia was gone. YMMV
JohnJamesRambo 5y ago
I think I’m going to start taking aspirin. Oddly enough I took that a few times because I didn’t have ibuprofen and I do feel like it helped a lot with the weird long symptoms I am experiencing. I’m triple vaccinated before anyone asks. I haven’t tested positive for Covid on rapid tests but a lot of people seem to be in the boat I’m in right now.
- open-source-ux 5y ago
  "I think I’m going to start taking aspirin" In the UK there is a large, ongoing clinical trial called 'RECOVER' to test different COVID treaments for hospitalised COVID patients. One of the trials included giving hospitalised patients aspirin. The trial was not looking at the treatment of long-covid symptoms (at least not directly in hospital patients). "A total of 7351 patients were randomised to aspirin 150 mg once daily and compared with 7541 patients randomised to usual care alone. There was no evidence that aspirin treatment reduced mortality." Link: RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19: https://www.recoverytrial.net/news/recovery-trial-finds-aspirin-does-not-improve-survival-for-patients-hospitalised-with-covid-19 https://www.recoverytrial.net/news/recovery-trial-finds-aspi...
  - cdrini 5y ago
    This doesn't feel super applicable. The body in the middle of a COVID infection vs months later is in a VERY different state. Also I don't even know if there's any mortality data for long COVID; it could just provide quality of life degradation.
    - jacobolus 5y ago
      I saw an observational study tracking hospitalized (but nominally surviving) Covid patients for a year where a far higher number died (of various causes) than the base rate in the population [sorry I can’t find a link now in a few minutes of searching]. Some of this is selection bias (people who get bad Covid cases tend to be in worse shape to begin with), but I would expect the after-effects of Covid to cause significantly increased mortality. We’ll have much better data about this in a few years.
LinuxBender 5y ago
Are there by chance any similar tests on long covid patients using the enzymes Serrapeptase and Nattokinase? Or any of the other 30 or so related enzymes? Asking because Natto has the nice side benefit of binding to ACE2 and it is super easy to acquire. These enzymes are also Fibrinolytics. As a related question, how is Japan doing in terms of long covid cases relative to everywhere else? They eat a lot of Natto.
- nykiwi 5y ago
  Thanks for this comment, I found it very interesting and now I want to learn about it all. Thanks :)
- pfisherman 5y ago
  Why would fibrinolytics have any therapeutic effect? They are not anti coagulants (i.e. serine protease inhibitors), and work via an entirely different mechanism.
  - LinuxBender 5y ago
    Absolutely not anti-coagulants. They work in conjunction with them to break up clots and absolutely have many different mechanisms. I use six of those mechanisms for controlling blood pressure. The article topic covers fibrin amyloid microclots which is precisely what many surgeons have used these enzymes for in addition to removing scar tissue from the vasculature. On a side note this is a very divided and heated topic within the different groups of heart surgeons.
    - sithadmin 5y ago
      You're specifically using compounds like nattokinase to control blood pressure? Would be interested in hearing what your approach here is, or any literature you could share.
      - LinuxBender 5y ago
        You're specifically using compounds like nattokinase to control blood pressure? Correct. Here [1] is one of the studies though there are quite a few on nih.gov that vary in results and P-value. In full disclosure I use much higher FU's than what is used in their test and have been using it for a long time building up to those levels so my risks are lower. I use this in combination with vascular de-calcification methods and other molecules that break down plaques. I don't have any of them handy but you can also find some videos that talk about the different mechanisms that Natto interact with that affect BP. It is surprisingly not what one might expect. While it does bind to ACE2 that has a very insignificant role in BP. The biggest effect comes from how it changes a feedback mechanism in a peptide chain. I was taken aback when I learned how many roles peptides play in mammals well beyond tissue repair. On a fun side note Natto also has an effect on von Willebrand factor which is also plays a significant role in covid. I should of course add that I am not a doctor and this is not medical advise. Enzymes can break down scar tissue, plaques and more. These come with some risk of bleeding and stroke - one must study the risks and discuss with their doctors that will likely give them blank stares until they say "orally bioavailable tissue plasminogen activator" which is not entirely correct but it will help them understand the intent and might tickle their curiosity. [1] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066864/
cpncrunch 5y ago
Uncontrolled, open label.
Madmallard 5y ago
So is long covid post-thrombotic syndrome like in patients that survive pulmonary embolisms?
cdrini 5y ago
The link between microclots and long COVID is new to me and fascinating. Anecdotally, this gels with some of the symptoms I've seen in friends/family. My father had reduced motility in his arm-- where he'd broken it many years before--for many months after recovering from COVID. Then one random day, after he'd strained himself a bit, he noticed the pain/restriction completely gone, and the skin had turned slightly black in the region where it used to hurt. Not a doctor, but feels like something related to a microclot? He described the pain as almost like a twisted nerve or vein. This HN post talks more about the link: https://news.ycombinator.com/item?id=29808020 https://news.ycombinator.com/item?id=29808020
- SOLAR_FIELDS 5y ago
  One of my more bizarre long COVID symptoms was blood vessel leakage on my feet. One day a month or so after getting over COVID my feet started noticeably swelling. I was worried I had a clot in my leg so I went to the ER but sonogram came out fine. Turns out I had worn too-tight shoes the day before and the vessels in my feet had swelled/leaked. This was my same pair of shoes I had always worn at same tightness (they were running shoes that I had always slipped on and off, never tied or untied) so I knew that it had to be COVID related.
  - nradov 5y ago
    Why do you know it had to be COVID related? Many conditions can cause swollen feet.
    - SOLAR_FIELDS 5y ago
      Because I had been wearing those same shoes for years with the exact same level of tightness and never in my life had swollen feet problem before. The bruising was also following the lines of the shoes which is how it was discovered it was related to the shoe tightness
      - nradov 5y ago
        None of that implies that COVID was the cause. It could just be a coincidence.
jokethrowaway 5y ago
Sounds exactly like chronic fatigue syndrome, I don't know why we keep calling it Long COVID while we have a name for it. https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ > Suggested causes or triggers for ME/CFS include: > viral infections, such as glandular fever > bacterial infections, such as pneumonia > problems with the immune system > a hormone imbalance > your genes – ME/CFS seems to be more common in some families I have a friend who got CFS out of nowhere (shortly before the 2 years to flatten the curve started, no COVID involved) and it's bad, there is no cure and it's incredibly disruptive. At the same time, it's hard for people to take you seriously and not just call you lazy. Hopefully this study goes somewhere and we'll find a cure for CFS.
- myoldohiohome 5y ago
  I hope so too. I recognized the symptoms (in myself) as soon as I started reading the abstract. --- from the link cdrini posted above, which is a Guardian article by one of the authors of the study in the original post.[0] "Even those without long Covid could benefit from such research, as symptoms noted in long Covid patients show many similarities to those seen in chronic and viral-related illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – another disease that has been dismissed as “psychological” for decades. Just because we have not yet identified a biomarker for long Covid does not mean biomarkers do not exist. We just need to look harder." [0] https://news.ycombinator.com/item?id=29808020 https://news.ycombinator.com/item?id=29808020 PS. Hope the post is done correctly, it's my first one here.
  - aarongray 5y ago
    If you're interested in Biomarkers for Long Covid and ME/CFS, look up Chronic Inflammatory Response Syndrome (CIRS). MMP-9, MSH, ACTH, TGF-beta 1, Cortisol, Glutathione, and Vasoactive Intestinal Peptide are a few of them. Lots of research here that was started by illnesses triggered by mold mycotoxins and lyme disease - the initial trigger is different than Covid - but the end result in terms of biomarkers and dysregulation in the body is the same. Doctors have been using these protocols to successfully treat patients for a few years now, but it just hasn't trickled down to the mainstream medical community or the medical schools yet. Further reading: - https://www.survivingmold.com/Publications/2493-Treatable_metabolic_and_inflammatory_abnormalities_in_Post_COVID(2).pdf https://www.survivingmold.com/Publications/2493-Treatable_me... - https://www.survivingmold.com/docs/Shoemakers_Protocol_for_publishing.pdf https://www.survivingmold.com/docs/Shoemakers_Protocol_for_p... - https://www.survivingmold.com/Publications/CIRS_diagnostic_protocol_final_5_1_2018.pdf https://www.survivingmold.com/Publications/CIRS_diagnostic_p...
znd 5y ago
Ctrl+f placebo - Phrase not found. Such a waste.
wantsanagent 5y ago
This is a big hammer. Please note this section: "A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole." Induced hemophilia is no joke.
- merpnderp 5y ago
  Do people really get holes in their stomach often enough that this regiment would cause them to bleed to death?
  - kahrl 5y ago
    Yes. Absolutely. GI issues are some of the most common medical problems. Ucers, polyps, sores, diverticula...
    - QuercusMax 5y ago
      My dad got a hole in his stomach from taking too much Advil (ibuprofen) for pain related to a broken vertebra.
      - kahrl 5y ago
        jeez. NSAIDs can do some nasty stuff when taken regularly. Most people just pop 'em like candy.
- allturtles 5y ago
  To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.
  - favorited 5y ago
mkarliner 5y ago
So 24 patients reported relief of symtoms. It would occur to me that a placebo effect could account for this. A study with a control group would hold greater validity in my mind. This seems purely anecdoctal despite academic styling.
- merpnderp 5y ago
  Placebo effect accounts for changes in their blood markers for micro clots? I'm a big believer in the power of the mind, but this seems a stretch.
  - iamthepieman 5y ago
    The point is that without a control group there's no way to know.
    - texasbigdata 5y ago
      I drove to Germany to see the machines. Spoke to the doc admistering it. It's a potentially painful almost full day procedure. We discussed the placebo thing. I'm not an expert on medical ethics but personally I would not want to be intubated (potentially wrong word) into that thing for hours and not get treatment.
    - nradov 5y ago
      That's not strictly true. Consider our complete set of medical knowledge today. What percentage of that knowledge came from studies with control groups?
      - deleted 5y ago
        [deleted]
      - yamrzou 5y ago
        When experimenting with new treatments, a control group is very important. Otherwise the study could be biased in favor or against the treatment. Even when a control group is present, a poorly-designed experiment could later turn out to be problematic, such as the Diethylstilbestrol (DES) medical tragedy (https://en.wikipedia.org/wiki/Diethylstilbestrol https://en.wikipedia.org/wiki/Diethylstilbestrol). In that case, studies that were in favor of the treatment were poorly-designed and used historical controls instead of contemporaneous ones.
ck2 5y ago
It's a preprint that has already been criticized by peers It's resolving a symptom, not the cause and there's no long-term followup to see if the results stuck around.
- texasbigdata 5y ago
  Can you please link to discussion (positive or negative) by knowledgeable commentators? Genuinely interested.
- tcamde 5y ago
  What are the critics saying?
imnotreallynew 5y ago
It was my understanding that the existence of “long covid” is still debated as there hasn’t been any real evidence for it other than patient anecdotes.
- nradov 5y ago
  Most any serious viral infection can potentially cause post-viral fatigue syndrome. We've known that for decades and COVID-19 is nothing special in that regard. https://pubmed.ncbi.nlm.nih.gov/3063394/ https://pubmed.ncbi.nlm.nih.gov/3063394/ But many cases of "long covid" appear to be psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
  - ciphol 5y ago
    And that's why this result is exciting - not only is it promising for long covid, but also for post-viral fatigue syndrome and chronic fatigue syndrome.
  - henrikschroder 5y ago
    An old friend of mine has long covid, the real deal, but she was also sick in covid for months in 2020. What she has matches post-viral fatigue syndrome perfectly, and she's getting care for it, from realistic doctors who've been saying that recovery is gonna be slow but steady. She's better now, a year later. And then, just as you say, there's "long covid", which is a large number of people who have very generic ailments, and if you start digging into the numbers, you realize it's all self-reported bullshit, where a good chunk of the sufferers haven't even been diagnosed with covid in the first place! Their symptoms match depression very well, though. It's extremely frustrating watching people like my friend getting ridiculed for having an imaginary disease. She doesn't. And at the same time it's even more frustrating watching a relatively huge number of psychosomatic hypochondriacs getting all the attention and using up the wrong kind of healthcare resources, just because a lot of people are using long covid for generating fear porn and want it to be worse than it is.
- deleted 5y ago
  [deleted]
swader999 5y ago
I'd urge anyone suffering long covid to take a look at the FLCCC protocol for treating it. Results were immediate for myself and I've seen tens of others that have followed it resolve their issues. https://covid19criticalcare.com/covid-19-protocols/i-recover-protocol/ https://covid19criticalcare.com/covid-19-protocols/i-recover...
- yuubi 5y ago
  Is this the FLCCC that pushes ivermectin (a fine worm killer, but no panacea) for covid?
  - swader999 5y ago
    Ivermectin has many modes of action. It's been recognized as a potent anti viral long before covid. For instance, see Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus. Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug. A screen of FDA-approved drugs for inhibitors of Zika virus infection.
    - deleted 5y ago
      [deleted]
  - mikeyouse 5y ago
    Yes - a bunch of discredited quacks (with multiple papers now retracted for the terrible quality of their science) causing enormous headaches for every practicing doctor and nurse having to treat the unvaccinated "Facebook Researchers" who end up in the hospital trying to get their useless cocktail of meds.
    - swader999 5y ago
      What specifically in the linked protocol do you disagree with?
rendang 5y ago
Does anyone know if microclots have ever been investigated in relation to other post-viral disorders?
neom 5y ago
Although never formally diagnosed I'm pretty sure I have/had long covid. I had mild covid in the summer, and it never fully went away, but what was left was inability to recall facts, brutal short term memory, and waking up with pounding pounding head aches that would not go away no matter how much Tylenol I took. Honestly it was awful, working was so difficult. It started to clear up about 2 months ago, around the same time I switch from Tylenol to Advil, and also started rubbing high CBD cream on my head daily. Headaches are now at about once a week, and last a lot less time, memory is getting better. I also decided to spend long period of time listening to familiar music from high school and college. My memory is pretty auditory, I thought maybe it would somehow help with recall. There was a time there that I genuinely worried about getting back to normal in terms of being able to work hard. I'm not exactly sure what this paper is about, but I'd love to get back to normal. :\
jonathan-adly 5y ago
I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. All my patients got a higher dose of Lovenox (anticoagulant) as soon as they hit the unit. The trick is balancing risk vs. benefits. Anticoagulants and antiplatelet will kill a 30 yo healthy person who slips on ice and hit his head. Your mild concussions are now massive brain bleeds.
- dpark 5y ago
  > I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. Sorry, what? You’re telling us that you were treating long COVID patients in the ICU when the pandemic started? I don’t know if you misspoke or misread the headline or what, but in no way is it possibly true that you were treating long COVID with anything in the ICU at the beginning of the pandemic, or any time for that matter.
  - GenerocUsername 5y ago
    I can tell you with absolute certainty that there are circles of of the web which knew incredible amounts of very accurate and precise details about COVID in Feb/March of 2020. The early mistreatments accounted for vast amounts of preventable deaths while people proposing the eventual correct solutions were deplatformed
    - dpark 5y ago
      1. I would love some actually citations rather than a hand-wavey claim that sounds like conspiracy theory. This sounds like you’re talking about hydroxychloroquine. 2. None of this matters to the claim I addressed. Long COVID it’s not something that would be treated in an ICU. It’s also not something that even had a name “when COVID hit”.
      - surgeryres 5y ago
        The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba. (1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ Attached article was written during initial outbreak
surgeryres 5y ago
Very interesting study. I am an expert in the field of clotting mechanics (US NIH funded research / vascular surgery fellow). Not sure why they chose TEG to monitor coagulation status - it does not reflect well changes from any of the drugs used in the study. It would be interesting to see the results broken down by gender - females respond much differently to aspirin and have less of a survival benefit than males (don’t get me started, many of the initial trials in the 60’s with aspirin were done with mostly males). Also, in my own research - we have found that aspirin “softens” clots which allows platelets to squeeze pathological clots to smaller sizes, which allows more recannalization of thrombosed vessels and thus less ischemia - would be interesting to see if that same MOA happens here.
- sizzle 5y ago
  I always take aspirin before flights to avoid DVT due to chronic venous insufficiency and ankle swelling. Do you recommend aspirin to thin blood for flights where I am sitting with legs bent and pressure from the seat underneath the leg pressing into the skin contributing to clotting?

233 points by tcamde 5y ago

Could covid not actually be just a disease? Maybe it's a disease + chronic unhealth. Due to age, pollution, obesity, bad diet, sitting on yr butt too much and/or etc

ciphol 5y ago
Nearly all diseases are worse if you're in bad health to begin with. That doesn't make them "not just diseases".
- swayvil 5y ago
  Well if they have no symptoms then they aren't really diseases, right? And there are a thousand species of varmint that inhabit our body without helping or hurting anyway. So yes, massive unhealth can definitely spell the difference there.
  - SketchySeaBeast 5y ago
    I'm not following. For some people a cold can have basically no symptoms and can even spread asymptomatically, and for most people it's just an irritation, but for the especially vulnerable it can kill. Would you argue that the common cold is also not a disease?
    - swayvil 5y ago
      The key word here is "for some". If nobody gets a symptom then it isn't a disease. If only a very few get a symptom then maybe we call it a disease and maybe we call it something else. A disease requires some minimum proportion of the infected to feel it. Otherwise it's just commensalism or something. Therefore, as the general health shifts, so does what we call our relationship with that varmint.
      - SketchySeaBeast 5y ago
        I'm still confused, because I don't know how that connects to your question "Could covid not actually be just a disease?", because it clearly is as it's affecting people. If we assume that the cold is a disease so is COVID, by the same criteria. Is the cold not just a disease? If so, what is just a disease?
        swayvil 5y ago
        It's a pretty simple idea. I'm having doubts about this "confusion".
        SketchySeaBeast 5y ago
        Fair enough. I think you're throwing a weird "disease" distinction and then moralizing angle into COVID which doesn't make any sense. We didn't just hit some sort of health critical mass for illness. COVID is its own beast and it's hurting a ton of people and implying it's people's fault for eating junk is bizarre.
        swayvil 5y ago
        The moral trip is all yours.

invitrom 5y ago

How risky is this therapy?

aborsy 5y ago
Anticoagulants and anti-platelets increase the chance of hemorrhage in the brain. So while they prevent ischemic stroke and help with circulation, they might cause hemorrhagic stroke. The dose and time duration has to be carefully adjusted. It’s a slippery slope in dealing with cerebrovascular accidents. Anti platelets (specially Aspirin 80 and Clopidogrel) are less risky than anticoagulants (such as heparin or warfarin).
haroldskavar 5y ago

hammock 5y ago

axel6665 5y ago
SketchySeaBeast 5y ago
Just for my own curiosity I clicked on your link. The I-MASK+ protocol also currently recommends Ivermectin (and if you don't have ivermectin, use black cumin seed), mouthwash, and a half dozen different vitamins for prevention and early treatment.
- nradov 5y ago
  There is some clinical evidence to support curcumin as a prophylactic or treatment for COVID-19. The evidence so far is weak, but it's cheap and has no real side effects at normal dosage so from a risk versus reward standpoint it may be worth a look. https://www.frontiersin.org/articles/10.3389/fphar.2021.669362/full https://www.frontiersin.org/articles/10.3389/fphar.2021.6693...
  - SketchySeaBeast 5y ago
    Fair enough, but outside of the ivermectin misinformation, it feels a lot like busywork, giving people agency and a feeling of having done something when they haven't.
    - nradov 5y ago
      Where is the busywork? Other than ivermectin, the other recommended interventions also have at least some clinical evidence and no major negative side effects for those that choose to use them. Have you actually analyzed each of them within a risk versus reward framework?
      - SketchySeaBeast 5y ago

nicoburns 5y ago

Huh. This is interesting. I also have some fatigue, but my most obvious long-covid symptom is heart pain/strain which is aggravated by either an elevated heart rate or dehydration. I'm no expert, but intuitively this would seem to provide a good explanation of those symptoms.

runnerup 5y ago
I'm hopeful that research into whatever "long covid" syndrome is/isn't leads to excellent new medical knowledge that applies to much more than just COVID edge-cases. I suddenly got similar symptoms since getting a nasty version of strep throat last October. Notably I had an elevated fever (>102F) for quite a few days straight. I've never had COVID but I did get the mRNA vaccines + booster. Since that fever, my heart goes into light arrhythmia all too frequently. It used to be maybe once or twice a year I'd notice 1-3 seconds of "off-beat" heart pattern. All of of a sudden it's a few times a week. I'm also getting older (entering mid 30's now), live in some of the worst air quality in the US (next to a bunch of chemical plants which are frequently releasing quantities of ethylene oxide/mercaptans/styrenes/acrylates/etc), and haven't been exercising much at all the past few years (largely due to air quality issues). My diet isn't the best either, but I incorporate a lot of fresh salmon which keeps my blood pressure down, triglycerides low, and HDL really quite high. There's probably more I could do to help myself using just current medical knowledge, but additional knowledge and medical practices are always, always welcome IMO.
- superbaconman 5y ago
  Tell your doctor about your symptoms and then ask for an ECG. You want to know if you have an underlying heart condition. Depending on what you find, there may be options that will eliminate your arrhythmias.
  - dmichulke 5y ago
    Anecdotally, I also had arrhythmia and after a few months and visits to doctors I figured out it was the type of coffee I drank. Changed back (from Espresso so standard) and the arrythmia was gone. YMMV

JohnJamesRambo 5y ago

I think I’m going to start taking aspirin. Oddly enough I took that a few times because I didn’t have ibuprofen and I do feel like it helped a lot with the weird long symptoms I am experiencing. I’m triple vaccinated before anyone asks. I haven’t tested positive for Covid on rapid tests but a lot of people seem to be in the boat I’m in right now.

open-source-ux 5y ago
"I think I’m going to start taking aspirin" In the UK there is a large, ongoing clinical trial called 'RECOVER' to test different COVID treaments for hospitalised COVID patients. One of the trials included giving hospitalised patients aspirin. The trial was not looking at the treatment of long-covid symptoms (at least not directly in hospital patients). "A total of 7351 patients were randomised to aspirin 150 mg once daily and compared with 7541 patients randomised to usual care alone. There was no evidence that aspirin treatment reduced mortality." Link: RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19: https://www.recoverytrial.net/news/recovery-trial-finds-aspirin-does-not-improve-survival-for-patients-hospitalised-with-covid-19 https://www.recoverytrial.net/news/recovery-trial-finds-aspi...
- cdrini 5y ago
  This doesn't feel super applicable. The body in the middle of a COVID infection vs months later is in a VERY different state. Also I don't even know if there's any mortality data for long COVID; it could just provide quality of life degradation.
  - jacobolus 5y ago
    I saw an observational study tracking hospitalized (but nominally surviving) Covid patients for a year where a far higher number died (of various causes) than the base rate in the population [sorry I can’t find a link now in a few minutes of searching]. Some of this is selection bias (people who get bad Covid cases tend to be in worse shape to begin with), but I would expect the after-effects of Covid to cause significantly increased mortality. We’ll have much better data about this in a few years.

LinuxBender 5y ago

Are there by chance any similar tests on long covid patients using the enzymes Serrapeptase and Nattokinase? Or any of the other 30 or so related enzymes? Asking because Natto has the nice side benefit of binding to ACE2 and it is super easy to acquire. These enzymes are also Fibrinolytics. As a related question, how is Japan doing in terms of long covid cases relative to everywhere else? They eat a lot of Natto.

nykiwi 5y ago
Thanks for this comment, I found it very interesting and now I want to learn about it all. Thanks :)
pfisherman 5y ago
Why would fibrinolytics have any therapeutic effect? They are not anti coagulants (i.e. serine protease inhibitors), and work via an entirely different mechanism.
- LinuxBender 5y ago
  Absolutely not anti-coagulants. They work in conjunction with them to break up clots and absolutely have many different mechanisms. I use six of those mechanisms for controlling blood pressure. The article topic covers fibrin amyloid microclots which is precisely what many surgeons have used these enzymes for in addition to removing scar tissue from the vasculature. On a side note this is a very divided and heated topic within the different groups of heart surgeons.
  - sithadmin 5y ago
    You're specifically using compounds like nattokinase to control blood pressure? Would be interested in hearing what your approach here is, or any literature you could share.
    - LinuxBender 5y ago
      You're specifically using compounds like nattokinase to control blood pressure? Correct. Here [1] is one of the studies though there are quite a few on nih.gov that vary in results and P-value. In full disclosure I use much higher FU's than what is used in their test and have been using it for a long time building up to those levels so my risks are lower. I use this in combination with vascular de-calcification methods and other molecules that break down plaques. I don't have any of them handy but you can also find some videos that talk about the different mechanisms that Natto interact with that affect BP. It is surprisingly not what one might expect. While it does bind to ACE2 that has a very insignificant role in BP. The biggest effect comes from how it changes a feedback mechanism in a peptide chain. I was taken aback when I learned how many roles peptides play in mammals well beyond tissue repair. On a fun side note Natto also has an effect on von Willebrand factor which is also plays a significant role in covid. I should of course add that I am not a doctor and this is not medical advise. Enzymes can break down scar tissue, plaques and more. These come with some risk of bleeding and stroke - one must study the risks and discuss with their doctors that will likely give them blank stares until they say "orally bioavailable tissue plasminogen activator" which is not entirely correct but it will help them understand the intent and might tickle their curiosity. [1] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066864/

cpncrunch 5y ago

Uncontrolled, open label.

Madmallard 5y ago

So is long covid post-thrombotic syndrome like in patients that survive pulmonary embolisms?

cdrini 5y ago

The link between microclots and long COVID is new to me and fascinating. Anecdotally, this gels with some of the symptoms I've seen in friends/family. My father had reduced motility in his arm-- where he'd broken it many years before--for many months after recovering from COVID. Then one random day, after he'd strained himself a bit, he noticed the pain/restriction completely gone, and the skin had turned slightly black in the region where it used to hurt. Not a doctor, but feels like something related to a microclot? He described the pain as almost like a twisted nerve or vein. This HN post talks more about the link: https://news.ycombinator.com/item?id=29808020 https://news.ycombinator.com/item?id=29808020

SOLAR_FIELDS 5y ago
One of my more bizarre long COVID symptoms was blood vessel leakage on my feet. One day a month or so after getting over COVID my feet started noticeably swelling. I was worried I had a clot in my leg so I went to the ER but sonogram came out fine. Turns out I had worn too-tight shoes the day before and the vessels in my feet had swelled/leaked. This was my same pair of shoes I had always worn at same tightness (they were running shoes that I had always slipped on and off, never tied or untied) so I knew that it had to be COVID related.
- nradov 5y ago
  Why do you know it had to be COVID related? Many conditions can cause swollen feet.
  - SOLAR_FIELDS 5y ago
    Because I had been wearing those same shoes for years with the exact same level of tightness and never in my life had swollen feet problem before. The bruising was also following the lines of the shoes which is how it was discovered it was related to the shoe tightness
    - nradov 5y ago
      None of that implies that COVID was the cause. It could just be a coincidence.

jokethrowaway 5y ago

Sounds exactly like chronic fatigue syndrome, I don't know why we keep calling it Long COVID while we have a name for it. https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ > Suggested causes or triggers for ME/CFS include: > viral infections, such as glandular fever > bacterial infections, such as pneumonia > problems with the immune system > a hormone imbalance > your genes – ME/CFS seems to be more common in some families I have a friend who got CFS out of nowhere (shortly before the 2 years to flatten the curve started, no COVID involved) and it's bad, there is no cure and it's incredibly disruptive. At the same time, it's hard for people to take you seriously and not just call you lazy. Hopefully this study goes somewhere and we'll find a cure for CFS.

myoldohiohome 5y ago
I hope so too. I recognized the symptoms (in myself) as soon as I started reading the abstract. --- from the link cdrini posted above, which is a Guardian article by one of the authors of the study in the original post.[0] "Even those without long Covid could benefit from such research, as symptoms noted in long Covid patients show many similarities to those seen in chronic and viral-related illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – another disease that has been dismissed as “psychological” for decades. Just because we have not yet identified a biomarker for long Covid does not mean biomarkers do not exist. We just need to look harder." [0] https://news.ycombinator.com/item?id=29808020 https://news.ycombinator.com/item?id=29808020 PS. Hope the post is done correctly, it's my first one here.
- aarongray 5y ago
  If you're interested in Biomarkers for Long Covid and ME/CFS, look up Chronic Inflammatory Response Syndrome (CIRS). MMP-9, MSH, ACTH, TGF-beta 1, Cortisol, Glutathione, and Vasoactive Intestinal Peptide are a few of them. Lots of research here that was started by illnesses triggered by mold mycotoxins and lyme disease - the initial trigger is different than Covid - but the end result in terms of biomarkers and dysregulation in the body is the same. Doctors have been using these protocols to successfully treat patients for a few years now, but it just hasn't trickled down to the mainstream medical community or the medical schools yet. Further reading: - https://www.survivingmold.com/Publications/2493-Treatable_metabolic_and_inflammatory_abnormalities_in_Post_COVID(2).pdf https://www.survivingmold.com/Publications/2493-Treatable_me... - https://www.survivingmold.com/docs/Shoemakers_Protocol_for_publishing.pdf https://www.survivingmold.com/docs/Shoemakers_Protocol_for_p... - https://www.survivingmold.com/Publications/CIRS_diagnostic_protocol_final_5_1_2018.pdf https://www.survivingmold.com/Publications/CIRS_diagnostic_p...

znd 5y ago

Ctrl+f placebo - Phrase not found. Such a waste.

wantsanagent 5y ago

This is a big hammer. Please note this section: "A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole." Induced hemophilia is no joke.

merpnderp 5y ago
Do people really get holes in their stomach often enough that this regiment would cause them to bleed to death?
- kahrl 5y ago
  Yes. Absolutely. GI issues are some of the most common medical problems. Ucers, polyps, sores, diverticula...
  - QuercusMax 5y ago
    My dad got a hole in his stomach from taking too much Advil (ibuprofen) for pain related to a broken vertebra.
    - kahrl 5y ago
      jeez. NSAIDs can do some nasty stuff when taken regularly. Most people just pop 'em like candy.
allturtles 5y ago
To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.
- favorited 5y ago

mkarliner 5y ago

So 24 patients reported relief of symtoms. It would occur to me that a placebo effect could account for this. A study with a control group would hold greater validity in my mind. This seems purely anecdoctal despite academic styling.

merpnderp 5y ago
Placebo effect accounts for changes in their blood markers for micro clots? I'm a big believer in the power of the mind, but this seems a stretch.
- iamthepieman 5y ago
  The point is that without a control group there's no way to know.
  - texasbigdata 5y ago
    I drove to Germany to see the machines. Spoke to the doc admistering it. It's a potentially painful almost full day procedure. We discussed the placebo thing. I'm not an expert on medical ethics but personally I would not want to be intubated (potentially wrong word) into that thing for hours and not get treatment.
  - nradov 5y ago
    That's not strictly true. Consider our complete set of medical knowledge today. What percentage of that knowledge came from studies with control groups?
    - deleted 5y ago
      [deleted]
    - yamrzou 5y ago
      When experimenting with new treatments, a control group is very important. Otherwise the study could be biased in favor or against the treatment. Even when a control group is present, a poorly-designed experiment could later turn out to be problematic, such as the Diethylstilbestrol (DES) medical tragedy (https://en.wikipedia.org/wiki/Diethylstilbestrol https://en.wikipedia.org/wiki/Diethylstilbestrol). In that case, studies that were in favor of the treatment were poorly-designed and used historical controls instead of contemporaneous ones.

ck2 5y ago

It's a preprint that has already been criticized by peers It's resolving a symptom, not the cause and there's no long-term followup to see if the results stuck around.

texasbigdata 5y ago
Can you please link to discussion (positive or negative) by knowledgeable commentators? Genuinely interested.
tcamde 5y ago
What are the critics saying?

imnotreallynew 5y ago

It was my understanding that the existence of “long covid” is still debated as there hasn’t been any real evidence for it other than patient anecdotes.

nradov 5y ago
Most any serious viral infection can potentially cause post-viral fatigue syndrome. We've known that for decades and COVID-19 is nothing special in that regard. https://pubmed.ncbi.nlm.nih.gov/3063394/ https://pubmed.ncbi.nlm.nih.gov/3063394/ But many cases of "long covid" appear to be psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
- ciphol 5y ago
  And that's why this result is exciting - not only is it promising for long covid, but also for post-viral fatigue syndrome and chronic fatigue syndrome.
- henrikschroder 5y ago
  An old friend of mine has long covid, the real deal, but she was also sick in covid for months in 2020. What she has matches post-viral fatigue syndrome perfectly, and she's getting care for it, from realistic doctors who've been saying that recovery is gonna be slow but steady. She's better now, a year later. And then, just as you say, there's "long covid", which is a large number of people who have very generic ailments, and if you start digging into the numbers, you realize it's all self-reported bullshit, where a good chunk of the sufferers haven't even been diagnosed with covid in the first place! Their symptoms match depression very well, though. It's extremely frustrating watching people like my friend getting ridiculed for having an imaginary disease. She doesn't. And at the same time it's even more frustrating watching a relatively huge number of psychosomatic hypochondriacs getting all the attention and using up the wrong kind of healthcare resources, just because a lot of people are using long covid for generating fear porn and want it to be worse than it is.
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swader999 5y ago

I'd urge anyone suffering long covid to take a look at the FLCCC protocol for treating it. Results were immediate for myself and I've seen tens of others that have followed it resolve their issues. https://covid19criticalcare.com/covid-19-protocols/i-recover-protocol/ https://covid19criticalcare.com/covid-19-protocols/i-recover...

yuubi 5y ago
Is this the FLCCC that pushes ivermectin (a fine worm killer, but no panacea) for covid?
- swader999 5y ago
  Ivermectin has many modes of action. It's been recognized as a potent anti viral long before covid. For instance, see Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus. Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug. A screen of FDA-approved drugs for inhibitors of Zika virus infection.
  - deleted 5y ago
    [deleted]
- mikeyouse 5y ago
  Yes - a bunch of discredited quacks (with multiple papers now retracted for the terrible quality of their science) causing enormous headaches for every practicing doctor and nurse having to treat the unvaccinated "Facebook Researchers" who end up in the hospital trying to get their useless cocktail of meds.
  - swader999 5y ago
    What specifically in the linked protocol do you disagree with?

rendang 5y ago

Does anyone know if microclots have ever been investigated in relation to other post-viral disorders?

neom 5y ago

Although never formally diagnosed I'm pretty sure I have/had long covid. I had mild covid in the summer, and it never fully went away, but what was left was inability to recall facts, brutal short term memory, and waking up with pounding pounding head aches that would not go away no matter how much Tylenol I took. Honestly it was awful, working was so difficult. It started to clear up about 2 months ago, around the same time I switch from Tylenol to Advil, and also started rubbing high CBD cream on my head daily. Headaches are now at about once a week, and last a lot less time, memory is getting better. I also decided to spend long period of time listening to familiar music from high school and college. My memory is pretty auditory, I thought maybe it would somehow help with recall. There was a time there that I genuinely worried about getting back to normal in terms of being able to work hard. I'm not exactly sure what this paper is about, but I'd love to get back to normal. :\

jonathan-adly 5y ago

I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. All my patients got a higher dose of Lovenox (anticoagulant) as soon as they hit the unit. The trick is balancing risk vs. benefits. Anticoagulants and antiplatelet will kill a 30 yo healthy person who slips on ice and hit his head. Your mild concussions are now massive brain bleeds.

dpark 5y ago
> I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. Sorry, what? You’re telling us that you were treating long COVID patients in the ICU when the pandemic started? I don’t know if you misspoke or misread the headline or what, but in no way is it possibly true that you were treating long COVID with anything in the ICU at the beginning of the pandemic, or any time for that matter.
- GenerocUsername 5y ago
  I can tell you with absolute certainty that there are circles of of the web which knew incredible amounts of very accurate and precise details about COVID in Feb/March of 2020. The early mistreatments accounted for vast amounts of preventable deaths while people proposing the eventual correct solutions were deplatformed
  - dpark 5y ago
    1. I would love some actually citations rather than a hand-wavey claim that sounds like conspiracy theory. This sounds like you’re talking about hydroxychloroquine. 2. None of this matters to the claim I addressed. Long COVID it’s not something that would be treated in an ICU. It’s also not something that even had a name “when COVID hit”.
    - surgeryres 5y ago
      The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba. (1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ Attached article was written during initial outbreak

surgeryres 5y ago

Very interesting study. I am an expert in the field of clotting mechanics (US NIH funded research / vascular surgery fellow). Not sure why they chose TEG to monitor coagulation status - it does not reflect well changes from any of the drugs used in the study. It would be interesting to see the results broken down by gender - females respond much differently to aspirin and have less of a survival benefit than males (don’t get me started, many of the initial trials in the 60’s with aspirin were done with mostly males). Also, in my own research - we have found that aspirin “softens” clots which allows platelets to squeeze pathological clots to smaller sizes, which allows more recannalization of thrombosed vessels and thus less ischemia - would be interesting to see if that same MOA happens here.

sizzle 5y ago
I always take aspirin before flights to avoid DVT due to chronic venous insufficiency and ankle swelling. Do you recommend aspirin to thin blood for flights where I am sitting with legs bent and pressure from the seat underneath the leg pressing into the skin contributing to clotting?