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Possibility 1: The Longhaulers Hidden Virus Hypothesis (More Here). The virus may be hiding in certain types of cells, where the immune system has difficulty attacking it, called “immune privileged cells”, which includes cells in the Central Nervous System, the anagen hair follicles (explains why hair falls out), and more. This would represent a low viral load, meaning tests would often be negative. But then it would flare up, with a flare up of symptoms, until the immune system, now seeing the virus, knocks it back down. So this would be a standoff between the virus and the immune system.
Possibility 2: The virus is gone, but it has left behind damage to major organs. This damage causes the symptoms. Lasting damage means lasting symptoms.
Possibility 3: The virus is gone, but it has left the immune system in disregulation, with constant or recurring over-inflammation.
* Singh, Shubh Mohan, and Chaitanya Reddy. “An Analysis of Self-reported Longcovid Symptoms on Twitter.” medRxiv (2020).
* Banda, Juan M., et al. “Long-term patient-reported symptoms of COVID-19: an analysis of social media data.” medRxiv (2020).
* Chua, Robert Lorenz, et al. “COVID-19 severity correlates with airway epithelium–immune cell interactions identified by single-cell analysis.” Nature Biotechnology (2020): 1-10. — This study suggests that continued symptoms of Covid-19, after viral clearance, could be due to a continuation of a hyperactive immune system. Reducing inflammation would then be the key to stopping the symptoms of long haulers.
* Ibrahim, Homam, et al. “Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous n-acetylcysteine.” Clinical Immunology (2020): 108544. — This case series used N-Acetyl-L-Cysteine by IV as a way to decrease inflammation, resulting in clinical improvement and reduced markers of inflammation.
* Stat News: My Covid-19 symptoms have lasted more than 100 days, and I’m not alone. Will they ever end? – Opinion
* the guardian: The coronavirus ‘long-haulers’ show how little we still know – Article
* the guardian: It feels endless: four women struggling to recover from Covid-19
* the Atlantic: COVID-19 Can Last for Several Months – Article
* the Today show: Coronavirus ‘long haulers’ are sick for months. This doctor is one of them – Dr. Scott Krakower says he was diagnosed with COVID-19 in April and is still experiencing symptoms today.
Individual Stories by Long Haulers
* Elephant Journal: Lisa Jensen Thomas – she deserves more than 33 followers.
Support Groups and their Projects
* COVID Long Haulers Support Group Canada
* Survivor Corps
* Body Politic COVID-19 Support Group – a slack discussion group for Covid-19 longhaulers
* Patient Led Research for COVID-19
* An Analysis of the Prolonged COVID-19 Symptoms Survey by Patient-Led Research Team – Google Doc – Video discussing the study
* Helen Salisbury: When will we be well again? BMJ column
* O’Keefe, James B., and Michele Cellai. “Characterization of prolonged COVID-19 symptoms and patient comorbidities in an outpatient telemedicine cohort.” medRxiv (2020).
* Agarwal, Vineet, et al. “Long-term SARS-CoV-2 RNA Shedding and its Temporal Association to IgG Seropositivity.” medRxiv (2020).
* JAMA: Persistent Symptoms in Patients After Acute COVID-19 – An average of 60 days after Covid-19 onset, only 12.6% of patients were symptom-free.