According to the CDC, Post-acute sequelae of COVID-19 (PASC), also known as “Long COVID,” are long-term symptoms that might be experienced weeks to months after primary infection with SARS-CoV-2, the virus that causes COVID-19.  Post-viral syndromes have been around for ages but nothing to the scale we are seeing now. 
The symptoms of PASC are extensive with over 200 symptoms reported ranging from general systematic fatigue , sensorimotor, neurologic , digestive, and cardiovascular.
Like any new  problem it helps to have a framework to think through problems and its especially helpful if other models are are available from other conditions that have been treated. We desperately need a framework to help with Long-Covid.
Our Guest, Dr. Amy Proal,   as been looking at post-viral syndromes for many years especially in her work with Myalgic Encephalitis and Chronic Fatigue Syndrome
Dr. Amy Proal, Phd is Microbiologist with expertise on the molecular mechanisms by which pathogens modulate human gene expression, metabolism and immunity.
She recently used this knowledge and experience to author a highly cited paper with her co-researcher Dr. Michael VanElzakker called ⁠Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms⁠
This outstanding paper gives a framework to think through the Long Covid puzzle and start treating it.  In this episode we dive into all aspects of the Biological Factors of Long Covid PASC and discuss how this research will give us a roadmap to help people feel better.
In this episode:
(00:00) Opening

(02:17)  Intro

(08:50) Vagus nerve   

(10:46) Biological Factors

(14:00) Viral Reservoirs in human tissue

(15:07)  Pathogen   reactivation

(20:33) Why is Covid-19 so unique? 

(24:17)  EBV and   molecular mimicry

(29:47)  Dysbiosis

(31:49)  MIS-C and   Zonulin

(34:41)  Brain Fog in post-viral syndromes

(35:47)  Microclots in Covid-19 .

(38:18) Mast cell involvement in post-viral syndromes

(43:38)  Mitochondria

(45:27) Functional Redundancy

(48:10) Long Covid Prognosis .

(54:18 ) Biomarkers   for LC

(1:00:10) Treatment Outlook

(1:06:02)  Closing thoughts
About Amy Proal, PhD
Amy Proal graduated from Georgetown University in 2005 with a degree in biology. While at Georgetown she wrote her senior thesis on the role of infectious agents in the disease ME/CFS. In 2012, she obtained a PhD in microbiology from Murdoch University in Australia. Her graduate thesis focused on “Autoimmune disease re-examined in light of metagenomic concepts.” She is a research leader at ⁠PolyBio⁠ , and she has ⁠authored papers⁠ that examine the role of the human microbiome and human virome in chronic inflammatory disease. Proal has also written book chapters for organizations like the J.Craig Venter Institute and lectured at the NIH and numerous USA/international conferences.
Social Media:
@microbeminded2
Referenced in this episode:
⁠Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms⁠ https://www.pnas.org/content/pnas/118/34/e2024358118.full.pdf

Biological Factors In Long-Covid with Dr. Amy Proal

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