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

"Rest, drink fluids, and you will get over it"

That is what most people are being told when they have been diagnosed with Long Covid.

With many of these cases of Long-covid lasting months to years; that advice is not helpful or empowering.

Fortunately, there are more holistic approaches such as the ones discussed by my guest Dr. Carla Kuon; a medical doctor and author of 
⁠The LONG COVID Solution: A holistic, integrative approach to post viral recovery⁠.

This book looks at the underlying factors that need to be addressed in long covid such as gut health, mast cell activation, immune balance, and brain/stress balance. It is an actionable guide for those dealing with or caring for Long covid.
We discuss some of the pillars of the long covid in this discussion such as inflammation, oxidative stress, and immune imbalance.

I first met Dr. Kuon through the Cogence Immunology course that is taught by ⁠Dr. Samuel Yannuck⁠

Her background in Oncology and Immunology; made her well-equipped to condense much that we have learned since 2020 in how to approach Long-Covid. Plus she has long worked with other post-viral conditions such as Chronic Fatigue Syndrome.

I think you will enjoy this discussion and gain some actionable insight.


More about Dr. Kuon:
Carla Kuon, MD is an an associate professor of medicine in the Department of Hospital Medicine at the University of California, San Francisco,
where she created and directs the adult inpatient bone marrow transplant massage service. She is dual board certified in internal medicine and addiction medicine. She is faculty at the Osher Center for Integrative Health in San Francisco where she provide consultations in integrative oncology and integrative medicine, and is the chair of their educational case conference series. She teaches the“Food as Medicine” CODA series for residents and students at the university. She is the author of  The LONG COVID Solution: A holistic, integrative approach to post viral recovery 


⁠longcovid⁠ ⁠#covid⁠ ⁠#chronicillness⁠ ⁠#mecfs⁠ ⁠#longcovidrecovery⁠ ⁠#myalgicencephalomyelitis⁠ ⁠#chronicfatigue⁠ ⁠#pwme⁠ ⁠#cfs⁠ ⁠#spoonie⁠ ⁠#longhaulers⁠ ⁠#health⁠ ⁠#chronicpain⁠ ⁠#fatigue⁠ ⁠#chronicfatiguesyndrome⁠ ⁠#postcovid⁠ ⁠#fibromyalgia⁠ ⁠#invisibleillness⁠ ⁠#millionsmissing⁠ ⁠#pots⁠ ⁠#covidsurvivor⁠ ⁠#spoonielife⁠ ⁠#longcovidsymptoms⁠ ⁠#recovery⁠ ⁠#cfsme⁠ ⁠#publichealth⁠ ⁠#brainfog⁠ ⁠#corona⁠

bTk8XSVVrcerUeG2rilG

The Long Covid Solution with Carla Kuon, MD

In this podcast Dr Mairi McLean talks to Dr Joanna Jalanka about her recently published article in Gut entitled "Effects of bowel cleansing on the intestinal microbiota".

They discuss what was already known in the field and what has since been discovered, and how long these effects last and how the microbiota were measured.

Effects of bowel cleansing on the intestinal microbiota

Today I’ll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most common medical interventions of our time.

Antibiotics, immunosuppressive drugs and the downfall of the human immune system

Dr. Geoff Lecovin discusses Metabolic Flexibility and how to avoid getting caught in Fads on "One Thing" With your host Dr. Adam Rinde.

episode 1.One Thing. Dr. Geoff Lecovin on Metabolic Flexibility

Richard Sprague on Metagenomic Testing For Post Meal Glucose Response

Podcasts of Adam Rinde, ND of Sound Integrative Health

The Long Covid Solution with Carla Kuon, MD

Adam Rinde

Related tracks