Low serotonin levels might explain some Long Covid symptoms, study proposes
science.org
science.org
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
https://www.nature.com/articles/s41590-023-01601-2
https://www.nature.com/articles/s41586-023-06651-y
https://www.youtube.com/watch?v=z189Z7tS1w4
https://www.youtube.com/watch?v=VYNMzaZk_iU
The researchers here have a specific hypothesis:
> Our animal models demonstrate that serotonin levels can be restored and memory impairment reversed by precursor supplementation or SSRI treatment. While the effectiveness of SSRIs in acute COVID-19 has been a subject of debate,69,70,71,72,73,74 no systematic exploration of SSRIs in individuals with PASC has been performed to date. Our study, together with recent findings linking depression with cognitive impairment in Long COVID75 and the effect of SSRIs on vagus nerve activity,67 call for the assessment of targeting serotonin signaling for the prevention or treatment of neurocognitive manifestations.
Any type of inflammation will cause tryptophan to be pushed down an alternative pathway instead of going to make serotonin.
Also, it’s very possible that low zinc after Covid would cause the lack of serotonin as well.
References people. Especially when it comes to anything related to subjects outside of tech.
I undersand the reasons to do it, also, but I think you clearly elucidate what was lost... (T_T)
Post that there's no verifiable empirical evidence for aliens in a thread about Navy pilots spinning tall tales and you'll get a lower post score than the people saying that Navy pilots are unimpeachable founts of truth who would never lie, much less get confused. All this reflects is the fact that people who want to believe are more likely to be drawn to a thread about aliens, and people who are skeptical of it tend to ignore those threads or actively stay away because they're afraid of what might happen to their worthless internet point score.
They cut the vagus nerves of rats and see behavior change.
Which makes sense to me - when "brains" first evolved, the connection to the stomach would've been the prime connection.
So they also seem to be effective via the enteric nervous system!
Your confidence is totally and completely unwarranted.
[1] https://www.ucl.ac.uk/news/2022/jul/no-evidence-depression-c...
In that case, a gastrointestinal lavage (as applied before a colonoscopy) could be a potential remedy. It's a long shot, but since the process doesn't have any side effects (other than the inconvenience of having to change your diet for a few days), it'd be worth a try.
> So people and doctors will throw SSRIs at the problem, and maybe that will relieve some symptoms, but will not address the fundamental cause.
Additionally, SSRIs cause severe - and in many cases permanent - side effects. What's worse, we don't even really know how SSRIs work - or if at all (at least, as intended). Nevertheless, they're handed out like sweets.
https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
Additional potential long-term side effects include, but are not limited to, weight gain, feeling emotionally numb, and an increased suicided risk. Furthermore, there's the SSRI discontinuation syndrome: https://en.wikipedia.org/wiki/Antidepressant_discontinuation...
SSRIs are truly fun stuff.
It's theorized that the suicide risk from most anti-depressants are from transitioning from so depressed that you have no motivation to do anything, to having enough motivation, but still feeling the related pain from depression.
Likewise with weight-gain. For many depressed people they have a suppression of appetite, and relieving the depression causes return of appetite.
AFAIK, neither the sexual side effects nor the withdraw symptoms are generally considered to be long term much less permanent.
They’re often not permanent, but particularly with sexual problems there is a significant minority of people who do not get better after they stop the drugs. The term to search for is “PSSD” (post-SSRI sexual dysfunction).
We still need to understand the gut <-> brain connection and why trials like prozac or precursor supplementation helps.
It is already inconclusive that SSRIs help acute covid, but no studies have been done for long covid. That's what the researchers are calling out here.
The other side effect this may have is delegitimatizing the condition, much like SSRIs are thrown at chronic pain, menstrual issues and more. Since the medical institution doesn't really take these conditions seriously this is going to become another half recognized condition that doctors can say "Maybe it's Long Covid HAVE YOU TRIED SSRIS" vs working with the patient or doing research into the true causes.
I sound like I'm jesting, but I love food, and I'm a big fan of scent too - things just don't smell or taste right anymore.
SSRIs can cause neurogenesis, wonder if that's some of the interaction - I thought perhaps the exhaustion could be too much tryptophan turning into serotonin in the brain, which causes fatigue?
Though I guess it's not really a long covid symptom since it's not anything active, just a result of getting covid.
There you have it, one long term bad economical effect. There are many others, maybe even more significant.
- COVID infection, virus messing with your brain
- Disappointment from believing COVID is man made (regardless of whether true or not)
- Death of someone close, remember that 1.1 million people have died from COVID in the United States alone
- Disappointment that the lack of care for the vulnerable exposed a survival of the fittest nonchalance where some of the most able among us couldn't be bothered to breathe through an n95 to avoid a however negligible chance of someone dying
The effects appear to be quite bad, and haven't yet recovered in many places (especially among lower income groups). This will take some more time to distill with more accuracy, but lockdowns and remote schooling almost certainly had a negative impact.
https://www.npr.org/2022/09/01/1120510251/reading-math-test-...
> See: People having tea during during a long, drawn out war.
Flu is also a very nasty disease. I've only had it once in the last 10 years and my god I do not want it again.
- Sexual dysfunction. Unable to maintain physical arousal or reach orgasm. Mental arousal may be hyper or hypo active. You take having a working dick for granted until it stops working.
- Tinnitus
- Depression/suicidal ideation. It should be noted that “suicidal ideation” less typically expresses as a direct “Yeah alright, time to kill myself now” sort of thoughts, which is often called “active ideation”. Instead it’s more often “passive ideation”, something like “I now spend hours in an whirlpool of involuntary negativity, a sort of emotional agony at existing. Daydreaming about dying/disappearing/evaporating is my only source of comfort, and hope for escape”.
- It can fuck with the very important but often ignored mechanisms that determine if your body is satisfied with what and how much you’ve eaten. Imagine the feeling of never quite having eaten enough, or always having eaten too much.
There are other things but those are the big ones I recall offhand. The side effects listed on medications are always horribly understated, because they come without human context.
We don’t actually know how SSRIs (or really, any neurochemical effecting med) work, and have no way of predicting the efficacy or side effects for a given individual yet, outside of trial and error.
Tread extremely carefully.
When I browse through Pubmed and read studies (a/b-tests) of Vitamin D intake and respiratory tract infections (including Covid), many large studies found a positive effect.
A huge amount of study does not lead to patentable medication, but is either performed by research groups, or is performed as part of R&D of another products and then published in papers.
There is a difference between something that could never be patented (Vitamins), and the possibility of something working becoming patented (Prozac for example).
The first does not get the funding but from benefactors, as in the case of the study I collaborated with.
https://clinicaltrials.gov/study/NCT05633472
https://clinicaltrials.gov/study/NCT05356936
How do you mean "preventative in nature"? Are you aware of any studies which a/b tested Vitamin D on active respiratory tract infections which showed that the Vitamin D has no effect in this situation?
I’m just calling out the fact that your complaint is not rooted in reality.
The studies you refer to are observational tracking people who supplement vitamin D or live in places where they get it naturally more. To say vitamin D is the cure to most things or even long covid is shortsighted and frankly irresponsible. Linus Pauling did that with vitamin C and tainted public opinion on vitamins.
If this turns out to be as interesting as it sounds, well buy SSRI maker stocks
I don't take an SSRI but perhaps it could indeed help.
Really? SSRIs are outside of patent so there is little moat and thin margins.
People naturally heal all the time from illnesses like this. They just get better with time.
People also get desperate (and sometimes their doctors) and try all manner of remedy.
You get a situation where people who naturally recover end up attributing that recovery to whatever random remedy they were trying at the time. This can be compounded by having bands of people who got sick around the same time, tried whatever flavor of the month remedy was talked about at the time, and recovered around the same time.
Having long covid myself since summer 2020, I've watched this play out more times than I can count now.
NAC + Aspirin is the only thing that helps me but it also makes me feel detached and not hyper as my previous brain state.
I started nicotine after reading through the (probably shoddy) studies on the topic and reading through the anecdotal reports of others experiencing relief with it. (I was desperate, have tried everything I can get my hands on + every kind of dietary intervention.) The experiences seem to be pretty mixed but at least for my form of LC it has made a substantial positive difference.
Out of everything I've tried the only other step I've taken that has made a noticeable difference for me is quitting caffeine. During my acute infection phase it was like a switch flipped that hasn't yet flipped back which completely changed how my body reacts to it. Took me forever to wean off it but doing so has also been a net positive.
Some links (forgive me for reddit link): https://pubmed.ncbi.nlm.nih.gov/36650574/ https://www.reddit.com/r/covidlonghaulers/comments/13uwtme/s...
I do but with each reinfection it takes at least 6 months for me to get better again.
> If this turns out to be as interesting as it sounds, well buy SSRI maker stocks
Unfortunately, that suggestion on the other hand might be spot-on. Not because SSRIs truly are the cure-all they're often marketed as, but rather because manufacturers have managed to sell them as such.
Proclaiming that there wasn't even a "theoretical basis"... It was just so... obviously wrong. And honestly, dangerous.
I'll have to remember that one. Really succinct.
https://vinayprasadmdmph.substack.com/p/long-covid-kills-sad...
https://www.youtube.com/watch?v=yqAjrMNN-Vs
https://www.youtube.com/watch?v=D4NqsU-Dk9A
https://www.dailywire.com/news/taxpayer-funded-1-billion-lon...
Even the linked article has a bunch of caveats like:
Joanna Hellmuth, a cognitive neurologist and clinical researcher at UC, San Francisco, who has collaborated with some of the authors but was not involved in the current study, questions the paper’s focus on the hippocampus. She notes there’s currently little evidence the typical cognitive symptoms of Long Covid are linked to memory encoding in this brain region. Although the results are interesting, in her view, “the model they’re testing doesn’t reflect the clinical condition.”
This is far from the truth. Over 400 long covid publications a month for the last couple years. Science has pushed this forward to be more conclusive and defined.
Covid contrarians like Vinay are nothing but minimizers with MDs. They cherry pick what serves their narrative while ignoring the rest.
> Over 400 long covid publications a month for the last couple years.
Let's just assume that statement is true. I said nothing about the quantity of research on long COVID; I said it was inconclusive and largely low-quality. If anything, your factoid could support my "low quality" assertion given how little benefit has been derived from said research.
https://academic.oup.com/nar/article/51/D1/D1512/6814452
In his video on the paxlovid trials he doesn't even know what the arm sizes are. Let alone take a minute to read the trial designs:
> The placebo includes ritonavir, which does not have an effect on the virus, but will help ensure people don’t know whether they are in the Paxlovid or placebo group.
https://medicine.yale.edu/cii/research/paxlc-study/
I don't care to further argue with you. I used to like Vinay, for what it is worth. But not anymore.
If you can't be bothered to make a good argument, then why make one at all? Also, I want to know, what kind of religious world view leads people like yourself to make evidence-less statements with an air of authority and then dig in your heel no matter how much evidence contradicts you?
> https://www.ncbi.nlm.nih.gov/research/coronavirus/docsum?fil...
Sorry. Linking to 15,000 publications doesn't count as providing a reference. Did that work for you in school?
>https://academic.oup.com/nar/article/51/D1/D1512/6814452
Linking to "300,000" articles also doesn't count as providing a reference, by the way. Let me know what school you went to so I can make sure my kids avoid that one.
> The placebo includes ritonavir, which does not have an effect on the virus, but will help ensure people don’t know whether they are in the Paxlovid or placebo group.
I think his point was that it was a poor choice of placebo.
From Wikipedia: https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir
"Ritonavir is not active against or thought to directly contribute to the antiviral activity of the medication against SARS-CoV-2."
I'm sure you can pick up that there is a difference between "we know for sure it has no relevant impact to the study" and "we think it doesn't have any relevant impact to the study."
> One particular instance is the long-term symptoms experienced by a significant percentage of COVID-19 survivors, a condition named long COVID by the patients affected (4). Some survivors of acute COVID-19 began reporting symptoms lasting much longer than the amount of time then reported for clinical recovery. Long COVID has caused skepticisms and slow responses, and to date, there is no effective treatment (5). In contrast, there is now substantial evidence that a significant percentage of COVID-19 survivors experiencing ongoing multisystemic symptoms (6–8), including respiratory issues (9), cardiovascular disease (10), cognitive impairment (11) and profound fatigue (12).
> LitCovid has so far accumulated almost 10 000 long COVID articles (https://www.ncbi.nlm.nih.gov/research/coronavirus/docsum?fil...) and nearly 70% of them do not mention long COVID by name in the title or abstract. We have further collected over 800 synonymous terms for long COVID and shared with the community.
This specific HN thread is a very well done publication. There are a number of prestigious institutions researching long covid and have published in nature, science, cell, jama, and more. Use the tool I just linked so you can confirm that. Perhaps you can stop with the ad hominem.
What do the relevant bits you cited have to do with you providing evidence that the research on long covid is high-quality or conclusive? I guess I should define conclusive while I'm here:
1) conclusively defines and scopes long COVID symptoms and disambiguates those symptoms from symptoms of other conditions.
2) conclusively determines the cause(s) of long COVID.
3) conclusively determines a treatment.
We already know, even from your links, that there is little to nothing for 2) or 3), and we can argue that 1) still isn't well-defined to this day.
Here's another direct reference for you from June of this year: https://www.yalemedicine.org/news/long-covid-symptoms
Begin Quote:
The World Health Organization (WHO) defines Long COVID as “the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation.”
The Centers for Disease Control and Prevention (CDC) adds that Long COVID includes a wide range of ongoing health problems that can last weeks, months, or years. The condition can affect any part of the body, and serious cases may affect multiple body systems, including the heart, lungs, kidneys, skin, and brain.
End Quote.
If the definition of symptoms includes any "new symptom" after 3 months "with no other explanation" and if it includes a "wide range of ongoing health problems", then it's pretty clear no one has conclusively scoped out what long COVID is and what it is not. "Oh, I see you're sick and we can't come up with a reason why. Let's chalk it up long COVID!"
And, of course, the best quote: "Long COVID, the condition where symptoms that surface after recovering from COVID-19 linger for weeks, months, or even years, is still a mystery to doctors and researchers.".
So there you have it. Thousands of research articles, no conclusive set of symptoms, no conclusive causes, no conclusive treatments, and still a mystery to researchers.
It says nothing remotely conclusive about 1), 2), or 3). It literally only says "Here's some hypotheses. We need more research."
And I think I'm done wasting my time with you. I've given you ample opportunity come up with something even a tiny fraction as definitive as the references I've given you and you've failed multiple times in a row.
We had no effective treatments. 3) is gone.
We didn't know about HIV yet, or the link to AIDS. 2) is gone.
AIDS makes you susceptible to a ton of infections that healthy people normally don't get, so the list of possible symptoms was large - and we couldn't disambiguate those symptoms from other conditions - they were those other conditions. Isn't that 1) gone?
Thank goodness we kept researching. And concerns about long-term health impact of AIDS were well-founded, weren't they?
I also think you're forgetting that we can measure things about populations, and correlate conditions with people who have had a known COVID diagnosis. Then, when symptoms are more common, even years later, in the people who have had COVID, if you want us to say "people who have had a known COVID diagnosis" all of the time, we could... Or maybe it's okay to just say "Long COVID."
Clinical practice is not epidemiology is not actuarial science.
I think you're (rightly?) disappointed that we don't have the Long COVID Manual for clinical practitioners. But people who study epidemics are for sure seeing a thing, and it's measurable. And it has long-term impacts on human health.
a) We do not have evidence that humans suffer from long-term consequences of COVID-19.
b) We do not know why humans suffer long-term consequences of COVID-19.
c) We have no evidence that COVID-19 could possibly cause long-term consequences.
Because I think the answer you have... is different from the answer that [1] would have.
I think [1] thinks c). And I think you think b) or possibly a).
Or maybe I'm wrong - do you agree with c?
On July 12 and 13th, 2020, my uncle emailed me, "For what it’s worth, I predict the COVID-19 death toll in the next 30 months will be 2.5-3 million Americans." I emailed him "I don't know what to predict.... By 2023, I'll go with 300,000."
I'm pretty certain that my 300,000 Americans by 2023 was dramatically higher than what most people were estimating. And I was low.
And at that point, July 2020, I was just barely beginning to be concerned about long-term health impacts of those who survive COVID.
It probably was c-19. I had a nasty flu back in 2017. I coughed so much I thought I had broken a rib. It took months to recover.
I need to come up with something because it was very clever.
For the deniers here is the work of Brandon Gilles who was a hacker like us, who died from long-covid
he tried everything, methodically, with great research, to no avail
https://docs.google.com/document/d/1X3dNPgEuQ2j8x7w8OqLEDP7l...
https://twitter.com/BrandonGilles
https://discuss.luxonis.com/blog/2078-in-loving-memory-celeb...
https://jamanetwork.com/journals/jamainternalmedicine/fullar...
“With significant proportions of individuals with long COVID unable to return to work7, the scale of newly disabled individuals is contributing to labour shortages”
And I thought it was the Fed!
Long covid is still not properly defined and is more of a blanket term of feeling like shit after virus infection
List includes https://www.nhs.uk/conditions/covid-19/long-term-effects-of-...
* extreme tiredness (fatigue) * feeling short of breath * loss of smell * muscle aches
OR.
* problems with your memory and concentration ("brain fog") * chest pain or tightness * difficulty sleeping (insomnia) * heart palpitations * dizziness * pins and needles * joint pain * depression and anxiety * tinnitus, earaches * feeling sick, diarrhoea, stomach aches, loss of appetite * a high temperature, cough, headaches, sore throat, changes to sense of smell or taste * rashes
Many of these symptoms are simply post viral fatigue https://www.medicalnewstoday.com/articles/326619#what-is-it. Post-viral syndrome may cause additional symptoms, such as:
* confusion * trouble concentrating * headaches * aches and pains in the muscles * stiff joints * a sore throat * swollen lymph nodes Which was considered perfectly normal before the big C.
Maybe long covid is a thing, but it really needs proper definition then.
How sick I am of the Covid nutters. If you want research money for something it seems to be just enough to slap some covid label or other and a cheque will be written no questions asked.
Also nature is falling from grace as a top notch elite non-partisan publisher as they have definitely turned partisan in the last few years, they still had the courage to publish the devastating outcome of their political agenda though
I myself take 6 months to have my brain work like before after contact with someone with COVID.
Wym "maybe long covid is a thing"? Didn't the deaths show the response to COVID is extremely varied already? I'm happy you didn't have it but I bet you know someone that does.
I agree Nature is admittedly dodgy to the left if the issue is political (climate change models, the infamous proximal Origins) but I honestly don't see long COVID being one.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
This study does not control for psychosocial factors, like the impact of anxiety and social isolation emanating from a positive COVID diagnosis.
So this is another example of the lack of rigor seen in claims about long COVID.
I remember a close family member having a nasty viral infection aged 32/33 - not exactly old and frail - and they left it a very different person in terms of energy and general health. It really did take a year or so to clear up.
Any mention of this on HN results in immediate downvote brigade.
What a joke; I hope no one ever does that to you.
I think what GP was talking about when saying overdiagnoses was LC diagnoses where no physical symptoms are present.
COVID seems to have become a conflict line between the left and the right, where the left wants it to be seen as more dangerous to justify the government shutdowns of businesses and restrictions on freedom of movement and association, and the right wants to expose those government controls as unjustified and disproportionate.
I’d love to see a study that took long COVID people and got them to do daily cardio exercise, go outside into nature, and sleep better (ie not over sleeping) and seeing if the symptoms improve vs a placebo group that sits inside all day reading doomer posts about COVID on Twitter/Facebook.
Even if we accept it as truth there's so many reasons why you might only be seeing that demographic. Starting with the people you surround yourself with to the possibility that anyone else needs to get by and can't show weakness without worrying about losing their income. What other demographics are you missing?
Are they all also stay at home mothers who don't need to appease a boss for instance? I don't have a better example as I don't really buy your initial claim, but things like that
0. https://www.census.gov/library/stories/2023/05/long-covid-19...
After 2 years, she is now unable to leave home and read a single book of course this makes her depressed. But long covid is very real and it starts always a few weeks after the recovery. It impacting mostly women than men has probably something to do with the immune system differences and your comment is offensive to all the people suffering this terrible disease and all the scientist investigating it.