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#covidcompetent

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This preprint seems so good!

goals were: a) to detect viral load in indoor air in different areas and floors of a separate COVID building in a hospital [...], b) to evaluate the effect of an air-cleaner in the reduction of viral load in the presence of patients, and c) to examine the correlation between viral presence in the air and particle matter burden.

their methodology is making me happy!

Their system separated aerosols into > 2.5 μm, 1.0 to 2.5 μm, 0.5 to 1.0 μm, 0.25 to 0.50 μm, and < 0.25 μm, and found

SARS-CoV-2 was detected in all different fractions and the highest viral loads were detected at stages A (> 2.5 μm) and B (1 - 2.5 μm).

however this was in open-window conditions, ie. low CO2 and higher airflow; sampling with the same equipment in households, they found

the highest amount was detected in Stage 4 (0.25 - 0.5 μm)

The data is mostly PCR but they did do some sequencing, and positively confirmed the dominant variants were stable through the study, and not confounding.

Note the air cleaner was a "Airocide (APS GCS-25 model) air purifier" which uses "photocatalytic oxidation technology" as well as 254nm UV, with no HEPA or other mechanical filter.

Also, this is vindicating for those of us pleading with folks to not immediately de-mask in the hallway:

the highest concentration was detected in COVID clinic rooms displaying a high peak of 1123 copies/m3, whereas at the corridor area showed 481 copies/m3

Also highly of note, they could not detect any virus in the areas that were upstream of negative-pressure COVID-19 care. So yes, home isolation protocols that emphasize negative pressure zones absolutely are well founded!

sciencedirect.com/science/arti via aus.social/@Sidherian

www.sciencedirect.com“SARS-CoV-2 airborne detection within different departments of a COVID-19 hospital building and evaluation of air cleaners in air viral load reduction”The pandemic of COVID-19 has brought in light the necessity for the development of novel detection methods for airborne transmitted pathogens, and the…

These findings support the “Broken Bridge Syndrome” hypothesis, positing that structural disconnections between the brainstem and cerebellum contribute to PCS [Long COVID] symptomatology. Furthermore, we propose that chronic activation of the Extended Autonomic System (EAS), encompassing the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, may perpetuate these symptoms

In this high quality brain volume data,

Significant volume loss was observed in the superior cerebellar peduncle (SCP) in LC patients compared to healthy controls (LC: 219.74 mm³ vs. controls: 347.03 mm³, p < .001, Hedges’ g = 3.31). Furthermore, reduced volumes were evident in the dorsal raphe (DR) and midbrain reticular formation (mRt) (p < .001)

It was not metabolism-marker scanning, but volumentric, so they were able to capture:

Three-dimensional reconstructions revealed deformities in the 4th ventricle and cerebellar peduncles, suggesting impaired cerebrospinal fluid dynamics [...] Importantly, these volume reductions and FA changes correlated with motor deficits,
proprioceptive dysfunction, and autonomic dysregulation

TLDR?

Our findings reveal significant structural and functional alterations in the brainstem and cerebellar peduncles of LC patients

medrxiv.org/content/10.1101/20

via zeroes.ca/explore/links

medRxiv · Brainstem Reduction and Deformation in the 4th Ventricle Cerebellar Peduncles in Long COVID Patients: Insights into Neuroinflammatory Sequelae and "Broken Bridge Syndrome"Post-COVID Syndrome (PCS), also known as Long COVID, is characterized by persistent and often debilitating neurological sequelae, including fatigue, cognitive dysfunction, motor deficits, and autonomic dysregulation (Dani et al., 2021). This study investigates structural and functional alterations in the brainstem and cerebellar peduncles of individuals with PCS using diffusion tensor imaging (DTI) and volumetric analysis. Forty-four PCS patients (15 bedridden) and 14 healthy controls underwent neuroimaging. Volumetric analysis focused on 22 brainstem regions, including the superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP), periaqueductal gray (PAG), and midbrain reticular formation (mRt). Significant volume reductions were observed in the SCP (p < .001, Hedges' g = 3.31) and MCP (p < .001, Hedges' g = 1.77), alongside decreased fractional anisotropy (FA) in the MCP, indicative of impaired white matter integrity. FA_Avg fractional anisotropy average tested by FreeSurfer Tracula, is an index of white matter integrity, reflecting axonal fiber density, axonal diameter and myelination. These neuroimaging findings correlated with clinical manifestations of motor incoordination, proprioceptive deficits, and autonomic instability. Furthermore, volume loss in the dorsal raphe (DR) and midbrain reticular formation suggests disruption of pain modulation and sleep-wake cycles, consistent with patient-reported symptoms. Post-mortem studies provide supporting evidence for brainstem involvement in COVID-19. Radtke et al. (2024) reported activation of intracellular signaling pathways and release of immune mediators in brainstem regions of deceased COVID-19 patients, suggesting an attempt to inhibit viral spread. While viral genetic material was detectable, infected neurons were not observed. Matschke et al. (2020) found that microglial activation and cytotoxic T lymphocyte infiltration were predominantly localized to the brainstem and cerebellum, with limited involvement of the frontal lobe. This aligns with clinical observations implicating the brainstem in PCS pathophysiology. Cell specific expression analysis of genes contributing to viral entry (ACE2, TMPRSS2, TPCN2, TMPRSS4, NRP1, CTSL) in the cerebral cortex showed their presence in neurons, glial cells, and endothelial cells, indicating the potential for SARS-CoV-2 infection of these cell types. Associations with autoimmune diseases with specific autoantibodies, including beta 2 and M 2 against G protein coupled alpha 1, beta 1, beta 2 adrenoceptors against angiotensin II type 1 receptor or M1,2,3 mAChR, among others, voltage-gated calcium channels (VGCC) are known (Blitshteyn et al. 2015 and Wallukat and Schminke et al. 2014). These findings support the "Broken Bridge Syndrome" hypothesis, positing that structural disconnections between the brainstem and cerebellum contribute to PCS symptomatology. Furthermore, we propose that chronic activation of the Extended Autonomic System (EAS), encompassing the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, may perpetuate these symptoms (Goldstein, 2020). Perturbations in this system may relate to the elevation of toxic autoantibodies AABs (Beta 2 and M 2), specific epitopes of the COVID virus's SPIKE protein and Cytokine storm of IL-1, IL-6, and IL-8 in their increased numbers (1,000->10,000) Further research is warranted to elucidate the underlying neuroinflammatory mechanisms, EAS dysregulation, and potential therapeutic interventions for PCS. Keywords: Long COVID, Brainstem, Cerebellar Peduncles, Diffusion Tensor Imaging, Neuroinflammation, Broken Bridge Syndrome, Extended Autonomic System (EAS) ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by OTTO Research Group ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: 2022-100867-BO-ff 1. Ethics approval was granted by the Ethics Committee of the Hamburg Medical Association, Germany, on September 5, 2022, under the title "MRI Biomarkers in Chronic Fatigue," by Prof. Dr. Rolf Stahl. 2. The project complies with the ethical and professional requirements. The Ethics Committee approves the project. The Ethics Committee operates on the basis of German law and professional regulations, as well as in accordance with ICH-GCP. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors All data produced in the present work are contained in the manuscript
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Some highlights from @ducky 's weekly roundup at covidbc.webfoot.com/2025/03/28

SARS-CoV-2 can interact with / activate the CD147 receptor to get into lymphocytes (T-cells and B-cells). (sciencedirect.com/science/arti)

women are 13.4 times more likely to get Long COVID if they are 🤰pregnant than if they are 🚫🤰not, with the danger highest if they catch COVID-19 in the third trimester. (sciencedirect.com/science/arti)

the rate of cases of postural orthostatic tachycardia syndrome (POTS) has gone up more than fourteen times compared to pre-pandemic (academic.oup.com/ehjqcco/advan)

covidbc.webfoot.com2025-03-28 General – Pandemics in British Columbia
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Most interesting detail: "we detected the virus passing from one sinus at the peak of infection to the other a few days later"

Model animals: "cynomolgus macaques"

They also evaluated "two convalescent animals [...] exposed to the SARS-CoV-2 Delta variant three months prior" and found "no major uptake by the nasal cavity" but "detection of the PET signal for SARS-CoV-2 spike antigen up to three months post initial infection in the lungs and brains"

"local accumulation [...] in areas of the brain [...] consistent with previous findings of neuroinflammation in humans infected with SARS-CoV-2 and in rhesus macaques up to six weeks after SARS-CoV-2 infection. The localized crossing of the blood-brain barrier (BBB) by the radiotracer in convalescent animals can be explained by thrombo-inflammation previously reported in patients with active long-COVID."

nature.com/articles/s41467-025

h/t @EricCarroll

NatureWhole-body visualization of SARS-CoV-2 biodistribution in vivo by immunoPET imaging in non-human primates - Nature CommunicationsThere are limited approaches to monitor virus spread in vivo. Here, the authors report PET/CT-based in vivo imaging to track SARS-CoV-2 biodistribution in a COVID-19 non-human primate model using a radiolabeled human antibody revealing persistent detection in the lung and brain 3 months after infection.