I’ve previously discussed about how frequent POTS can be in children and adolescents following Covid-19, and the importance of treating it even in adolescents and pre-adolescents.
In a new German publication containing recommendations for the assessment of Long COVID for the German statutory insurance, it is claimed that a connection between Long COVID and PoTS is only present if a positive diagnosis of small fiber neuropathy (SFN) via skin biopsy is also provided. But this is not medically or scientifically substantiated, is it?
In che rapporto percentuale un paziente con disautonomia post-covid risulta poi positivo alla diagnosi con biopsia cutanea di "Neuropatia delle piccole fibre"?
Si può parlare in questo caso di danno diretto alla fibre autonomiche?
Another pertinent comprehensive overview by Mohandas S, Jagannathan P, et al; RECOVER Mechanistic Pathways Task Force. Immune mechanisms underlying COVID-19 pathology and post-acute sequelae of SARS-CoV-2 infection (PASC). Elife. 2023 May 26;12:e86014. doi: 10.7554/eLife.86014. PMID: 37233729
This multi-institutional consortium provides an excellent overview of many aspects of the acute and chronic processes relating to the pandemic virus. Our own independent research, both collaborative pre-clinical, inpatient post-acute illness recovery and subsequent observation case reporting (>2,500 encounters with prescription therapy) dating back to February 2020 supports the growing consensus that there are multiple lines of immunopathology coupled with novel infection mechanisms responsible for these two disorders. Our unifying molecular concepts focus on the ultimate targets for these disorders, namely a7nAChRs. Intervention with a specific immune modulator, stimulation of the dysfunctional cholinergic system, as well as mitigation of early viral mechanisms has consistently shown efficacy. Why? Because our novel therapeutic approach addresses multisystemic dysfunctions simultaneously. Blocking viral entry by reducing the viral load, countering the immune disruption of the target a7Rs and stimulating the Cholinergic Anti-inflammatory Pathway (CAIP) mitigating the cascade of cytokines and production of anti-idiotypic antibodies all appear to convincingly restore normal functions consistently through all viral variants to date. Our comprehensive summary, kindly published earlier in Dr Buonsenso's substack, provides details and references to this approach to treatment utilizing a repurposed drug that has proven safety over decades of use for other disorders. More focus and trials to confirm our approach are needed. Much clinical research has been proposed utilizing narrow spectrum therapeutics - pure antivirals that are subject to immune escape as variants have evolved; monoclonals addresses certain inhibitors or enzymes; and broad spectrum potent corticosteroids to name a few. But there have been no officially promoted multifunctional approaches using repurposing save for the hyper-politicized and spectacular failures of hydroxyCHLOROQUINE and Ivermectin. These two well-studied drugs that made it to trials essentially poisoned the waters for considering any subsequent repurposed drugs. Has the "baby been tossed out with the bathwater"? Many Federal agencies and/or their consultants have been alerted to no avail. More than 500 successful case reports from 2020-2023 were submitted to the Cure Drug Repurposing Collaboratory (CDRC) via its website CURE ID using an approved HIPPA compliant data gathering format. This data fulfilled the CDRC mission of identifying potential repurposed drugs esp in the setting of this pandemic virus when the usual R & D process of 10-12 years was not feasible. The information was ignored and failed to generate any interest without explanations or requests for clarification. Will it take another pandemic to bring these unique discoveries to the forefront?
Feel free to ask any questions, clarifications, scientific inquiries, etc. I/we don't have all the answers and we invite others with expertise to critique or expand on our discoveries both from the lab of our collaborators as well as our own clinical observations over the past 5 year. The information should not be summarily dismissed as it has been. Thank you for your curiosity! The references provided in that summary tell the story from many angles.
In a new German publication containing recommendations for the assessment of Long COVID for the German statutory insurance, it is claimed that a connection between Long COVID and PoTS is only present if a positive diagnosis of small fiber neuropathy (SFN) via skin biopsy is also provided. But this is not medically or scientifically substantiated, is it?
I dont entirely agree, as SFN testing is not entirely standardized and only a minority of patients have access to the biopsy
But are you sure that all people with PoTS that first appeared after a COVID-19 infection also have small fiber neuropathy (SFN)?
If SFN cannot be detected, does that mean it is merely a coincidental occurrence without any connection to the infection or Long COVID?
Does that mean the cause of PoTS must lie elsewhere?
I agree with your piont, SFN is not the cause of dysautonomia but an epiphenomenon like POTS, the root cause of all these events is still unknown
Caro dottore,
In che rapporto percentuale un paziente con disautonomia post-covid risulta poi positivo alla diagnosi con biopsia cutanea di "Neuropatia delle piccole fibre"?
Si può parlare in questo caso di danno diretto alla fibre autonomiche?
si in quel caso si. la percentuale precisa non è nota, dato che solo una minoranza dei pazienti fanno questo test
Another pertinent comprehensive overview by Mohandas S, Jagannathan P, et al; RECOVER Mechanistic Pathways Task Force. Immune mechanisms underlying COVID-19 pathology and post-acute sequelae of SARS-CoV-2 infection (PASC). Elife. 2023 May 26;12:e86014. doi: 10.7554/eLife.86014. PMID: 37233729
This multi-institutional consortium provides an excellent overview of many aspects of the acute and chronic processes relating to the pandemic virus. Our own independent research, both collaborative pre-clinical, inpatient post-acute illness recovery and subsequent observation case reporting (>2,500 encounters with prescription therapy) dating back to February 2020 supports the growing consensus that there are multiple lines of immunopathology coupled with novel infection mechanisms responsible for these two disorders. Our unifying molecular concepts focus on the ultimate targets for these disorders, namely a7nAChRs. Intervention with a specific immune modulator, stimulation of the dysfunctional cholinergic system, as well as mitigation of early viral mechanisms has consistently shown efficacy. Why? Because our novel therapeutic approach addresses multisystemic dysfunctions simultaneously. Blocking viral entry by reducing the viral load, countering the immune disruption of the target a7Rs and stimulating the Cholinergic Anti-inflammatory Pathway (CAIP) mitigating the cascade of cytokines and production of anti-idiotypic antibodies all appear to convincingly restore normal functions consistently through all viral variants to date. Our comprehensive summary, kindly published earlier in Dr Buonsenso's substack, provides details and references to this approach to treatment utilizing a repurposed drug that has proven safety over decades of use for other disorders. More focus and trials to confirm our approach are needed. Much clinical research has been proposed utilizing narrow spectrum therapeutics - pure antivirals that are subject to immune escape as variants have evolved; monoclonals addresses certain inhibitors or enzymes; and broad spectrum potent corticosteroids to name a few. But there have been no officially promoted multifunctional approaches using repurposing save for the hyper-politicized and spectacular failures of hydroxyCHLOROQUINE and Ivermectin. These two well-studied drugs that made it to trials essentially poisoned the waters for considering any subsequent repurposed drugs. Has the "baby been tossed out with the bathwater"? Many Federal agencies and/or their consultants have been alerted to no avail. More than 500 successful case reports from 2020-2023 were submitted to the Cure Drug Repurposing Collaboratory (CDRC) via its website CURE ID using an approved HIPPA compliant data gathering format. This data fulfilled the CDRC mission of identifying potential repurposed drugs esp in the setting of this pandemic virus when the usual R & D process of 10-12 years was not feasible. The information was ignored and failed to generate any interest without explanations or requests for clarification. Will it take another pandemic to bring these unique discoveries to the forefront?
Which Post in particular are you referring to by doctor b u o n s e n s o? Thanks in advance
April 19, 2025 "Comparative Therapies of COVID-19, Long COVID and Sickle Cell Disease. Can we learn something?" Ray
Wow that was fast! Thank you so much. And thank you for the work that you're doing.
Feel free to ask any questions, clarifications, scientific inquiries, etc. I/we don't have all the answers and we invite others with expertise to critique or expand on our discoveries both from the lab of our collaborators as well as our own clinical observations over the past 5 year. The information should not be summarily dismissed as it has been. Thank you for your curiosity! The references provided in that summary tell the story from many angles.