Demystifying Long COVID International Conference 2024

This was held toward the end of Nov 2024 and videos are now available on YouTube. I haven't seen any but from the titles I've split into two groups, with the first looking like discussions of published or upcoming mechanistic papers.

Viral Persistence & Long COVID: Lessons Learned from the First Clinical Trials - Michael Peluso, MD

Long COVID Therapeutic Trials: Current Status - Dominique Salmon, MD, PhD

Tomorrow and Tomorrow...Studies of the Neuropathogenesis of Long COVID - Serena Spudich, MD

Unraveling Molecular Signature of Long COVID with Post-Exertional Fatigue - Marta Massanella

Molecular PET Imaging of Long COVID - Eric Guedj, MD, Dipl.-Ing, PhD

Anticoagulant and Antiviral Therapy in Long COVID - Johan van Weyenbergh

Immune Dysregulation and Autoimmunity in Long COVID - Daniel M. Altmann, PhD

Autonomic Dysfunction in Long COVID - Nicola Montano, PhD

Sub-Maximal 2-day Cardiopulmonary Exercise Testing - Callum Thomas

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Exploring the Efficacy of Plasma Exchange Therapy in Post-COVID-19 - Sergio España Cueto

Patient Perspective on Clinical Trials Design - Chantal Britt, MA

Epidemiology and Long Term Evolution of Long COVID - Olivier Robineau, MD, PhD

Long COVID: State of the Science and Directions for Policy and Research - Roger Paredes, MD, PhD

Long COVID and Associated Outcomes Following COVID-19 Reinfections - Assaf & Soares

Clinical Insights From a Pediatric Long COVID Clinic - Sindhu Mohanadas

Lessons Learned from Observational Studies for Future Clinical Trials - Igho Ofotokun, MD, MSc, FIDSA

Case 1: Differential Diagnosis - Gemma Lladós, MD

Dutch Example - Mischa Huson, MD, PhD, DTM&H

French Example - Jérôme Larché, MD, MSc

Impact of Persistent Symptoms on Quality of Life in Long COVID - David Lerma Irureta

 

Some summary points —

• The general lack of clinical interest by neurologists, compared with the on-point quote in her WaPo article in 2020: "Given that more than one hundred million people worldwide have been infected by the novel coronavirus, how the disease affects the brain might be the neurologic research question of our time."
• No evidence of viral invasion in LC
• No evidence of viral antigen persistence in CSF
• Autoantibodies in Covid recovered and LC with no difference to explain: CSF mirrors blood

• No difference in basic clinical markers of inflammation or BBB breakdown in CSF
• No evidence of neuroinflammation in terms of immune cell trafficking and CSF cytokines (cf HIV). Small panel, now running a larger panel for subtle changes
• No difference in microglial markers, except astrocyte activation (GFAP), which may explain previous PET-TPSO findings
• Pilot study on miRNA changes in astrocyte exosomes (including angiogenesis signalling)
• No ongoing neuronal damage, but astrocyte dysfunction may be important

• Preliminary evidence of epigenetic alterations in CSF monocytes
• Described one unusual case of post-Covid psychosis with unique anti-neuronal antibody, rapidly cured by IVIG
• Evidence of endotheliitis and blood flow alterations, but not hypercoagulability
• Upcoming imaging studies: cortical volume changes, white matter integrity (DTI), regional perfusion (ASL), glymphatics