Overstimulation of the ergoreflex—A possible mechanism to explain symptoms in long COVID, 2022, Sze et al

Long COVID refers to a multitude of symptoms that persist long after SARS-CoV-2 infection. Fatigue and breathlessness are the most common symptoms of long COVID across a range of studies. They are also cardinal symptoms of chronic heart failure (CHF). In this review, we propose that fatigue and breathlessness in patients with long COVID may be explained by skeletal muscle abnormalities, in a manner similar to patients with CHF. The ergoreflex is a cardiorespiratory reflex activated by exercise, which couples ventilation and cardiovascular function to exercise intensity. At least part of the symptomatology of CHF is related to abnormal skeletal muscle and an enhanced ergoreflex, resulting in heightened sympathetic, vasoconstrictor and ventilator drives. Similarly, SARS-CoV-2 infection results in a hyperinflammatory and hypercatabolic state. This leads to reduction in skeletal muscle mass and altered function. We postulate that the ergoreflex is chronically overstimulated, resulting in fatigue and breathlessness. Exercise training preserves muscle mass and function as well as reduces ergoreflex activation; therefore may have a role in improving symptoms associated with long COVID. Should the ergoreflex be proven to be an important pathophysiological mechanism of long COVID, tailored exercise interventions should be trialed with the aim of improving both symptoms and perhaps outcomes in patients with long COVID.

Open access, https://www.frontiersin.org/articles/10.3389/fcvm.2022.940832/full

 

Nevermind how incoherent the overall reasoning is here... So they take chronic breathlessness and think: what else causes breathlessness? Exercise of course! Once you start exercising your body needs more oxygen so it activates the cardiovascular system to increase the flow of oxygen to tissues, especially muscles.

So to solve chronic breathlessness, they suggest to activate breathlessness. To solve a chronic deficit of oxygen, they think that adding acute deficit of oxygen is smart. This is like homeopathy, except even more foolish. Somehow.

What's becoming clear to me is that no amount of expertise, training and education can overcome local ignorance. That is when someone is trying to solve a specific problem using a mix of a handful of puzzle pieces and whatever stuff they have in their pockets, which obviously are not pieces of the puzzle, it's just impossible. There is no amount of expertise that will add pixels to an image (nevermind AI, that's coming but not yet) and especially not fill in completely missing parts.

Medicine has basically become the textbook example of how a little knowledge can be dangerous. It's not about overall knowledge, it's about knowledge specific to the problem and its full context. Mixed in with a need to be confidently incorrect, this is a perfect recipe for the disaster we've had to endure. It leads to nonsense like this.

And meanwhile chronic illness deniers love to dunk on the issue by saying that most LC research is bad, yet I'd assume that 90-99% of them would think this paper is smart. Because they know nothing about the issue, have only the most superficial misunderstanding.

It's almost like they have warehouses of exercise programs they don't know what to do with. Except they don't there is literally no downside to ending this nonsense other than hurting egos and damaging reputation. It's even demanded by the so-called principles and oath of medicine.

And yet here we are.

 

“A little learning is a dangerous thing
Drink deep, or taste not the Pierian spring:
There shallow draughts intoxicate the brain,
And drinking largely sobers us again.”

There are an awful lot of intoxicated brains out there. Why do so many researchers keep taking lots of ‘shallow drafts’ but go no further?