Serum Metabolic Profile in Patients With Long-COVID (PASC) Syndrome: Clinical Implications, 2021, Pasini et al

Background: Many patients who have been suffering by COVID-19 suffer of long-COVID syndrome, with symptoms of fatigue and muscular weakness that characterize post-acute sequelae SARS-CoV-2 infection (PASC). However, there is limited knowledge about the molecular pathophysiology, and about the serum profile of these patients.

Methods: We studied the blood serum profile of 75 selected patients, with previous confirmed COVID-19, 2 months after hospital discharge, who reported new-onset fatigue, muscle weakness and/or dyspnea not present prior to the virus infection and independently from concomitant diseases and/or clinical conditions.

Results: All patients had very high serum concentrations of ferritin and D-Dimer. 87 and 72% of patients had clinically significant low levels of hemoglobin and albumin, respectively. Seventy three percentage had elevations in erythrocyte sedimentation rate and CRP. Twenty seven percentage had elevations in LDH.

Conclusions: The co-existence of patient symptoms along with blood markers of coagulation, protein disarrangement and inflammation suggests ongoing alterations in the metabolism, promoting an inflammatory/hypercatabolic state which maintains a vicious circles implicated in the persistence of PASC. The persistence of altered D-Dimer levels raises the possibility of long-term risks of thromboembolic disease. All these markers levels should be accurately evaluated in the long-term follow-up, with individualized consideration for prophylactic nutritional, anti-inflammatory and/or anticoagulant therapy if indicated.

Open access, https://www.frontiersin.org/articles/10.3389/fmed.2021.714426/full

 

Moved posts

Have you seen this?

 

No, I hadn't seen that.

Link : https://www.frontiersin.org/articles/10.3389/fmed.2021.714426/full
Title : Serum Metabolic Profile in Patients With Long-COVID (PASC) Syndrome: Clinical Implications

I found this bit from the Abstract interesting :

These patients appear to have Anaemia of Chronic Disease (ACD) which was still apparent 60 days after hospital discharge (See Table 3)

It would have helped if serum iron had been tested in those LC patients and been found to be low because it would have made diagnosis of ACD more certain.

1) https://irondisorders.org/anemia-of-chronic-disease-2/ [Published a few years ago but I don't know exactly when]

A couple of sentences from link 1 :

"Taking iron pills for anemia of chronic disease could be harmful, even fatal. "

"There is no treatment for anemia of chronic disease except to address the underlying condition. Iron supplementation is inappropriate in these patients because the added iron can become free to nourish bacteria and cancer cells."

The Iron Withholding Defence System - Link 2 is the easy reading version (the kind I like) of how it works - there are many others available :

2) See Page 8 : https://web.archive.org/web/2020021...ers.org/Websites/idi/Images/4QTR2008FINAL.pdf [Published 2008]

"Controlling access by these pathogens to iron is a naturally occurring iron balance mechanism: The Iron-Withholding-Defense-System (IWDS). First described by E. D. Weinberg, Ph.D. in the early 1980’s, IWDS is triggered when harmful invaders penetrate the human body. When activated, hemoglobin drops below normal levels allowing just enough iron to function. Meanwhile ferritin rises sometimes significantly, containing the extra iron that is being withheld from the invader. Once the invader is identified and eradicated, the hemoglobin and serum ferritin levels return to normal.
This temporary “anemia” is relieved when the underlying cause is identified and cured. Iron pills should never be taken by a patient with this type of anemia. Doing so could be fatal"

And a paper I've just discovered (Reference 31 in the first link in this post, the one from @Mij ) - and haven't read it all - on how to manage ACD

3) Title : Management of Anaemia of Chronic Disease: Beyond Iron-Only Supplementation [Published 2021]

3) Link : https://iris.unibs.it/retrieve/handle/11379/540717/132224/67 Pasini and Corsetti Eme nutrients-13-00237.pdf

It appears from Link 3 that ACD is treated differently now to how it was treated just a few years ago, and that patients are given iron for ACD.

CD = Chronic disease ; CHF = Congestive Heart Failure

"Based on the current biochemical knowledge, the pathogenesis of anaemia in CD (including CHF) should be considered in its entirety [11]. Although heme is the principal biochemical constituent of haemoglobin, with ID contributing partially to the anaemia in CD, one of the additional contributory factors in anaemia includes the impaired synthesis of the tetrapyrrolic rings to which iron binds, thereby facilitating the metabolic function of heme, a hemoprotein. The production of D-amino-levulinic acid (D-ALA), the limiting step in the synthesis of the heme ring, warrants significant consideration. D-amino-levulinic acid (D-ALA) is derived from one amino acid, glycine, and Kreb’s cycle intermediate succinyl-coenzyme A (CoA) [12]. Therefore, an adequate treatment of anaemia in CD necessitates the incorporation of a standard iron infusion, along with the supplementation of essential amino acids (EAAs) and vitamins involved as precursors or cofactors in heme synthesis."

I have never studied iron infusion, so I have no idea how successful it is for treating Anaemia of Chronic Disease. It does seem to be completely at odds with the advice from the older articles.

---

I read this blog post earlier today, posted on the forum by somebody else but can't remember who or where :

https://dontbelievehype.co.uk/life-...ntist-i-had-a-severe-chronic-vaccine-reaction

The author of the blog has Long Covid, and after many months of illness was discovered to have undetectable vitamin D3 and undetectable vitamin B12 :

"They ran extensive bloods and found vitamin B12 and D3 severe deficiency (both below detectable range), and supporting evidence from a basic neuro exam for subacute combined degeneration of the spinal cord."

I wish the author's B12 and D3 were known before she had developed Covid, because it would have been very informative.

In my (untrained) opinion it is possible that people with Covid end up stripped of nutrients, and that could be the cause of at least some of the problems in Long Covid.