Kelly-Anne Bryan, RN retweeted
Long-Term Effects of Myocardial Injury on 1-Year Outcomes in Hospital Survivors With COVID-19: A Prospective Cohort Study
🚨Myocardial injury in hospitalised COVID survivors → higher 1-year death & MACE. Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) cut that risk, with 71 % still symptomatic(LongC0VID).
You only have ONE HEART and it remembers!
➡️Prospective cohort from Tongji Hospital (Wuhan) of 2,185 hospitalized COVID-19 survivors (Omicron era), of whom 531 had acute myocardial injury (elevated cardiac troponin),
➡️At 1-year follow-up, myocardial injury was independently associated with higher all-cause mortality and major adverse cardiovascular events (MACE) after multivariable Cox regression and propensity-score matching,
➡️Kaplan–Meier curves show the highest event rates in the myocardial-injury group not receiving ACEI/ARB,
➡️Long-term ACEI/ARB use was linked to significantly lower mortality (aHR ~0.44) and MACE in this subgroup,
➡️At one year, 71.5 % of survivors still reported persistent symptoms (LongC0VID, mainly fatigue and sleep disturbance), those with prior myocardial injury had worse quality of life.
➡️Whether prior vaccination attenuated the risk of myocardial injury itself, or whether reinfection modified 1-year outcomes, is not addressed in this study
➡️This is the first large Omicron-era Chinese prospective dataset that combines hard clinical endpoints, patient-reported outcomes, and an analysis of ACEI/ARB benefit specifically in the myocardial-injury subgroup.
‼️So, myocardial injury during acute Omicron hospitalization is not a transient lab abnormality, it marks a high-risk group that continues to die and suffer cardiovascular events and poorer quality of life a full year later, yet a simple, already-available drug class (ACEI/ARB) appears to blunt that excess risk.
‼️For clinicians and patients, the practical message is straightforward: anyone who had elevated troponin while hospitalised with COVID (even in the Omicron period) should be flagged for closer cardiac follow-up. The finding that continued ACEI/ARB use is associated with lower mortality and MACE supplies an immediately actionable, low-cost intervention for this subgroup. Persistent fatigue and sleep problems(LongC0VID) in nearly three-quarters of survivors also underscore that post-hospital recovery remains incomplete for many, reinforcing the need for structured post-COVID follow-up and clinics rather than a simple discharge! YOU ONLY HAVE ONE HEART!
#AvoidSars2 #AvoidReinfections
onlinelibrary.wiley.com/doi/…
Kelly-Anne Bryan, RN retweeted
Pulmonary vascular abnormalities in Long COVID: a radiological perspective
🚨Your CT is ‘normal,’ yet you’re still breathless months after COVID. New review shows hidden microvascular damage (perfusion defects, vessel pruning, gas-transfer defects) that standard scans miss, explaining LongC0VID symptoms that routine imaging miss!
➡️Interesting new narrative review from India shifts the focus of LongC0VID from parenchymal lung damage to a distinct pulmonary vascular phenotype! REMEMBER SARSCOV2 is basically a VASCULAR VIRUS!
➡️Core mechanisms:
- SARSCoV2 enters endothelial cells via ACE2 receptors, triggering endotheliitis that creates a pro-coagulant environment and promotes the formation of in-situ microthrombi,
- This is amplified by immunothrombosis (driven by neutrophil extracellular traps) and the generation of amyloid-like fibrin microclots that resist normal breakdown,
- Over time, the vasculature undergoes maladaptive remodelling, including intussusceptive angiogenesis and progressive “pruning” of small vessels, which reduces the available surface area for gas exchange,
➡️Conventional CT pulmonary/angiography frequently appears normal or near-normal and misses microvascular disease,
➡️Advanced imaging uncovers the pathology:
1. Dual-energy CT (DECT) detects persistent wedge-shaped perfusion defects in otherwise normal lung tissue, seen in 36–60% of symptomatic patients and still present in 36.3% at roughly 3 months,
2. Quantitative CT shows reduced small-vessel volume (PBV5), which correlates with lower DLCO and poorer exercise tolerance,
3. Hyperpolarized xenon-129 MRI reveals a hallmark gas-transfer defect, impaired alveolar-to-RBC gas exchange, even when standard CT and pulmonary function tests appear normal,
4. V/Q SPECT and PREFUL MRI demonstrate mottled perfusion patterns consistent with diffuse small-vessel disease,
➡️Findings correlate with ongoing dyspnoea, fatigue, and reduced exercise capacity,
➡️Higher (admission) D-dimer/CRP often predict later defects,
➡️2025 RSNA/STR/ESTI consensus guidelines recommend imaging at 3 months with paired inspiratory/expiratory protocols and the term “Post-COVID-19 Residual Lung Abnormality.”
‼️So, AGAIN, routine CT scans can look reassuring while the pulmonary microvasculature remains structurally and functionally damaged, directly accounting for persistent breathlessness and fatigue in a substantial subset of LongC0VID patients.
‼️The proposed framework matters clinically every day: many patients with ongoing dyspnoea or exercise intolerance after COVID have occult vascular injury that conventional imaging and basic Pulmonary Function Tests(PFTs) fail to detect. Recognizing the vascular phenotype guides use of functional/quantitative techniques (DECT, xenon MRI, etc.), supports standardized 3-month imaging protocols, and should shift management toward vascular rather than purely parenchymal explanations. It also helps differentiate vascular from airway-related causes of symptoms and UNDERSCORES the public-health scale of residual impairment in survivors!
REMINDER AGAIN, COVID-19(SARSCOV2) is basically a VASCULAR INFECTION!
#AvoidSars2 #AvoidReinfections #Mitigation
link.springer.com/article/10…
Kelly-Anne Bryan, RN retweeted
Acute covid usually clears in days. Alzheimers and Parkinsons take decades to build. A new warning narrative review from the COMMUTE consortium tries to connect those two timescales - to map how one might lead to the other. 🧵
🧠Proposed timeline and framework from SARS2 infection, neuroimmune response, Blood–Brain Barrier compromise, immune dysregulation to the development of neurological symptoms.
link.springer.com/article/10…
Kelly-Anne Bryan, RN retweeted
Replying to @____katieee @violet1petals
As someone who is homebound with long COVID (which happened to me in 2024 well after being vaccinated), the issue is you cannot know who has COVID. We obviously know everybody is not asymptomatic but when you don’t know who is who you have to just mask generally 🤷♀️
Kelly-Anne Bryan, RN retweeted
So like yes, some people are asymptomatic, that’s just a reality we have to contend with. This meta analysis of 38 studies found that over 40% of cases were asymptomatic. In addition, many ppl are contagious 1-2 days before symptoms
pmc.ncbi.nlm.nih.gov/article…
Kelly-Anne Bryan, RN retweeted
Replying to @NSWHealth
@NSWHealth, this advice is disappointing and inconsistent with the science of airborne transmission. Please reconsider your messaging and provide the public with accurate, evidence-based guidance. youtu.be/GPUTTjjdT4A?si=yW1X… 🙏
Meanwhile in the year of our lord 2026, public health is advising people that for "daily protection" from airborne viruses on public transport, they should ... wash their hands when they get off. And that masks are "not practical". Shout out to @NSWHealth
Kelly-Anne Bryan, RN retweeted
While you sleep, your brain's white matter is charging up like a battery
Myelin, the insulation around your nerve fibers, has been considered a passive structural component that speeds up signals. A new hypothesis from @FScholkmann and colleagues proposes it's actually an energy storage system that fills up during sleep and powers your neurons throughout the day.
The paper, published in Progress in Biophysics and Molecular Biology, presents a radical reimagining of what myelin does beyond speeding up electrical signals along nerves.
What is myelin?
Myelin is the fatty sheath that wraps around nerve fibers like insulation around electrical wires. It's produced by specialized cells called oligodendrocytes in the central nervous system and makes up about 40% of your brain's volume.
Traditionally, myelin's job has been simple: speed up nerve signals and provide structural support. This new hypothesis suggests it does something far more dynamic.
The proton capacitor hypothesis
The researchers propose myelin functions as a proton capacitor, meaning it stores energy in the form of protons (hydrogen ions) that accumulate during sleep and get released during wakefulness to produce ATP, the cell's energy currency.
Think of it like a rechargeable battery. During sleep, myelin charges up by accumulating protons. During wakefulness, those protons flow through ATP synthase enzymes embedded in myelin, generating the energy neurons need to function.
The mechanism involves two abundant myelin proteins:
Myelin basic protein (MBP) sits between myelin layers and contains amino acids (lysine, arginine, histidine) that can absorb and hold protons. It functions as the energy storage component.
Proteolipid protein (PLP) spans the myelin membrane and contains serine and threonine amino acids that form efficient proton conductors, creating pathways for protons to flow from storage sites to ATP synthase.
How the charging cycle works
During sleep, your myelin is actively storing energy. Specialized molecules in myelin pump protons (think of them as tiny charged particles) into storage proteins, like filling up a battery. During this phase, no energy is being used, just stored.
When you wake up, the system switches into discharge mode. Those stored protons flow through protein channels to enzymes that convert them into ATP, your cells' usable energy form. This ATP travels through tiny tunnels called gap junctions directly into nerve fibers, where it powers your brain's activity.
The researchers calculated that the amount of protons a small cube of myelin can hold matches exactly what your brain would need during 8 hours of wakefulness. The storage capacity and the daily demand align.
The molecular sleep switch
A naturally occurring molecule called oleamide acts as the on/off switch for this system.
Throughout your waking hours, oleamide gradually accumulates in your brain. When it reaches a certain level, it closes those gap junctions, the tunnels that deliver ATP from myelin to nerve fibers. Once the tunnels close, your neurons can't access the energy supply. Neural activity drops. You get sleepy.
With the delivery system shut down, myelin switches from discharge mode to charging mode. While you sleep, oleamide slowly breaks down. When enough of it clears out, the gap junctions reopen, ATP starts flowing to neurons again, and you wake up.
This explains why you can't just decide to stay awake indefinitely. As oleamide builds up during the day, it eventually forces the system offline whether you want it to or not. Sleep isn't optional, it's a programmed metabolic requirement driven by molecular accumulation.
How myelin produces energy without the usual machinery
Here's where it gets strange: myelin can make ATP (cellular energy) even though it doesn't contain the typical power plants that cells use to generate energy.
Normally, structures called mitochondria produce nearly all of a cell's ATP. But myelin has very few, if any, complete mitochondria. So how does it make energy?
The researchers propose that mitochondria send small cargo packages carrying energy-producing equipment to the myelin. These packages fuse with myelin membranes and drop off the machinery, allowing myelin to produce ATP on its own.
Think of it like getting a portable generator delivered to a remote cabin. You don't need a full power plant on site, just the essential equipment to generate electricity locally.
The bigger the battery, the less time spent charging
The researchers examined 23 different mammal species and discovered something remarkable: animals with more white matter (the brain tissue that's 95% myelin) need less sleep.
Here's the pattern:
• Bats have tiny brains with minimal white matter and sleep 20 hours a day
• Humans have moderate white matter and sleep 8 hours a day
• Elephants have massive white matter and sleep just 3.5 hours a day
The logic is straightforward. More myelin means greater energy storage capacity. With a bigger battery, you need less time plugged in to fully recharge.
The pattern suggests that more myelin provides greater energy storage capacity, reducing the time needed to recharge. Less myelin means longer recharging periods are required.
This relationship also appears within humans across the lifespan. White matter volume peaks between ages 30-50, the same period when sleep duration reaches its minimum. Both follow inverted U-shaped curves over the human lifespan.
Even sex differences align: women have less white matter than men and require more sleep on average.
Experimental support
The hypothesis draws on experimental work showing:
• Isolated myelin vesicles consume oxygen and synthesize ATP via oxidative phosphorylation
• Myelin vesicles exposed to NADH retain an energy charge that's later used for ATP synthesis when ADP and phosphate are added
• Longer exposure to NADH produces more ATP in subsequent phases
• This matches the predicted two-phase system: charging during simulated sleep, discharge during simulated wakefulness
Sleep deprivation studies show myelin thickness decreases when animals are kept awake, consistent with discharge without adequate recharging time.
Marathon runners show notable reductions in myelin after intense physical activity, suggesting the energy reserves get depleted during sustained neural and physical exertion.
Key takeaways:
• Myelin may function as a proton battery, storing energy during sleep and releasing it during wakefulness
• Two myelin proteins (MBP and PLP) form a coupled system: one stores protons, the other conducts them to ATP synthase
• Sleep duration correlates with white matter volume across 23 mammalian species
• Oleamide, a natural sleep inducer, closes the gap junctions that deliver ATP from myelin to axons
• Myelin contains functional mitochondrial components delivered via mitochondrial-derived vesicles
• The human brain requires approximately 8 hours to fully recharge myelin's proton storage capacity
• Sleep deprivation leads to measurable myelin degradation
Limitations and open questions
This remains a hypothesis requiring direct experimental validation in living systems. The calculations provide plausibility but don't prove the mechanism operates as proposed.
Key questions:
• Can proton accumulation and discharge be measured directly in myelin during sleep/wake cycles?
• Does blocking this proposed system prevent normal sleep function?
• How does this mechanism integrate with other established functions of sleep?
• Can therapeutic interventions targeting this system improve sleep quality or neurological function?
The challenge is that protons moving between membrane-bound buffers without entering free solution is difficult to measure experimentally.
Why this matters
If validated, this hypothesis fundamentally reframes our understanding of sleep. Rather than viewing sleep as a period when the brain passively recovers, it positions sleep as an active metabolic phase when the brain's white matter systematically stores energy for the next waking period.
It also elevates myelin from a passive structural element to an active metabolic organizer that administers energy distribution to neurons.
The framework could explain why myelin disorders often involve fatigue and why conditions affecting white matter integrity produce cognitive deficits even when gray matter remains intact.
The identification of oleamide as the molecular switch controlling this cycle points to a natural compound that's been overlooked as a potential sleep therapeutic despite decades of evidence.
The convergence of structural data (protein composition and positioning), metabolic data (oxygen consumption and ATP synthesis in myelin), molecular data (oleamide and gap junctions), and cross-species data (white matter volume and sleep duration) creates a compelling case that myelin plays a previously unrecognized role in sleep energetics.
Whether this represents the primary function of sleep or one component of a multi-system process remains to be determined. But the hypothesis provides testable predictions and a mechanistic framework for understanding the metabolic foundations of the sleep-wake cycle.
Kelly-Anne Bryan, RN retweeted
At the Corsi-Rosenthal Foundation, we're committed to improving human health by promoting clean indoor air and supplying air purifiers to those who need it most. Here's how we're making it happen:
Kelly-Anne Bryan, RN retweeted
🚨The $64,000 question is whether herpesvirus reactivation drives COVID illness (especially long COVID) or is merely a marker of how badly the immune system has been battered??
Excellent study explanation( as always) and 🧵👇
Kelly-Anne Bryan, RN retweeted
If this chip falls, everything else will fall into place.
Kelly-Anne Bryan, RN retweeted
We've been calling it mitochondrial dysfunction for decades. Turns out that term is scientifically meaningless, and it's been holding back progress in understanding how mitochondria actually work.
@MitoPsychoBio and colleagues published a perspective in Nature Metabolism arguing that the language mitochondrial scientists use fails to capture what mitochondria actually are: multifunctional organelles that dynamically recalibrate across dozens of independent activities depending on what cells need.
The problem starts with oversimplification. Mitochondria get reduced to the powerhouse of the cell in introductory biology. That framing suggests a single primary job: make ATP. Reality is more complex.
Mitochondria synthesize steroid hormones. They produce iron-sulfur clusters required for hundreds of proteins throughout the cell. They regulate innate immunity and antiviral responses. They control programmed cell death. They generate signaling molecules that reprogram nuclear gene expression. They can transfer between cells to rescue damaged tissue.
Key insight: These aren't backup functions that kick in when energy production fails. They're simultaneous, independent, cell-type-specific roles that mitochondria perform constantly.
Here's why the terminology matters:
When researchers measure decreased ATP production and call it mitochondrial dysfunction, they're collapsing dozens of distinct mitochondrial activities into a binary working/broken framework. That creates problems:
• A mitochondrion producing less ATP might be signaling rather than failing
• Different mitochondrial activities can change independently
• What looks dysfunctional in one context may be adaptive in another
• Cell-type differences get lost when using generic terms
The paper proposes a hierarchical terminology system with five levels:
1. Cell-dependent properties: Mitochondrial characteristics that vary by cell type. Neurons, muscle cells, and immune cells contain functionally distinct mitochondrial populations adapted to tissue-specific demands.
2. Molecular features: The structural and compositional elements. Membrane potential, protein composition, lipid content, mtDNA copy number, cristae architecture.
3. Activities: Specific biochemical processes. Oxygen consumption, ATP synthesis, reactive oxygen species production, calcium buffering, metabolite synthesis.
4. Functions: The biological purposes these activities serve. Energy provision, biosynthesis, signaling, quality control, cell death regulation.
5. Behaviors: Dynamic responses over time. Fusion, fission, movement, mitophagy, biogenesis, transfer between cells.
The framework distinguishes what mitochondria are made of, what they do biochemically, why they do it biologically, and how they change over time.
Example of how this improves precision:
Old framing: This drug causes mitochondrial dysfunction.
New framing: This drug decreases complex I activity, reducing ATP synthesis capacity while increasing superoxide production at complex III, without affecting calcium handling or steroid synthesis.
The second version identifies which specific mitochondrial activities change and which remain intact. That matters for predicting side effects, understanding mechanisms, and designing interventions.
The malleable nature of mitochondria creates additional complexity. Mitochondrial characteristics can shift within minutes to hours in response to nutrient availability, stress, or signaling molecules. These recalibrations are often reversible and physiologically appropriate.
Calling a physiological recalibration dysfunction conflates adaptation with pathology. A muscle cell's mitochondria after endurance training look different from before training. Neither state is dysfunctional. They're optimized for different demands.
The perspective argues this terminology shift will improve three outcomes:
Teaching: Students learn mitochondria are multifaceted organelles rather than single-purpose powerhouses, building a more accurate mental model from the start.
Research progress: Specific terminology forces specific measurements. Asking which mitochondrial activities change rather than whether mitochondria are dysfunctional leads to more mechanistic studies.
Interdisciplinary collaboration: Clearer language helps researchers from different fields understand exactly what aspects of mitochondrial biology are relevant to their questions.
The implications extend beyond semantics. How scientists conceptualize mitochondria shapes which questions get asked, which measurements get prioritized, and how findings get interpreted.
Moving from function/dysfunction binary to multidimensional assessment requires more complex experimental designs. But that complexity better matches the biological reality.
Mitochondria aren't failing when they recalibrate. They're responding. Understanding which specific activities change, in which cells, under which conditions, and with what biological purpose represents the path forward for mitochondrial science.
Kelly-Anne Bryan, RN retweeted
A Comparison in Short Term Outcomes of Coronary Artery Bypass Grafting Surgery between Post-COVID and Non-COVID Patients
🚨So AGAIN, Post-COVID patients after bypass surgery suffer nearly DOUBLE the arrhythmias (48% vs 26%) and kidney injury (38% vs 16%), plus days longer on the ventilator and in ICU. Prior COVID is not ‘just a cold’ for cardiac surgery!🫀
➡️An interesting small comparative observational study(July 2024 to June 2025, 100 patients with CAD were included, half of them had no previous history of COVID-19 infection (group A), other half had history of covid-19 infection (group B)).
➡️Key findings:
- Post-COVID patients had significantly higher rates of cardiac arrhythmias (48% vs. 26%, p=0.023) and acute kidney injury (38% vs. 16%, p=0.013).
- They also required longer mechanical ventilation (11.8 ± 5.2 vs. 7.1 ± 4.7 hours), ICU stay (6.9 ± 2.2 vs. 4.9 ± 2.4 days), and postoperative hospital stay (10.6 ± 3.3 vs. 8.4 ± 1.8 days) , all p<0.001.
- Re-exploration (10% vs. 2%) and mortality (8% vs. 2%) were numerically higher but not statistically significant.
➡️Post-COVID patients undergoing coronary artery bypass grafting(CABG) may be prone to experience worse short-term outcomes and face longer recovery periods!
‼️So, prior COVID-19 leaves a measurable residual burden: even after recovery, these patients face substantially higher rates of serious postoperative complications and markedly prolonged recovery after CABG. The physiological impact is clearly not trivial.
‼️IMPORTANT: Results are consistent with the broader literature on residual COVID-related vulnerability in the perioperative cardiac surgery setting, especially regarding recovery duration and certain organ-specific complications!
#AvoidSars2 #AvoidReinfections
banglajol.info/index.php/MED…
Kelly-Anne Bryan, RN retweeted
If our water tested positive for cholera, would we stop boiling/cleaning it & instead share it over & over with our children, elders, friends & neighbours?
Now replace cholera with COVID and water with air.
Why do we protect our water but hesitate to protect the air we breathe?
Kelly-Anne Bryan, RN retweeted
Outstanding thread as always from @ZdenekVrozina.
I see this in people almost every day now. Fundamentally, it's why I mask.
Kelly-Anne Bryan, RN retweeted
Your chances of being able bodied your entire life are slim to none. It is always in your best interest to advocate for a more accessible world fr
Kelly-Anne Bryan, RN retweeted
This is an outstanding summary of exactly where we are with H5N1, how the US has fumbled dealing with it, and the ongoing and increasing risk of reassortment leading to a new human influenza pandemic.
As I always say, we are giving this beast of a virus too much room.
Kelly-Anne Bryan, RN retweeted
Have you seen this 👇 @CMO_England?
Why are you staying silent on the harms COVID is still doing? Why will you talk about flu but not COVID……especially when we’re currently in a COVID wave?
Kelly-Anne Bryan, RN retweeted
Incidence of new-onset pulmonary fibrosis 4.5 years post SARS-CoV-2 infection in an academic urban medical center
🚨New 4.5-year study: COVID nearly doubles the risk of new pulmonary fibrosis, even in people who never went to hospital. AGAIN, the lung damage doesn’t end when the virus does.
➡️Large retrospective USA matched cohort study(March 2020–August 2024) examined new-onset pulmonary fibrosis (PF) up to 4.5 years after SARSCoV2 infection,
➡️COVID-positive patients (no prior PF) were propensity-score matched 1:2 to COVID-negative controls and analysed using Fine-Gray models for competing risks,
➡️Both groups showed roughly doubled risk of new-onset PF versus controls:
- Hospitalized patients sHR 2.05 (95% CI 1.69–2.49),
- Non-hospitalized patients sHR 2.33 (95% CI 1.88–2.88),
➡️Cumulative incidence remained elevated out to 54 months,
➡️Among those who developed PF:
- Prior COVID hospitalization strongly raised odds of pneumonia (OR 4.84), respiratory failure (OR 3.76), asthma/COPD exacerbations, and pulmonary hypertension,
- Non-hospitalized COVID patients also showed elevated pneumonia, asthma exacerbation, and pulmonary embolism risk,
➡️Sensitivity analyses (cause-specific Cox, inverse-probability weighting, pre-pandemic controls) supported the main findings,
➡️No clear sociodemographic disparities were observed,
➡️The discussion notes that vaccination could theoretically reduce infection rates or severity and thereby lower fibrotic risk, but this remains an untested hypothesis within the paper itself,
➡️Well noted and specified limitations.
‼️So, even mild, non-hospitalized SARSCoV2 infection roughly doubles the long-term risk of clinically coded new-onset pulmonary fibrosis and its cascading respiratory complications for up to 4.5 years.
‼️This is one of the longest large-scale EHR studies linking SARSCoV2 to new-onset PF in both hospitalized and non-hospitalized patients. It elevates post-COVID fibrotic lung disease from a theoretical concern to a measurable, multi-year population risk that can drive repeated pneumonia, respiratory failure, exacerbations, and vascular complications. The findings argue for sustained respiratory surveillance, earlier risk stratification, and proactive management, particularly in diverse urban populations with high baseline respiratory burden, rather than treating infection as a purely acute event. #ProactiveScreening
#AvoidSars2 #AvoidReinfections
link.springer.com/article/10…
Kelly-Anne Bryan, RN retweeted
Here is the Covid debate in a nutshell....
On one side you have "Covid is dangerous" backed by 500,000 peer reviewed publications showing the damage Covid causes, coupled with the reality that more people are sick more often, for longer, more severely.
On the other side you have, "Covid is mild", backed by, "the government said so", with zero proof, publications, or even real world evidence to show it to be true.
There really is no debate, it's just facts vs fiction at this point, and the fiction is winning because its less work and more comfortable.
Policy should match the reality.































