Down the rabbit hole of inflammation in Long Covid

and I'm not sure where the bottom is yet...

You know that feeling where you are searching and searching and searching for something, sometimes for days, and you just can’t find what you’re looking for?

You find all kinds of information that circles all around what you’re looking for, but nothing directly relevant…

And the frustration that comes with knowing what you want is in the ocean of information in front of you, but you have to empty the entire ocean one teaspoon at a time to find it…

That’s where I’m at right now.

I’ve spent this week trying to look at inflammation and endotheliitis in Long Covid. And paper after paper after paper gives me a ton of information, but none of it is assembled into any kind of complete picture that is useful.

For example, here is a figure I found that shows the interactions between coagulation (via the platelets), inflammation, and the endothelium:

That’s a lot of mechanistic pathways and signaling molecules to look at to try to make some sense of what’s going on with inflammation and endotheliitis in Long Covid, and how that interplays with coagulation and microclotting.

I’ll be honest - I’m feeling a little bit defeated right now.

Normally, I see my job as a medicinal chemist to take biological pathways and systems like this and simplify them to only what’s relevant. To cut through the noise. To drill down to the exact pathway and molecular target that we can inhibit with a small molecule to treat a symptom or disease.

And I haven’t been able to do that with inflammation in Long Covid.

Yet.

Because it’s a really complicated system. That I need more time to research, digest, and then be able to communicate to you all in a way that’s easily understood.

A manageable first step that I’m looking at right now is a paper that talks about pro-coagulation and pro-inflammatory molecules that are elevated in the blood samples of Long Covid patients

That’s the paper that I’m going to be talking about next.

I had started this week wanting to talk about the link between inflammation, endotheliitis, and peripheral resistance in POTS. So far, I just haven’t been able to assemble a picture for those molecular pathways that makes sense yet. So that will be coming some time in the future once I get a handle on that literature.

So stay tuned for the next piece on pro-inflammatory biomarkers for Long Covid.

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