Pathology
This paper from UK (2024-02-21) found, with careful genetic sequencing of samples of every sample, that a small but surprisingly high number of people had COVID-19 infections for long periods: about 1-3% had infections lasting ~30 days, and 1-5 out of 1000 for ~60 days. They even found one patient who was infected for 193 days!
Many of the patients had viral load “rebound”, with the viral load dropping and then rising again. Without genetic sequencing, those would have probably been declared as reinfections. (They were very conservative in declaring what was a reinfection and what was persistent, so the percent of people who have long-duration persistent infections might have been UNDERcounted here.)
They also found that people who had persistent infections had ~50% greater risk of Long COVID.
This preprint from USA (2024-02-15) is mostly about a pan-coronavirus vaccine they tested in rodents (which BTW worked well), but also found that unvaccinated people who never developed symptoms when infected by COVID-19 happened to have T-cells which recognized “specific sets of highly conserved SARS-111 CoV-2 non-Spike antigens”. From this, I infer that the difference between “really sick” and “asymptomatic” is at least partially random chance: when your body was rolling dice to figure out which T-cells to make, did the randomness generate helpful ones or not?
I think this is important: this means that (to a large extent) it isn’t the fault / good behaviour of people which determines their outcome, it’s luck.
Long COVID
This paper from Ireland (2024-02-22) found evidence of leaks in the blood-brain barrier among long haulers. In blood collected very early in the pandemic or pre-pandemic, they found higher levels of a brain protein in arm-blood of people-who-ended-up-developing-Long-COVID than in people-who-had COVID-but-not-Long-COVID or in arm-blood collected before the pandemic. They also did tracer-dye studies and found that blood from outside the brain was getting into the brain of Long COVID patients.
They also found higher levels of clotting proteins among people with Long COVID than others.
This paper from USA (2024-02-22) found that vaccinated people had a lower risk of getting Long COVID. The risk was 43% lower for Long COVID which lasted at least 30 days and 58% lower for Long COVID which lasted more than 90 days. Editorial: Many papers define Long COVID as lasting more than 90 days, so maybe this should be called “medium COVID”?
Vaccines
This paper (2024-02-12) looked at a huuuuge number of people to find the risk of vaccine harms. It did find that COVID-19 vaccination did raise the risk of a few rare conditions. After getting these vaccines, the risk of these harms was significant and at least 1.5x higher:
| Brand | Dose # | Harm | Risk |
| AZ | 1 | Guillain-Barré | 2.49x |
| AZ | 1 | Brain blood clot | 3.23x |
| AZ | 3 | Pericarditis | 1.74x |
| Pfizer | 1 | Myocarditis | 2.78x |
| Pfizer | 2 | Myocarditis | 2.86x |
| Pfizer | 3 | Myocarditis | 2.09x |
| Moderna | 1 | Brain/spine auto-immune inflammation | 3.78x |
| Moderna | 1 | Myocarditis | 3.48x |
| Moderna | 2 | Myocarditis | 6.10x |
| Moderna | 3 | Myocarditis | 2.01x |
| Moderna | 1 | Pericarditis | 1.74x |
| Moderna | 4 | Pericarditis | 2.64x |
Note: The risks of harms from vaccines is way higher than the risk of harms from COVID-19. So, yeah, if you want the least risk, don’t get vaccinated and don’t catch COVID. (Good luck with not catching COVID!)
I think it’s really strange how the risk varies so much by dose number. Why does Moderna have such a big risk of Myocarditis after dose 2, but no extra risk after dose 4? Why does AZ only give a Pericarditis risk after the third dose?
This preprint from Mexico (2024-02-14) says that the Mexican version of my beloved NDV-HPX-S (AKA Patria) is “non-inferior” to AZ as a booster. (After at least one vaccine has been approved, country regulations usually say that for another to be approved, it has to be no worse than one of the approved vaccines. Studies tend to use AZ as their benchmark because it’s weakest and easier to get their hands on. It is my understanding that big pharma doesn’t like to sell their vax to competitors.)
NDV-HPX-S is stupid-easy to make, cheap, and has a much gentler cold chain requirement than most others.
This preprint from Mexico (2024-02-13) compared intramuscular Patria with intranasal Patria. The intranasal vax’s antibody level (as withdrawn from human blood later) was not as high as the intramuscular one. They did not give any measurements of mucosal immunity. 🙁
This paper from Germany (2024-02-02) found that their intranasal live attenuated virus did better than Pfizer given intramuscularly, at least in male hamsters.
This preprint from USA (2024-02-06) found that Ad5.SARS-CoV-2-S1, an intranasal protein subunit vaccine from University of Pittsburgh/Gaphas Pharmaceutical, works really well as a booster in mice, especially across variants.
This Comment (i.e. completely self-reported) from Japan (2024-02-01) reports that Arcturus’ ARCT-154 vaccine does not wane as fast as Pfizer:
This paper from Canada (2024-02-22) found that the mid-season 2023/2024 vaccine effectiveness was 47% (presumably of what was being given, which would have been mostly Pfizer and Moderna) against medically attended outpatient COVID-19 for the general population and 67% among previously infected people.
Treatments
This paper from USA (2022-02-22) says that adults who tested positive for COVID-19 who got Paxlovid had a 84% lower risk of hospitalization than those who did not. (Note: The US is far, far more relaxed about what ages can get COVID-19 than BC is.)
This paper from USA (2024-02-15) says that Evusheld — a combo of two monoclonal antibodies tixagevimab and cilgavimab, which was used sort of like a vaccine for immunocompromised people — showed no clinical benefit against Omicron in a small study. 🙁
This web page says that some well-respected Long COVID researchers are starting a study to try HIV anti-virals against COVID. Cross your fingers!