Prof Pretorius publishes a new paper on micro clots and their treatment in Long Covid and at least some cases of ME

Countrygirl

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Prof Pretorius has just published a paper on micro clots and their treatment in Long Covid and in (some cases) of ME.

It is 37 pages long and I am only on page 4 so far, but it is a very interesting read.

Below is part of the introduction and I have attached the whole paper as a pdf file.


As many of 30% of COVID-19 patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) continue, and in some cases begin, to suffer a variety of debilitating symptoms weeks or months after the acute phase of infection. The precise definition of this Long COVID/ Post-Acute Sequelae of COVID-19 (PASC) (here referred to as Long COVID/PASC) is rather unclear and in some instances even vague. This is because most pathophysiological mechanisms have not yet been fully identified, and many different symptoms have been reported.

The most frequently reported symptoms persist for as much as 6 months or longer after acute infection 1 . COVID-19 survivors complain of recurring fatigue or muscle weakness, being out of breath, sleep difficulties, and suffer from anxiety or depression 2 . Symptoms noted in Long COVID/PASC patients show numerous similarities to those seen in chronic illnesses, including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) 3, 4, 5, 6, 7, 8, postural orthostatic tachycardia syndrome 9 and Mast Cell Activation Syndrome 1, 10 .

In a large global study, a survey of 3,762 Long COVID/PASC patients from 56 countries found that nearly half still could not work full-time six months postinfection, due mainly to fatigue, post-exertional malaise, and cognitive dysfunction 11 .
 

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BrightCandle

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Interesting. Basic treatment seems to have been after finding microclots in a subset of patients they used anticoaglulants and antiplatelet treatments for 30 days. This is now the third group I have seen that has validated the microclots and using these types of treatments to solve it and its impacting causing these symptoms.

I have just finished 60 days of Bromelain and Nattokinase, I stopped because my blood was clotting super weirdly on my lancet wounds, I was getting pale ring bruises. But after it recovers I will try an anticoagulant like nattokinase and an antiplatelet like Gingko or grape seed extract together. I do have more energy but I am also lightheaded and my blood pressure is a little erratic at the moment.
 
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ChookityPop

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Interesting. Basic treatment seems to have been after finding microclots in a subset of patients they used anticoaglulants and antiplatelet treatments for 30 days. This is now the third group I have seen that has validated the microclots and using these types of treatments to solve it and its impacting causing these symptoms.

I have just finished 60 days of Bromelain and Nattokinase, I stopped because my blood was clotting super weirdly on my lancet wounds, I was getting pale ring bruises. But after it recovers I will try an anticoagulant like nattokinase and an antiplatelet like Gingko or grape seed extract together. I do have more energy but I am also lightheaded and my blood pressure is a little erratic at the moment.
Interesting! Which dosage of Bromelain and Nattokinase did you take? And what is lancet Wounds?
 

BrightCandle

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Interesting! Which dosage of Bromelain and Nattokinase did you take? And what is lancet Wounds?
Bromelain x3 a day (the packet dose) and Nattokinase was x1 a day (the packet dose).

A lancet is a small pin that diabetics and such use to get a droplet of blood for testing. I have been using one for years for uric acid measurements for gout so its a device I already have and specifically I have been looking at my blood and its flow weekly since I started the anticoagulants. It leaves a small pin prick which typically in normal circumstances does't bleed more than a drop or two if I stroke the blood out and otherwise is mostly gone a few moments later. In this case the blood came out very easily and I got too much (I was making a slide for a microscope) and I had to hold it closed for a few minutes to stop it bleeding. But then about 4 hours later what happened was I had a bruise underneath my skin, only it wasn't dried blood it was active, I could push it about a bit, it was failing to clot. This is when I considered I was in dangerous territory and I felt pretty lightheaded so I stopped taking them.

Not 100% yet but improved feeling already a day later, not sure what if anything lays this way, its certainly not been a magic cure yet.
 

lenora

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Hello @bensmith....Content wasn't available, so don't know the outcome.

Martin had a treatment for this just recently, didn't he? (Didn't help him if it's what I'm thinking of.) I should say that I closed my FB account so perhaps that's the reason I can't access the information. Thanks. Yours, Lenora.
 

Pyrrhus

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Here is the full abstract:

Combined triple treatment of fibrin amyloid microclots and platelet pathology in individuals with Long COVID/ Post-Acute Sequelae of COVID-19 (PASC) can resolve their persistent symptoms (Pretorius et al., 2021 preprint)
https://doi.org/10.21203/rs.3.rs-1205453/v1

We recognise that fibrin(ogen) amyloid microclots and platelet hyperactivation, that we have previously observed in COVID-19 and Long COVID/Post-Acute Sequelae of COVID-19 (PASC) patients, might form a suitable set of foci for the clinical treatment of the symptoms of long COVID/PASC.

We first report on the comorbidities and symptoms found in a cohort of 845 South African Long COVID/PASC patients who filled in the South African Long COVID/PASC registry, of which hypertension and high cholesterol levels (dyslipidaemia) were the most important comorbidities. The gender balance (70% female) and the most commonly reported Long COVID/PASC symptoms (fatigue, brain fog, loss of concentration and forgetfulness, shortness of breath, as well as joint and muscle pains) were comparable to those reported elsewhere. This suggests that our sample was not at all atypical.

Using a previously published scoring system for fibrin amyloid microclots and platelet pathology, we analysed blood samples from 70 patients, and report the presence of significant fibrin amyloid microclots and platelet pathology in all cases; these were associated with Long COVID/PASC symptoms that persisted after the recovery from acute COVID-19.

A subset of 24 patients was treated with one month of dual antiplatelet therapy (DAPT) (Clopidogrel 75mg/Aspirin 75mg) once a day, as well as a direct oral anticoagulant (DOAC) (Apixiban) 5 mg twice a day. A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole. Thromboelastography (TEG®) was used to assist in determining their clotting status.

Each of the 24 treated cases reported that their main symptoms were resolved and fatigue as the main symptom was relieved, and this was also reflected in a decrease of both the fibrin amyloid microclots and platelet pathology scores. Nine patients were genotyped for genetic variation in homocysteine metabolism implicated in hypertension, a common COVID-19 co-morbidity reported in both patients found to be homozygous for the risk-associated MTHFR 677 T-allele.

Fibrin amyloid microclots that block capillaries and inhibit the transport of O2 to tissues, accompanied by platelet hyperactivation, provide a ready explanation for the symptoms of Long COVID/PASC. The removal and reversal of these underlying endotheliopathies provide an important treatment option that seems to be highly efficacious, and warrants controlled clinical studies.
(spacing added for readability)
 

BrightCandle

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I did nattokinase and Bromelain for about 2 months. I stopped due to my blood problematically not clotting properly. I definitely gained something from it so I intend to start again once my lumbrokinase arrives from Germany probably alongside grape seed extract for its anti-platelet effect. There has been some effect for me but its not enough to be certain its working I need more time and doses before I have any confidence its not just some natural variance.
 

Treeman

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Apologies if this has already been asked. But is it possible in UK to get tested for microclots.
From what I understand its called, "thromboelastography test". However asking them to carry it out for an ME/CFS sufferer wont get much support.

I assume its mainly carried out for peoples lives that are threatened. It is recommended for severe covid patients and for treatment if positive with anti coagulation medication.

I will ask my GP for a referral but last time I did something similar, they wouldn't do it but did recommend a chest x ray! Oh the life of a ME/CFS sufferer!
 

ruben

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Thanks for reply. Yes it's one obstacle after another. I'm wondering if there's a private root to go down somewhere out there for this microclot test. But sometimes we just don't have the will to keep searching.
 

ruben

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From what I understand its called, "thromboelastography test". However asking them to carry it out for an ME/CFS sufferer wont get much support.

I assume its mainly carried out for peoples lives that are threatened. It is recommended for severe covid patients and for treatment if positive with anti coagulation medication.

I will ask my GP for a referral but last time I did something similar, they wouldn't do it but did recommend a chest x ray! Oh the life of a ME/CFS sufferer!
 

ruben

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Also have you had the covid vaccination. I have had the 2 Astra Zeneca ones. But I won't be having the booster as have felt worse since those 2 jabs.
 

Treeman

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Thanks for reply. Yes it's one obstacle after another. I'm wondering if there's a private root to go down somewhere out there for this microclot test. But sometimes we just don't have the will to keep searching.
There will be, but it's to expensive for me compered to the outcome. If I knew it would recover me, great, but at this time there is little evidence it will. It would be a cheaper option just to do a safe trial of anti coagulants.

I had covid a year ago which took me 3 months to recover from. Since then 2 oxford jabs and 1 pfitzer all with no problems.
 

SWAlexander

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Prof Pretorius mentioned: "Nine patients were genotyped for genetic variation in homocysteine metabolism implicated in hypertension, a common COVID-19 co-morbidity reported in both patients found to be homozygous for the risk-associated MTHFR 677 T-allele."

In my case dealing with thrombosis I´m worry very much about C1orf167, MTHFR - https://www.ncbi.nlm.nih.gov/snp/rs3737967 - ischemic stroke.
1641727693844.png

Any suggestion?
 
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From what I understand its called, "thromboelastography test".
The significance of TEG in LongCovid has not been established yet. It's recommended for the evaluation of Acute Covid19 patients only, so the results of a thromboelastography won't tell you about microclots unequivocally.

The only way to diagnose microclots at the moment is using fluorescence microscopy, and it's not a standardized test you can ask for at a lab. You would need to find a pathologist familiarized with its use, something very difficult right now. If you find someone, please keep me posted!
You can look at microclots in platelet poor plasma just with a light microscope at 400x, but you'll need an expert to evaluate what you are seeing. It could be an easier first step.
 
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Prof Pretorius mentioned: "Nine patients were genotyped for genetic variation in homocysteine metabolism implicated in hypertension, a common COVID-19 co-morbidity reported in both patients found to be homozygous for the risk-associated MTHFR 677 T-allele."
Can't help you with this, sorry. I'm heterozygous for that SNP, but have had elevated homocysteine and low folic acid in the past, probably due to a problem with my diet. Nothing consumption of folic acid wouldn't fix.