Covid Long Hauler Q&A with Dr. Bruce Patterson & Dr. Yo Notes (2.18.21)

All notes below are thoughts expressed during the above YouTube Q&A with Dr. Bruce Patterson on 2.18.21. Please consult a physician before acting upon any of the information presented below. Notes may be incomplete.

• Dr. Patterson’s website www.covidlonghaulers.com
• Long Hauler Index (LHI) was computer created – 0.75 Normal
• Acute Covid patients have lower scores than Long Haulers
• 50-66% of Long Haulers have elevated Rantes
• IL-2 high, INY-y high, and CCL4 low in Long Haulers
• CCL4’s key immune function is macrophage and nk cell migration
• Not many differences in demographics regarding Long Hauler Indexes
• LHI higher the worse the symptoms
• On Dr. Patterson’s Twitter he talks about Cytokines relating to specific symptoms
• 79% of Long Haulers have elevated VEGF
• VEGF relates directly with the symptoms of burning, brain fog, and neuropathy
• Maraviroc helps decrease VEGF and brain fog
• Low Dose Steroids for at least 2 weeks in combination with Ivermectin or Maraviroc – 85-90% respond in combo
• TNF-a, IL-6, VEGF, and Rantes all can be modulated with Maraviroc
• CD8 low in severe critical COVID
• CD4 & CD8 seen in viral or cancer response
• 25% of Long Haulers have low CD8 8-10 months after initial infection
• CCR5 is the quarterback of the immune system
• Delta 32 deletion in 50% of population, 20% mild to moderate, 25% of Long Haulers, and 4% of severe COVID
• Lower doses of Maraviroc for these people with Delta 32 deletion
• Children: Kawasaki Disease, Rantes high
• Drugs should be safe with children, high dose of steroids could be bad for children
• Gut has 98% of immune cells
• Dormant/reactivity – indicative of reactivation because dominance of type 1 cytokines
• Reactivated Epstein Barr Virus (EBV) often comes along with elevated B Cells
• EBV goes with swollen spleen, lymphs, and exhaustion
• Some Long Haulers have herpes virus(es) reactivate
• Maraviroc is neurotropic, it crosses the blood brain barrier (BBB) thus that and Leronlimab both get to the brain
• It’s possible there are COVID viral reservoirs
• Had trouble finding HIV in testing at first as well
• Hepatitis C, HIV – Look at CD14, CD18 and it likes to hide in macrophages
• Eventually with Covid we should be able to tolerate antigens, remove remaining particles and virus, and Dr. Patterson thinks the virus might not be replicating in LHers
• HIV has tremendous mutation rate, Covid doesn’t
• COVID may not mutate as much as HIV because there aren’t antivirals for it and/or it doesn’t need to because it’s a novel virus to peoples’ immune systems
• COVID tests are less than perfect (may have to repeat to get a proper result, and even then)
• Could be that 30%+ do not build antibodies to COVID
• Long Haulers have been complaining Quest and Labcorp cytokine panels are not equivalent to IncellDx panel
• There are reasons for this, but what you want to do is use the same lab as previously and ideally IncellDx’s as it has higher sensitivity and the sample isn’t traveling from lab to lab
• COVID Long Haul symptoms indicative of immunological abnormalities
• Dr. Patterson will have 2-3 partner labs up and running soon to analyze cytokines and chemokines (1 lab also operates in Europe)
• Dr. Gaylis wants to do testing as well (leader of Leronlimab trial)
• Dr. Patterson prefers precise medicine approach
• VEGF high, Vasculitis
• Believes hyper inflammation is causing false positive auto immunity and is causing auto reactive antibodies
• With real auto immunity he would be concerned with using CCR5 antagonists and steroids
• Does not believe steroid dose packs are very helpful, prefers 5-10mg of steroids consistently for 2+ weeks
• The blood panel might help other people with post infectious issues in the future
• Doesn’t particularly like immune modulators for autoimmunity
• Dysautonomia markers seem to be positive maybe 30% of the time for people with Covid, hyper inflammation may be causing a false positive
• App is on the way (in 2-3 months) to track your vitals and to get real time information on someone with Long Haul COVID (BP, VHR, etc.)
• Has data to show that disability insurance is needed for those with Long Haul COVID
• Has data to show how people are improving with his treatments (retesting blood)
• There’s no magic pill – likes using combinations – steroids, Ivermectin or Maraviroc and steroids, etc. (now Statins too)
• Has a favorable opinion of TA1 (peptide)
• Believes toolbox of therapies will grow in time
• Dr. Parikh can see patients in NJ or NY
• Dr. Yo and Dr. P have interest in Fluvoxamine
• Low Dose Naltrexone (LDN), anti histamines, and Niacin all can somewhat help LHers
• Dosing tricky with Ivermectin horse paste — Dr. Yo urging people to be careful getting Ivermectin and other drugs through unconventional means
• They can help with finding you doctors to prescribe helpful medication (check their website)
• 30 patients have taken Maraviroc and none of them have had liver issues thus far (Maraviroc has a black label warning)
• Didn’t believe stem cells were warranted based on abnormalities
• Has a favorable opinion of IVIG – IVIG can help with autoimmunity and respiratory
• Dr. Yo was warning about over testing and spending too much money on that
• Maraviroc is 2 pills a day
• Cytokines can go all over, even places where not needed
• Chest pain often Pericarditis
• TNF-a (depression) and VEGF (burning, brain fog, and neuropathy)
• IL-6, TNF-a, and VEGF should all go down with Maraviroc and Leronlimab
• Without high Rantes would not prescribe Maraviroc or Leronlimab
• CD40 elevated in up to 50% of Long Haulers, micro emboli may exist
• 85-90% of patients see response in some combination of Ivermectin, Steroids, and Maraviroc
• Doesn’t expect this to be a lifelong issue that you have to take drugs for
• Sometimes they see people improved with the above combination of drugs and stay there or they come off of them and revert
• Lab retests will tell how long the drug course duration will be
• Fairly convinced COVID can be persistent
• Publications can be found on website under resources
• Long Haulers who get 2nd vaccine shot seem to generally feel bad after it
• Believes 25% of LHers with Delta 32 deletion being reinfected wouldn’t have Covid as severely
• Leans towards Long Haulers not getting vaccine (nervous about adding fuel to the fire, being cautious)
• If you do get the vaccine, be prepared for potentially having a major reaction