Summary Individuals with SARS-CoV-2 infection can develop symptoms that persist well beyond the acute phase of COVID-19 or emerge after the acute phase, lasting for weeks or months after the initial acute illness. The post-acute sequelae of COVID-19, which include physical, cognitive, and mental health impairments, are known collectively as long COVID or post-COVID-19 condition. The substantial burden of this multisystem condition is felt at individual, health-care system, and socioeconomic levels, on an unprecedented scale. Survivors of COVID-19-related critical illness are at risk of the well known sequelae of acute respiratory distress syndrome, sepsis, and chronic critical illness, and these multidimensional morbidities might be difficult to differentiate from the specific effects of SARS-CoV-2 and COVID-19. We provide an overview of the manifestations of post-COVID-19 condition after critical illness in adults. We explore the effects on various organ systems, describe potential pathophysiological mechanisms, and consider the challenges of providing clinical care and support for survivors of critical illness with multisystem manifestations. Research is needed to reduce the incidence of post-acute sequelae of COVID-19-related critical illness and to optimise therapeutic and rehabilitative care and support for patients. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(23)00239-4/fulltext Clinical Approach to Post-acute Sequelae After COVID-19 Infection and Vaccination The spike protein of SARS-CoV-2 has been found to exhibit pathogenic characteristics and be a possible cause of post-acute sequelae after SARS-CoV-2 infection or COVID-19 vaccination. COVID-19 vaccines utilize a modified, stabilized prefusion spike protein that may share similar toxic effects with its viral counterpart. The aim of this study is to investigate possible mechanisms of harm to biological systems from SARS-CoV-2 spike protein and vaccine-encoded spike protein and to propose possible mitigation strategies. We searched PubMed, Google Scholar, and 'grey literature' to find studies that (1) investigated the effects of the spike protein on biological systems, (2) helped differentiate between viral and vaccine-generated spike proteins, and (3) identified possible spike protein detoxification protocols and compounds that had signals of benefit and acceptable safety profiles. We found abundant evidence that SARS-CoV-2 spike protein may cause damage in the cardiovascular, hematological, neurological, respiratory, gastrointestinal, and immunological systems. Viral and vaccine-encoded spike proteins have been shown to play a direct role in cardiovascular and thrombotic injuries from both SARS-CoV-2 and vaccination. Detection of spike protein for at least 6-15 months after vaccination and infection in those with post-acute sequelae indicates spike protein as a possible primary contributing factor to long COVID. We rationalized that these findings give support to the potential benefit of spike protein detoxification protocols in those with long-term post-infection and/or vaccine-induced complications. We propose a base spike detoxification protocol, composed of oral nattokinase, bromelain, and curcumin. This approach holds immense promise as a base of clinical care, upon which additional therapeutic agents are applied with the goal of aiding in the resolution of post-acute sequelae after SARS-CoV-2 infection and COVID-19 vaccination. Large-scale, prospective, randomized, double-blind, placebo-controlled trials are warranted in order to determine the relative risks and benefits of the base spike detoxification protocol. Keywords: covid-19 treatment; covid-19 vaccines; long covid; medicine; post-acute sequelae; sars-cov-2; sars-cov-2 spike protein; spike glycoprotein; spike protein detoxification; treatment protocol. https://pubmed.ncbi.nlm.nih.gov/38024037/ Clinical Approach to Post-acute Sequelae After COVID-19 Infection and Vaccination Critical Appraisal of Multi-Drug Therapy in the Ambulatory Management of Patients with COVID-19 and Hypoxemia Analysis Suggests Many Hospitalizations with Use of Mechanical Ventilation Unnecessary. PETER MCCULLOUGH, MD https://open.substack.com/pub/petermcculloughmd/p/critical-appraisal-of-multi-drug?r=djekz&utm_campaign=post&utm_medium=web Couragious Discourse SubstackPrize in Medicine 2015.Researching our book--The Courage to Face COVID-19: Preventing Hospitalization and Death While Battling the Bio-Pharmaceutical Complex—was often a distressing and maddening experience. The systematic lying about hydroxychloroquine to suppress its use in the outpatient setting was infuriating. However, for me, the most upsetting stories were about people who died in hospital after being systematically denied ivermectin. The sheer brutality of hospital chiefs and their attorneys, who fought tooth and nail against the administration of ivermectin to dying patients, must surely be the most morally repugnant story in modern medical history. As we document in our book, Drs. Pierre Kory, Paul Marik, and Tess Lawrie were on the front line of fighting for ivermectin in the hospital setting. Drs. Jean-Jacques and Juliana Cepelowicz Rajter published their seminal (ICON) study in the October 12, 2020 edition of the CHEST journal of pulmonary medicine. The investigative journalists, Michael Capuzzo and Mary Beth Pfeiffer, did a splendid job of covering this story in real time. All of the above are heroic figures of great intellectual and moral discernment to whom we should all be grateful. Many patients who were fortunate enough to prevail in court and receive ivermectin enjoyed an astonishing improvement of their condition within 24 hours of receiving their first dose—a recovery that struck family members as miraculous. In listening to their stories, I often asked myself: “How on earth could this substance (macrocyclic lactone)—derived from a bacteria (Streptomyces avermectinius) found in a soil sample on a golf course in Japan—possibly work such miracles?” Truly these testimonies struck me as the most wondrous stories I’d ever heard, and I occasionally asked myself if the recoveries observed were a fluke or the result of some other unknown factors. To be sure, we already knew from in vitro and from prior studies that ivermectin had demonstrated potent anti-viral activity, but the precise cause of action was unknown. Now, thanks to a study recently published by a research team at MEPHI, Aix-Marseille Université, we have a highly plausible description of ivermectin’s mechanism of action against the SARS-CoV-2 spike protein. In order to understand this mechanism, the reader must first understand that the SARS-CoV-2 Spike Protein Induces Hemagglutination—i.e., a reaction that causes clumping of red blood cells. A glycoprotein on the viral surface, namely hemagglutinin, interacts with red blood cells, leading to the clumping of red blood cells and the formation of a lattice. As the Aix-Marseille team documents in their study: IVERMECTIN blocked HEMAGGLUTINATION when added to RED BLOOD CELLS prior to spike protein and reversed HEMAGGLUTINATION when added afterward. By reversing the clumping of red blood cells, ivermectin enabled the dying patient’s proper respiratory function to return, thereby generating his or her astonishing recovery. If the Aix-Marsaille team’s findings are correct—and we have no reason to doubt that they are—they provide the final validation and vindication of the dying patients and their families who literally begged for the wonder drug. SHAME on the hospital administrators and their thuggish attorneys who denied the countless dying wishes. SHAME on the federal health officials who propagated the LIE that Ivermectin was merely a “horse de-wormer.” SHAME on the useful idiot media pundits such as CNN broadcasters and Late-Night Comedy hosts who flooded the zone with this foul lie. Source: https://open.substack.com/pub/petermcculloughmd/p/ivermectins-mechanism-of-action-against?r=djekz&utm_campaign=post&utm_medium=web VIEW FULL ARTICLE WITH VIDEOS:
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