Microbial and Cytokine Signatures in Long COVID Patients

Prior treatment

• Alcohol or another drug abuse ongoing within one year

Other illness

• Bipolar disorder, schizophrenia, or other psychosis
• History of malignancy, except basal cell carcinoma
• History of significant autoimmune disorder:
  • Addison disease
  • Dermatomyositis
  • Graves' disease
  • Multiple sclerosis
  • Myasthenia gravis
  • Pernicious anemia
  • Rheumatoid arthritis
  • Sjögren syndrome
  • Systemic lupus erythematosus
  • Type I diabetes
  • Celiac disease
• Active pulmonary infection (active pneumonia)
• Chronic kidney disease
• Chronic liver disease
• Chronic lung disease
• Interstitial pneumonitis
• Chronic obstructive pulmonary disease (COPD)
• Immunocompromised conditions or weaken immune system:
  • Cancer under treatment or treated within one year of enrollment
  • AIDS
  • Transplant patient
• Neurologic conditions:
  • Dementia or other neurological conditions
  • Acute Spinal Cord Injury
  • Alzheimer's Disease
  • Amyotrophic Lateral Sclerosis (ALS)
  • Ataxia
  • Cerebral Aneurysm diagnosed within one year of enrollment
  • Epilepsy and Seizures uncontrolled with medication
• Heart conditions:
  • Congestive heart failure
  • Myocardial infarction

Other

• Pregnant or nursing woman
• Severe depression or acute suicidal ideation
• Pulmonary fibrosis
• Uncontrolled asthma
• Reactive arthritis
• Biologicals impacting the immune system
• Taking immunosuppressor

• ≥ 18-year-old
• English speaking (per Sutter medical records information)
• Ability and willingness to provide signed Consent Form
• Ability to comply with the study protocol
• Ability to attend the study visit, complete questionnaires, have blood collected and tested And, either Long-COVID or Healthy control as described below
• Long-COVID patient Cohort (n=75)
  • Sutter patient who is a patient from Sutter Health Holistic/Integrative Medicine clinic
  • Documentation of a long-COVID diagnosis (U09.9) for patient's initial visit in clinic between 01/01/2021 and 06/30/2024.
  • Presence of active and ongoing long-COVID symptoms
  • Ongoing long-COVID symptoms consistently present over the previous 6 months or longer
  • Presence of the following long-COVID symptoms (a, b, and c plus either d or e) affecting you more than 50% of your life:
  • Fatigue that does not go away with rest.
  • Post-exertional malaise ((worsening of your symptoms following cognitive, emotional, physical efforts)
  • Unrefreshing sleep (sleep is not restorative)
  • Brain "fog" (e.g., difficulty with finding words or mental tasks)
  • Postural Orthostatic Hypotension (e.g., lightheadedness, dizziness, and/or palpitations with sitting up or standing up positions).
• Healthy controls with no Long COVID syndrome (n=75)
  • Sutter Health patients
  • Matched by age to a long COVID subject (+/-10 years and preferably by sex).