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COVID & Health News, 11/23/25
"Flu and RSV test positivity is starting to increase, signaling the start of a wave. Remember to get your Flu shot if you haven’t already because this year is expected to be a bad flu season. The Flu vaccine does not exactly match the subclade K that is circulating, but it should still offer some protection against serious illness, especially in children.
"RSV tends to affect babies and young children, as well as older adults. Check with your provider to see if you should get an RSV vaccine. RSV vaccination is recommended in pregnancy during the RSV season.
"Regional wastewater levels for COVID, RSV, Flu A, Flu B:
From: https://data.wastewaterscan.org/
"COVID levels in wastewater are very low now, but are just starting to increase in some places. Typically, we see an increase in respiratory illnesses after Thanksgiving because of travel and indoor gatherings. JP Weiland estimates that there are 150,000 new COVID cases per day in America and that every 1 in 220 people is currently infected with COVID. These are low levels.
"COVID levels in Europe and the UK are mostly low at this time, although Flu is increasing.
"The CDC’s website for COVID variants has not been updated since 8/28/25, but XFG continues to be the dominant COVID variant in America and globally.
"The BA.3.2 variant continues to pop up slowly around the globe and now represents about 10% of COVID cases in Germany. It would need to gain a few mutations in order for it to cause a significant COVID wave, but it is being watched closely.
"University of Alberta researchers studied 445,646 adults and found that those who had taken antibiotics in the three months prior to COVID infection were at least 50% to experience poor outcomes, including emergency room visits, hospitalization, or death, within 30 days of COVID infection. The increased risks persisted even after adjusting for comorbidities, suggesting that the disruption of the gut microbiome caused by recent antibiotic use may negatively impact the body’s immune response to a subsequent COVID infection.
"Stanford researchers found that some people develop weaker, narrower antibody responses to SARS-CoV-2 because their natural killer (NK) cells become overly activated by interferon during infection. These activated NK cells can kill T-follicular helper (T_FH) cells which are immune cells essential for generating broad, durable antibody responses. In the study, people with the strongest neutralizing antibody breadth had fewer interferon-activated NK cells, while “narrow neutralizers” showed highly activated, interferon-stimulated NK profiles.
"Researchers in Sweden analyzed 4.1 million adults and found that COVID infection increased long-term cardiovascular risk even after mild illness, with pulmonary embolism showing the strongest elevation. Some cardiovascular risks persisted for at least one year, especially among older adults and people with lower income. Vaccination reduced several of these risks, underscoring its protective value beyond preventing acute infection.
"The 3rd Long COVID International Conference 2025 took place in Boston this week. Abstracts are not available yet, but Jon Douglas tweeted the conference talks in a mega thread here.
"Recently, NIAID and the Foundation for the National Institutes of Health (FNIH) co-hosted the second annual RECOVER-TLC workshop. NIH researchers reported on upcoming clinical trials of four treatments for Long COVID:
Low-Dose Naltrexone (LDN) in children with Long COVID,
Baricitinib for persistent neurological and cardiopulmonary symptoms of Long COVID,
GLP-1 agonists for fatigue, brain fog, pain and mast cell activation syndrome
Stellate Ganglion Block to reduce pain, brain fog and fatigue.
"The authors emphasize the need for rigorous, biomarker-driven trials to match treatments to patient subgroups.
"Researchers in China injected the SARS-CoV-2 spike protein RBD into the medial prefrontal cortex of mice, triggering depressive-like behaviors by lowering astrocyte Connexin 43 (Cx43) and disrupting gap-junction communication. Treating the mice with Celecoxib or restoring Cx43 levels reversed these effects, pointing to a potential therapeutic target for depression linked to Long COVID.
"In a study from Trinity College Dublin, Ireland, 27 patients with Long COVID and 27 fully-recovered COVID controls were assessed via a digital symptom platform and immune profiling of lymphocyte and monocyte mitochondrial function plus cytokine responses. Researchers found that poorer mitochondrial membrane potential in CD4+ T cells and CD56^bright NK cells correlated with worse breathlessness and dizziness respectively, and that blunted IFN-γ, IFN-β and IL-10 responses after immune stimulation related to specific Long COVID symptom burdens. These findings point to immune-cell metabolic dysfunction as a possible biomarker and mechanistic target for Long COVID subgroups.
"Researchers at the University of Bergen, Norway used a global pooled prevalence of 36% for Long COVID (from 144 studies) and estimated an annual global economic impact approaching US $1 trillion (1 % of global GDP). They also estimated that in the U.S., average per-patient annual costs could be around US $9,000, with nationwide lost earnings reaching approximately US $170 billion annually. The study highlights that the burden spans macroeconomic (GDP/labour supply), cost-of-illness (direct & indirect costs), and microeconomic (wage loss, healthcare spending, financial distress) levels and underscores the urgency for policy and workforce support.
"Using machine learning to evaluate patient symptom questionnaires from four different cohorts (LIINC from UCSF, Icahn School of Medicine at Mount Sinai, Emory and Cardiff), researchers from JCVI and PolyBio identified ten global endotypes and a unified severity map for Long COVID. The study found a severe cluster characterized by neurological and hormonal dysfunction that was overwhelmingly female-predominant. This algorithm could be used to help stratify Long COVID patients for more targeted treatment trials.
"The first person ever to contract H5N5 Bird Flu has died in Washington State. The deceased was an older adult who owned a backyard flock of mixed domestic birds. Officials say that the risk to the general public is low, but the situation is being monitored closely.
"As of November 18, 2025, a total of 1,753 confirmed measles cases were reported in the United States, 12% of cases hospitalized (211 of 1753), and 3 confirmed deaths from measles.
"On November 19, Robert Kennedy Jr., a man who is not a doctor or a scientist, personally forced the CDC to post scientifically false information about vaccines and autism on the CDC website. “This was political actors overriding science in a place where accuracy, integrity, credibility, transparency, and honesty literally saves lives,” said Katelyn Jetelina. With misinformation being posted on one CDC site, scientists are saying that the CDC is no longer trustworthy on any subject.
"The American Academy of Pediatrics’ response:
"A new study in Science shows that a gut bacteria (Aeromonas variant MTB) makes a toxin called aerolysin that kills gut macrophages and increases inflammation to promote Ulcerative Colitis. Anti-aerolysin antibodies given to mice stopped the inflammation and colitis.
From: https://www.science.org/doi/10.1126/science.adz4712
"A new study shows that treatment with a low-dose GLP-1 receptor agonist induces molecular rejuvenation in aged mice, reversing aging RNA and methylation signatures across multiple organs with efficacy comparable to rapamycin. These anti-aging benefits were independent of weight loss and were driven by activation of GLP-1 receptors in the hypothalamus.
From: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(25)00474-7
"This week, the Lancet put out several papers on the health dangers of ultra-processed foods.
"A field study in Milan of 138 metro rides found that when a person dressed as Batman was on the train, 67% of passengers offered their seat to a pregnant woman vs 38% without. About 44% of those who offered their seat said that they did not notice Batman at all, suggesting that the Batman effect works subconsciously.
From: https://www.nature.com/articles/s44184-025-00171-5
"I hope that you have a wonderful Thanksgiving holiday. I will be taking next week off from the newsletter.
"Ruth Ann Crystal MD"
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