What about this study, then, that's suggesting there may be some benefit to taking things like antihistamines and an anti-inflammatory drug called colchicine?

So we were all waiting with great excitement for the, the study you're talking about because we were all complaining that there was a lack of at-scale randomized control trials that would take some of these rumored treatments that with people kind of trying DIY style anyway and actually look at them in a rational, evidence-based way.

And really heroic study by really good people doing everything you could possibly ask.

And I think it's probably fair to say that most people, including the investigators themselves, would say that it's been a little bit disappointing and that the drugs that they chose were the ones that when the protocol was drafted in twenty twenty-two were anybody's best guess of the licensed candidate drugs that people believed would make people long COVID better.

So there was colchicine, essentially a sort of anti-gout, anti-inflammatory, that was being used by lots of respiratory physicians seeing long COVID patients.

There were the antihistamines because there'd been a lot of thought and, and evidence abo- about disturbed pathways that looked allergic-like.

And then the, the anticoagulants because a lot of people thought it was a kind of disease of coagulation, a kind of coagulopathy.

But in terms of that culminating in something that actually makes a difference to one of those people that you described, that third of people that get long COVID, that get stuck in this horrific condition, that it's devastating their lives, and we still don't have much to say or to offer to that person.

Across

the two conditions, about 1,000 people get recruited.

And as you'd expect for an immunologist, the biggie is that they give us a blood sample.

and we analyze immune system cells, white blood cells.

They also get asked if they're prepared to give us a stool sample, a poo sample, and they also give us a mouth swab.

So the kind of things we do with that is to kind of interrogate the key hypotheses about possible shared pathways.

So if we start with the poo sample, there's an idea out there that one of the things that happens in these post-viral conditions is that there's disturbance of the gut microbiota and that you shift bacterial species and shift over to ones that are making their own kind of mediators, their own kind of short-chain fatty acids, and that they affect regulation of the immune system.

With long COVID, have we found ways of finding in the body a signal of the condition?