The Pandemic`s Unresolved Infectious Psycho-Neuro-Immunologies: Myeloid Cells, Vessels, Nasal Cross-Roads

Unresolved infectious psycho-neuro-endocrino-inflammation (PNEI) denotes an area of tragically accelerated interest because of SARS-CoV-2`s capacity to meddle with the immune responses in a stage-wise fashion. Its pandemic, interacting with antecedent further deteriorating health and living conditions, takes a direct toll of million human lives. In order to withstand the plethora of slowly or never easing ailments labeled "Post-acute Sequelae of Covid-19 (PASC)" a comprehensive understanding from the intrusions up to its emerging aftermaths is paramount. For the strained health professions these prospect care requirements of 1 in 5 for a non-convalescence overlapping also with other tedious long-hauling "triggered" disorders adjacent to psychiatry like chronic fatigue with orthostasis intolerance or intracranial hypertension (ME/CFS-OI; IIH). For the lattter two new pathophysiologies are proposed in order to inform a strong rehabilitative psychiatric liaison not referring sufferers to a psychiatric "enigmo-somatic bin", but to an invigorated somato-psychic care e. g. for exertional malaise. Starting from early stimulation of escalating myeloid-derived suppressor cells the neglected mast cells show up (for now without their lymphatic partners) as ambivalent core participants. They interact or orchestrate or sequentially explode in etosis guarding or breaking sane barriers especially at cerebral arteries. In Covid-19 they seem unleashed at the blood-brain-barrier by the early virally invaded nasal ganglia, which plausibly mis-direct the quickest interstitial arterio-intramural outflow - thus a.) losing its ability to "comply" with pulsatile flow through varying the width of its sliding chambers causing ME/CFS-Orthostatic Intolerance and b.) inflaming and stiffening the brain's interstitium through a "push-back" outpacing the confuted inventive "glymphatic-1.0" model. Mast cells - colonized or not - plausibly permeabilize the choroid plexus and venous or bony brain barriers co-causing the not so rare Idiopathic Intracranial Hypertension. Innate memory - as activated by short RNAs through BCG-vaccinations directed against the permanent TBC-pandemic leads to hopes for a hastening of resolutions through a combined medical, exertional, psychosocial, and psychiatric rehabilitation informed by a new "PNEI" - paving the way for amplified-BCG or future psychiatric vaccinations.