New research on the causes of prolonged COVID

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Feb. 7, 2022 — Jamie Cantrell was the picture of health when he contracted COVID-19. The 44-year-old marketing executive from Lewisville, TX had been an athlete her entire life and was training for a half marathon when a headache like no other prompted her to take a test.

Even after a positive COVID-19 test result, Cantrell was able to quarantine in his basement and continue working normally.

A few weeks after recovery, Cantrell returned to running, at which point he began to experience numbness in his foot. Guessing that he might be the wrong pair of in a hurry shoes, bought new ones and moved on. The numbness continued to travel up her leg until finally, she was “head to toe.” neuropathy. cantrell joined the millions from other people with long-distance COVID, which may affect up to 40% of COVID-19 survivors.

Until recently, little research existed that allowed doctors to determine who might develop long-distance COVID. The cases range from those who had experienced severe acute COVID-19 to those like Cantrell, whose initial illness was extremely mild. Now, however, a collaborative study is shedding some light on factors that may contribute to long-distance COVID, also known by the medical term PASC (post-acute sequelae of COVID-19).

The researchers identified four main risk factors for PASC:

  • The presence of particular autoantibodies
  • A high viral load (RNA)
  • Type 2 diabetes
  • Reactivation of the Epstein-Barr virus, which remains dormant in the blood of most people after a childhood infection.

Jim Heath, PhD, president of the Institute for Systems Biology in Seattle, was the study’s principal investigator. He says that some of the nearly 300 patients enrolled had only one factor, while others had two or more overlapping factors.

“We saw an overlap with other PASC factors, but we don’t know if that could herald more serious problems. long covid,” he says.

Some of the risk factors were more predictable than others.

“When we do a study of this size, there will be quite a few with type 2 disease,” says Heath. “We cannot conclude that diabetes itself puts you at higher risk, or if it is the many underlying health conditions that go along with it.”

A high viral load was also not entirely surprising, especially when most of the study participants were early COVID-19 patients, prior to vaccines.

“High viral markers in the blood probably indicate severe illness and that can have a strong effect on a patient’s long-term recovery from illness,” says Heath. “These viral signatures tell us that vaccines, in addition to potentially early intervention with antivirals, could make a difference in PASC.”

A third risk factor, autoantibodies, are essentially the opposite of antibodies, which vaccines provide and help fight the virus. Autoantibodies, however, attack their own proteins rather than foreign pathogens, altering their immune response. While everyone has autoantibodies, those with high levels don’t respond as well to serious illness.

The researchers found that the final risk factor, Epstein-Barr virus (EBV), had a strong link to neurological symptoms typically associated with long-standing COVID.

“My hypothesis here is that most of us have latent VEB in our blood and when you have COVID, the immune system suddenly you’re paying a lot of attention to this new virus,” says Heath. “Then reactivate the EBV.”

This is verified with the Cantrell case of long-distance COVID.

“I’m working with an integrative doctor now and he tested me for a number of things, including EBV, which turned out to be high,” she says. “My early long COVID showed up as small fiber sensory neuropathy, and it went into remission for several months last summer.

In October, however, Cantrell developed a sinus infection and began experiencing nauseavertigo and rapid heart rate. Now has POTS, postural orthostatic tachycardia syndrome, another common illness in long-distance COVID-19 patients.

“I had to redefine for myself what I can and can’t do,” she says. “But together with my doctor, we are digging deeper to find the root causes of my illness.”

where to go from here

While the new study was small, it was a great first step in identifying where the medical community might be heading with long-term COVID treatment in the future.

“For most of the conditions that we have identified as being associated with [long COVID], the treatments exist,” says Heath. “It is amazing to think that soon we will be able to identify who could get [long COVID] at the time of infection. We are learning that it is not just a random occurrence, but that some people have a higher susceptibility.”

The sooner you can detect COVID, says Heath, the sooner the medical community could start a type of treatment, which could prevent a possible prolonged COVID.

“Some of the treatments for these risk factors are very good,” he says, “such as antivirals, which could significantly decrease the burden carried.”

Follow-up studies are needed, but Heath remains optimistic that the mystery of long-distance COVID will be solved. “This was a big step and the willingness of patients to help us unravel this disease was really important,” he says.

For Cantrell, the study, along with her new doctor’s approach to helping her, offers hope for the future.

“For the long-distance community, there is a wide range of suffering,” she says. “It can feel like slow progress, and that’s hard when you’re not feeling well. But we will find an answer; do not lose hope.”

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