Long COVID leaves blood markers that can be targeted for treatment

Long COVID, a condition that affects millions of people worldwide, has been a puzzling and debilitating aftermath of SARS-CoV-2 infection. Patients with long COVID experience a wide range of symptoms that persist long after the initial infection has resolved.

Now, a game-changing study highlights the potential causes of this condition and opened up new avenues for treatment.

Distinct patterns of inflammation detected

The study, published in the journal Nature Immunology, was led by researchers from Imperial College London and involved collaborators from the Universities of Leicester, Edinburgh, and Liverpool.

The research team analyzed blood samples from over 650 people who had been hospitalized with severe COVID-19 and found that patients with prolonged symptoms showed evidence of ongoing inflammation and immune system activation.

Professor Peter Openshaw, from Imperial’s National Heart & Lung Institute and an ISARIC-4C lead investigator, emphasized the urgency of understanding long COVID.

“With one in ten SARS-CoV-2 infections leading to long COVID and an estimated 65 million people around the world suffering from ongoing symptoms, we urgently need more research to understand this condition. At the moment, it’s very hard to diagnose and treat,” Openshaw explained.

Key players in Long COVID symptoms and treatment

The researchers compared 426 people experiencing long COVID symptoms with 233 people who had fully recovered from COVID-19 hospitalization.

They measured 368 proteins involved in inflammation and immune system modulation and found that long COVID patients showed a pattern of immune system activation indicating inflammation of myeloid cells and activation of the complement system.

Dr Felicity Liew, from Imperial’s National Heart & Lung Institute, explained the significance. “Our findings indicate that complement activation and myeloid inflammation could be a common feature of long COVID after hospitalization, regardless of symptom type,” she explained.

“It is unusual to find evidence of ongoing complement activation several months after acute infection has resolved, suggesting that long COVID symptoms are a result of active inflammation,” Dr. Liew continued.

Five subtypes of Long COVID identified for treatment

The researchers also obtained comprehensive information about the range of symptoms experienced by long COVID patients and identified five overlapping subtypes with different immune signatures:

• fatigue
• cognitive impairment
• anxiety and depression
• cardiorespiratory
• gastrointestinal.

These subtypes suggest that different symptoms may have different underlying causes, which could be useful in designing clinical trials and targeted treatments.

Professor Openshaw concluded by saying, “This work provides strong evidence that long COVID is caused by post-viral inflammation but shows layers of complexity. We hope that our work opens the way to the development of specific tests and treatments for the various types of long COVID and believe that a ‘one size fits all’ approach to treatment may not work.”

Potential Long COVID treatments and future directions

The study’s findings suggest that existing drugs that modulate the body’s immune system, such as IL-1 antagonists and JAK inhibitors, could be helpful in treating long COVID and should be investigated in future clinical trials.

However, the researchers stress that more research is needed to understand the mechanisms behind long COVID in patients who experienced mild initial SARS-CoV-2 infection and were not hospitalized.

Hope and relief to tens of millions of people worldwide

In summary, the study led by Imperial College London has taken a significant step towards unraveling the mysteries of long COVID by identifying distinct patterns of inflammation and immune system activation in patients with persistent symptoms.

Their findings suggest that existing drugs targeting the immune system could potentially treat long COVID and should be investigated in future clinical trials.

While more research is needed to understand the mechanisms behind long COVID in patients with mild initial infections, this study offers hope and paves the way for the development of targeted treatments and personalized medicine approaches.

As the world continues to grapple with the far-reaching effects of COVID-19, understanding and addressing long COVID remains a critical priority in offering relief to the millions of people suffering from ongoing symptoms worldwide.

More about long COVID causes and treatments

As discussed above, Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist for weeks or months after the initial COVID-19 infection.

This condition affects a significant proportion of individuals who have recovered from COVID-19, regardless of the severity of their initial illness.

Symptoms of Long COVID

Long COVID presents a wide array of symptoms, which can vary from person to person. Some of the most common symptoms include:

• Fatigue
• Shortness of breath or difficulty breathing
• Cognitive issues, such as “brain fog,” memory problems, and difficulty concentrating
• Headaches
• Joint and muscle pain
• Chest pain or palpitations
• Gastrointestinal issues, such as diarrhea and stomach pain
• Skin rashes
• Mental health problems, such as anxiety and depression

Risk factors and prevalence

Studies suggest that up to 30% of individuals who have had COVID-19 may experience long COVID. While the condition can affect people of all ages and health statuses, some factors may increase the risk of developing long COVID, such as:

• Older age
• Pre-existing health conditions, such as obesity, diabetes, or hypertension
• Severe initial COVID-19 illness
• Being female

Long COVID diagnosis and treatment

Diagnosing long COVID can be challenging, as many of its symptoms overlap with other conditions. Healthcare providers typically rely on a combination of the patient’s history, physical examination, and various tests to rule out other potential causes and identify the specific symptoms associated with long COVID.

Currently, there is no specific treatment for long COVID. However, as discussed above, the new study from Imperial College hopes to change that very soon.

Management focuses on addressing individual symptoms and supporting overall health and well-being. This may include:

• Pain management
• Breathing exercises and pulmonary rehabilitation
• Cognitive rehabilitation and mental health support
• Gradual return to physical activity
• Lifestyle modifications, such as stress reduction and healthy eating

Ongoing research and support

As the understanding of long COVID continues to evolve, researchers are working to uncover the underlying mechanisms of the condition and develop targeted treatments.

Many healthcare systems and organizations have established dedicated long COVID clinics to provide specialized care and support for individuals experiencing persistent symptoms.

If you or someone you know is experiencing symptoms of long COVID, it is essential to seek medical attention and support. With ongoing research and the development of targeted interventions, there is hope for better management and improved outcomes for those affected by this challenging condition.

The full study was published in the journal Nature Immunology.

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