Can medicines reduce the risk of long COVID?What scientists have ever known

In the early days of the COVID-19 pandemic, urologist and clinical epidemiologist Kari Tikkinen noticed that his schedule was full of canceled surgery, so he had time to kill. “Do whatever you find most useful,” his boss at the University of Helsinki advised him. So Tikkinen devoted himself to conducting clinical trials of COVID-19 therapy.

From the beginning, Tikkinen believed that research participants would need to be followed for several months after recovery before the world learned of the long COVID. He wanted to monitor the long-term side effects of the drug. “It was immediately apparent. It’s not just about safety,” he says.

Currently, Tikkinen and a few other people want to know more about whether treatment given during the acute phase of COVID-19 can reduce the risk of experiencing symptoms after a few months. “People need to start focusing on urgent and urgent health needs,” says Charlotte Summers, an intensive care specialist at the University of Cambridge, UK.

Debilitating symptoms

Long COVID survey Also known as the acute sequelae of COVID-19, it is defined as a sign of COVID-19 that usually lasts more than 3 months, but lags behind the study of the acute phase of infection. People who experience long-term COVID live with a variety of symptoms, from mild to severe weakness. Researchers have suggested a variety of causes for this condition, from prolonged viral retention to autoimmunity to small blood clots. Many believe that the combination of these factors is the cause. Danny Altmann, an immunoscientist at Imperial College London, said: “It’s difficult to stitch the whole picture together.”

So far, vaccines are the best way to prevent long COVIDs. The COVID-19 vaccine may reduce the risk of SARS-CoV-2 infection and the risk of long-term COVID after breakthrough infection in vaccinated individuals.

Some studies I’ve watched it In this question: They gave different results, but the overall trend suggests that vaccination can reduce the risk of long COVID among people infected after vaccination by about half.For example, a study¹ Although not yet peer-reviewed, vaccination was found to reduce the likelihood of developing long-term COVID symptoms in more than 3,000 double-vaccinated participants who were later infected with SARS-CoV-2 by approximately 41%. ..

However, Altmann says that many people are still at risk of lengthening their COVID. “Half isn’t as good as I expected,” he says. “I was hoping that the long COVID would be a thing of the past.”

Early treatment

Other than vaccination, it is unclear whether existing COVID-19 therapies affect long-term COVID risk. In theory, drugs that reduce the severity of the disease may reduce the severity of long-term symptoms, Altman says. However, long COVIDs are not always associated with serious acute illness. “Many people have asymptomatic or nearly asymptomatic infections that have been actually destroyed by long COVIDs,” he says. “It’s really hard to work on.”

Nonetheless, some studies plan to investigate the effects of early treatment with antivirals on long-term COVID. A clinical trial called PANORAMIC is testing the effect of the oral antiviral drug molnupiravir on COVID-19 severity, developed by Merck in Kenilworth, NJ and Ridgeback Biotherapeutics in Miami, Florida. Although not the main goal of the study, researchers collect data from participants 3 and 6 months after treatment. This allows you to determine if a drug affects long-term COVID risk. Similarly, two trials of Paxlovid, an antiviral drug developed by Pfizer in New York City, will include a six-month follow-up of participants.

These antivirals are usually used to treat people with relatively mild COVID symptoms. Tikkinen and his colleagues want to know more about the long-term effects of treatment on people hospitalized with COVID-19. His team is following up participants in the International Division of the World Health Organization at the University of Helsinki. COVID-19 treatment trial called SOLIDARITY.. In the coming weeks, he hopes to get the results of a one-year follow-up of participants who were hospitalized with COVID-19 and treated with the antiviral drug remdesivir.

His team will also follow up on participants in the other two arms of the SOLIDARITY exam. One tested an immunosuppressive drug called infliximab, and the other tested imatinib, which may help reduce inflammation of blood vessels.

But Tikkinen warns. None of these studies had enough participants to give a clear answer about the long COVID. His team took special steps to contact participants months after remdesivir treatment and encourage them to fill out a symptom investigation. The team suggested hiring a graphic designer to help fill out the survey, have the questions translated into 10 languages, and hand the paperwork to the participants’ homes. As a result, a response rate of 95% was obtained. This is unusually high in such long-term studies, according to Tikkinen. However, the original survey included only about 350 people, so it may still be too small to draw definitive conclusions.

Small test

Researchers want to see if more treatments can reduce the risk of long-term COVID. A large UK-based study called HEAL-COVID is testing two drugs that target the cardiovascular system in people hospitalized with COVID-19. What is called apixaban is an anticoagulant. Another atorvastatin is a cholesterol-lowering drug that is thought to reduce inflammation of blood vessels.

This study investigates whether both treatments reduce hospitalization and mortality the year after people are first discharged. Almost one-third of people discharged after COVID-19 treatment are readmitted within 6 months, and 12% die within 6 months of their first discharge. “And when we looked at what was most likely to be fatal after hospitalization, it was probably a cardiopulmonary effect,” says Summers, who leads the study.

At the University of Chicago, Illinois, pulmonologist and critical care physician Ayodigi Adegunsoe was admitted to COVID-19, where the accumulation of scar tissue called fibrosis in the lungs increased after acute infections in people in need. I observed the possibility. Supplemental oxygen. He is currently testing a drug called sirolimus, an immunosuppressive drug that is sometimes given to organ transplant recipients, in such people, hoping to prevent the migration of cells that promote lung fibrosis.

By its very nature, long-COVID research requires patience. One of the generally accepted definitions of long COVID is that certain symptoms persist for more than 12 weeks after an acute infection. Altmann is optimistic that progress will be made this year, but he is careful not to over-read small exams that may not give statistically meaningful results. “There is such pressure,” he says. “There is this incredibly urgent need — we all feel that anxiety.”