‘Long COVID’ caused by hidden virus reservoirs

Surviving COVID-19 infection is only half the battle. About 20-30% of people infected with COVID-19 develop what is commonly called acute sequelae of her COVID-19 (PASC). “Long COVID.”

Common long-term COVID symptoms include fatigue, brain fog, shortness of breath, coughing, chest pain, heart palpitations, headaches, insomnia, and loss of taste and smell. These and other prolonged COVID symptoms can be debilitating, with an estimated 1 million Americans out of work due to prolonged COVID.

A recent study published in PLOS pathogencompared the frequency of COVID-19-specific T cells and inflammatory markers with lung function in patients with lung PASC or COVID-19 recovery.

Brent Palmer, Ph.D., senior author and associate of the study, said: Professor of Allergy and Clinical Immunology at the University of Colorado School of Medicine.

“Current treatments for prolonged COVID are necessarily focused on addressing specific symptoms rather than the underlying cause of the disease. It has been shown to be a factor and may guide future treatment.”

Palmer and colleagues found that patients suffering from long-term COVID had more than 100-fold higher virus-specific T-cell levels than those who fully recovered. PASC patients had 6- to 105-fold higher frequencies of IFN-γ- and TNF-α-producing SARS-CoV-2-specific CD4+ and CD8+ T cells in peripheral blood.

In long-term COVID patients, higher levels of SARS-CoV-2 T cells correlated with higher levels of inflammation, suggesting that T cells may be responsible for these and other conditions. The researchers concluded that elevated SARS-CoV-2 T-cell frequencies in long-term COVID patients are associated with increased systemic inflammation and decreased lung function.

This study is the first to identify that COVID-19-specific T cells can affect lung function and cause long-lasting COVID. The findings may change treatment recommendations for COVID-19 and may lead to prioritization of vaccines and antivirals to target long-lasting COVID symptoms and eliminate the virus.

“We hope our findings will help shift the focus of treatment to treatments that improve viral clearance,” Dr. Plamer explained. “For example, an antiviral drug like Paxlovid can help people suffering from her long-term COVID to reduce symptoms, rid the system of the virus, and return to a more normal life.”

Palmer and his team have applied for a National Institutes of Health (NIH) grant to continue this long-running COVID study. If approved, they will investigate flushing her T cells from the lungs in a non-invasive procedure, allowing the cells of patients with and without long-term COVID to be compared.

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