After catching Covid-19, some people lose genetic material from the virus in their stools for a long time. There is mounting evidence to support the idea that pockets of coronaviruses are contributing to long Covid.
Prof David R Walt and colleagues at Harvard Medical School announced earlier this month that they had detected a viral spike in the blood of 65% of the long Covid patients they tested.
The study provides some of the most compelling evidence to date for the idea that the virus can cause long-term health problems. The half-life of spikeprotein in the body is very short, so it indicates that there must be some kind of active viral reservoir.
The blood of Covid patients who didn't have ongoing symptoms didn't show SpikeProtein.
After detecting genetic material from the Covid virus in stool samples from children with multisystem inflammatory syndrome, Walt was motivated to carry out the study. They were treated with a drug that reduced the permeability of the GI tract. Walt thinks that people with long Covid may be experiencing the same thing.
Dr Amy Proal, a microbiologist at the Polybio Research Foundation, a US, said that if other groups could replicate Walt's findings, it would be " pretty much game over" for the idea that pockets of the virus were not still present in some long Covid patients
The virus continues to be present in patients who have recovered from Covid, according to other groups. Almost 4% of individuals continued to excrete viral RNA in their stools for at least seven months after catching Covid, according to a report by Ami Bhatt and colleagues. The people reported nausea, vomiting and abdominal pain.
There is a question as to whether or not the presence of the virus in the gut may cause the immune system to attack.
A separate research which analysed gut tissue from 46 people with inflammatory bowel disease who had recovered from mild Covid found that 70% of them could still be found seven months after. More than two-thirds of these individuals reported continuing symptoms, such as fatigue or memory issues.
Viruses can be recovered from other parts of the body, including the eyes, brain and heart.
The virus hides out in anatomical sanctuaries such as the eyeball or testicles that are less accessible to the immune system, and which are thought to contribute to ongoing symptoms such as joint and muscle pain.
There is still no conclusive proof that viral reservoirs contribute to long Covid.
Some of these are happening now. The Recover study is looking for signs of coronaviruses in stool samples from people with long Covid. These types of studies will be important for figuring out what the relationship is between long-term viral reservoirs and long Covid.
If viral persistence is driving a subset of people's symptoms, it could lead to an investigation into the use of antiviral drugs as a treatment for Covid. This may seem like a no-brainer, but some people are concerned about the consequences.
According to Dr Deepti Gurdasani, the idea of giving people long-term antiviral monotherapy to try and clear the virus is a pretty contentious issue. We can't afford to create more escape Mutants at this point in time so we need to trial dual or triple therapies.
Studies of tissue samples and trials of antivirals for people who have been with Covid for at least two years can be done quickly.
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