A study of people with Long Covid has turned up a number of anomalies in their blood. There is a body of evidence pointing to drivers of the condition. Many scientists and patients think Long Covid shares certain features with myalgic encephalomyelitis/chronic fatigue syndrome.
A small study looking at 99 people with Long Covid was posted last week. Eric Topol is the director of the research institute that was not involved in the work. This is exploratory, but it is the starting point for a lot of bigger studies.
Most of the Long Covid patients had low levels of cortisol, a stress hormone that helps the body control inflammation. The features of their T cells indicated their immune system was fighting invaders.
Other groups studying Long Covid patients have reported similar results this year, including in a January Cell paper that documented low cortisol in those with long-lived respiratory symptoms. The data makes me think about what other drugs we can test to tame the immune system, says Emma Wall at University College London and the Francis Crick Institute.
The Long Covid project began in late 2020 when Akiko Iwasaki and David Putrino collaborated to care for patients. They wanted to compare the patients with people who had recovered from the disease. It was difficult to find people who were recovered from the disease. Many post–COVID-19 volunteers said they were healthy but then admitted that they were too tired to continue working out. The team signed on 39 volunteers in the end.
Symptoms such as fatigue and muscle weakness are associated with less of the hormone, which is why the Long Covid patients have lowCortisol levels. The cause isn't clear. The Long Covid group had normal levels of the hormone ActH. Some Long Covid patients have tried short courses of steroids, which can treat low cortisol, but they have not helped. Cortisol levels will be tracked throughout the day in Long Covid, and the initial research only tested it in the morning.
The Long Covid blood samples had a lot of exhausted T cells that could be seen by markers. It's possible that the bodies of people with Long Covid are active fighting something.
Chronic inflammation would be produced by this battle. The study found that the genes of the Epstein-Barr virus and other herpesviruses can be found in the cells of people who have been exposed to them for a long time. Iwasaki was curious to know that the degree of T cell exhaustion appeared to be linked to the reactivation of the Epstein-Barr virus. She and others say that Long Covid patients could be affected by the disease. Some ME/CFS patients have shown up with a number of symptoms.
The new study makes clear that Long Covid is not uniform, for example, only 20% to 30% of the study's patients had very high levels of exhausted T cells. James Heath is the president of the Institute for Systems Biology and an author of the Cell paper that found low cortisol and virus reactivation. Iwasaki and Putrino's cohort was on average more than a year out from their COVID-19, but his group examined patients about 3 months after the disease.
New trials of potential therapies, as well as Long Covid's causes and whether subsets of patients are more likely to respond to certain interventions, should be done. Iwasaki has a long list of experimental therapies that he would like to see implemented.
Iwasaki wants us to try these right now. I want to have all the pieces of the puzzle before I start trials. Patients can't wait.
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