Long Covid Weekly 42: Australia Government funding research, Genetic component of Long Covid?
Plus studies showing similarities between ME/CFS & Long Covid
In this edition, we bring you articles on the prevalence of ongoing symptoms in the UK, the effects of exercise on long Covid patients, and the experiences of a global coronavirus expert who is now a long Covid patient. We also delve into the effects of COVID-19 on fertility and immunogenic properties, as well as the intersection between inflammation, Epstein-Barr virus, and multiple sclerosis. Additionally, we explore thrombophilia and genetic markers in long Covid, and evaluate hematological patterns in those with long Covid.
As always, my Twitter can be found here.
Media
Article: Long COVID: This professor is a global coronavirus expert. And he has long COVID
SUMMARY:
Phenomics, of which Professor Nicholson is considered among the top global leaders in the field
“There’s been some scepticism as to whether long COVID is a real thing,” Dr Freelander said.
For two and a half years Professor Nicholson has been on a rollercoaster of fatigue so chronic he can’t get out of bed due to bouts of illness. While the liver dysfunction finally corrected itself after about five months, the diabetes and atherosclerosis – which carries with it the risk of heart disease – will be with him for the rest of his life.
DEFINITIONS:
Self-reported long COVID: defined as symptoms persisting for more than four weeks after the first (suspected) COVID-19 infection that were not explained by something else.
SUMMARY:
An estimated 1.9 million people living in private households in the UK (2.9% of the population) were experiencing self-reported long COVID as of 5 March 2023.
Long COVID symptoms adversely affected the day-to-day activities of 1.5 million people (79% of those with self-reported long COVID), with 381,000 (20%) reporting that their ability to undertake their day-to-day activities had been “limited a lot”.
The prevalence of self-reported long COVID was greatest in people aged 35 to 69 years, females, people living in more deprived areas, those working in social care, those aged 16 years and over who were not working and not looking for work, and those with another activity-limiting health condition or disability.
Self-reported long COVID was defined as symptoms persisting for more than four weeks after the first (suspected) COVID-19 infection that were not explained by something else.
My Take:
The prevalence of long COVID in the UK highlights the serious impact it has on the daily lives of those affected.
It is concerning that almost 80% of those with self-reported long COVID reported their day-to-day activities being adversely affected by it.
The data also shows that certain demographics, such as those living in more deprived areas, are more affected
Article: No, These 2 Papers Don’t Show Face Masks Cause Long Covid, MIES, Stillbirths
SUMMARY:
Two recent publications claim that face masks can cause problems such as stillbirths, cognitive problems, long Covid, and MIES (Mask Induced Exhaustion Syndrome).
Both publications are deeply flawed and neither demonstrates that face mask wearing can cause such problems in humans.
Many other studies have shown the benefits of face masks in preventing the transmission of airborne viruses like SARS-CoV-2.
My Take:
It's essential to remember the plethora of studies that have shown the benefits of wearing face masks in preventing the transmission of airborne viruses.
Research
Replicated Findings in ME/CFS and Long COVID
Article: Frontiers | SARS-CoV-2 Spike protein alters microglial purinergic signaling
DEFINITIONS:
Purinergic receptors are a type of receptor that responds to nucleotides and nucleosides such as ATP and ADP.
SUMMARY:
COVID-19 is associated with neurological complications such as confusion, strokes, and neuromuscular disorders.
The virus may lead to pro-inflammatory and cytotoxic scenarios in the central nervous system regardless of local viral replication.
The study provides the first evidence that SARS-CoV-2 infection alters purinergic signaling.
My Take:
The Microglia seems like one of the most promising areas of research for both Long Covid & ME/CFS.
DEFINITIONS:
Semen parameters: characteristics of semen used to assess male fertility including concentration, volume, and motility.
Oxidative stress: an imbalance between reactive oxygen species (ROS) and antioxidants in the body that can lead to cell damage.
SUMMARY:
Patients diagnosed with COVID-19 showed a significant decrease in sperm parameters such as concentration, volume, and motility.
The decline in sperm parameters was related to the severity of the disease.
SARS-CoV-2 viral RNA was not found in semen samples from most COVID-19 patients.
These changes may be caused by several biological mechanisms that synergistically interfere with the reproductive system rather than direct viral infection.
DEFINITIONS:
Neuroinflammation: inflammation of the nervous system.
Pathogen-associated molecular patterns (PAMPs): molecules that are associated with pathogens and recognized by innate immune cells through pattern recognition receptors (PRRs).
Toll-Like Receptors (TLRs): a type of PRR that recognizes PAMPs and activates inflammatory responses.
SUMMARY:
Neuroinflammatory processes are considered key factors in the etiology of these symptoms.
Structural proteins derived from SARS-CoV-2 virions function as pathogen-associated molecular patterns (PAMPs) to elicit proinflammatory immune responses in the periphery and/or brain via classical Toll-Like Receptor (TLR) inflammatory pathways.
SARS-CoV-2 structural proteins might directly produce inflammatory processes in the brain independent of and/or in addition to peripheral proinflammatory effects, which might converge to play a causal role in the development of neurologic/neuropsychiatric symptoms in COVID-19.
My Take:
Understanding the mechanisms underlying these symptoms can inform the development of targeted treatments for COVID-19 patients experiencing neurologic and neuropsychiatric symptoms.
DEFINITIONS:
NLRP3 inflammasome: a multiprotein complex that plays a crucial role in initiating an immune response against pathogens.
SUMMARY:
drugs that target NLRP3 could prove to be effective in treating PASC in the future.
As mentioned earlier, PASC shares many symptoms with post-viral syndromes, including those associated with the Epstein-Barr Virus.
In fact, there is evidence to suggest that SARS-CoV-2 infection can reactivate the Epstein-Barr Virus.
A study of 185 hospitalized COVID-19 patients found that 52.4% had reactivated EBV infection compared to only 10.9% of a control group
EBV-specific antibodies were also elevated in COVID-19 patients compared to controls.
This study suggests that SARS-CoV-2 infection may be exacerbating pre-existing EBV infections or reactivating latent EBV infections, which could contribute to the development of PASC.
My Take:
This article highlights the complex relationship between inflammation, COVID-19, PASC, and the Epstein-Barr Virus.
EBV is implicated in both ME/CFS & a subset of Long Covid Patients.
A virus many think is innocuous has many long-term effects
Article: Viruses | Free Full-Text | Thrombophilia and Immune-Related Genetic Markers in Long COVID
DEFINITIONS:
Genetic Polymorphisms: variations in genes that occur between individuals or populations.
Thrombophilia: a tendency to develop blood clots in the veins or arteries due to a genetic or acquired abnormality in the clotting system.
Interferon Gamma (IFNG): a cytokine involved in several immunological pathways such as antigen processing and presentation, apoptosis, and antiviral mediators.
Methylenetetrahydrofolate Reductase (MTHFR): a gene involved in folate metabolism and regulating homocysteine levels in the blood.
SUMMARY:
The present study identified two genetic polymorphisms associated with long COVID in pathways related to inflammation and thrombophilia.
The initial results suggest that low expression genotypes for the Interferon Gamma (IFNG) and Methylenetetrahydrofolate Reductase (MTHFR) genes are associated with long COVID.
Long COVID is presumed to be related to residual inflammation and tissue damage in association with preexisting comorbidities.
My Take:
This study sheds light on the underlying genetic factors of long COVID that have been poorly understood.
My own personal hypothesis was that genetics definitely are somewhat implicated but it is hard to tell how.
SUMMARY:
This study evaluates the hematological laboratory markers of patients with long COVID-19 symptoms for up to 985 days after the acute COVID-19 phase.
Patients with worse long COVID outcomes, such as hospitalization or more simultaneous symptoms, had increased WBCs, lymphocytes, and a shorter PT.
Hospitalized patients presented with increased levels of hematological parameters, such as higher mean levels of RBCs and platelets, suggesting a benign compensation after the acute COVID-19 phase.
My Take:
Observing abnormalities in blood screening markers can provide several benefits for understanding long COVID.
Blood abnormalities seems to be implicated in Long Covid as we have seen from other papers.
Hope
Albanese government pledges $50m for long Covid research as inquiry calls for action
SUMMARY:
The Australian government has pledged a $50m funding boost for research into long Covid, as a parliamentary inquiry called for the establishment of a single Covid-19 database and a nationally coordinated research program into the condition.