Long Covid researchers work ’round the clock’ to solve puzzle

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Bulletin: The Road to Recovery

Amy Durant had her first appointment at a long NHS Covid clinic in July – 16 months after falling ill with the disease. But the 10-minute consultation did not reassure her.

Since a seemingly mild coronavirus episode last year, which did not get her to hospital, the 32-year-old book editor from Surrey, UK has spent weeks in bed, took months of sick leave and has become increasingly doubtful that she will ever fully recover.

Durant is among more than 380,000 people with long-standing Covid in the UK who have been battling the disease for more than a year, according to the National Statistics Office (ONS). Different official studies suggest that between 3% and 37% of people infected with Covid-19 have symptoms that persist for at least 12 weeks.

“I feel stuck,” says Durant, who is most affected by the characteristic symptoms of shortness of breath, brain fog and fatigue. “My body is constantly in fight mode and I need a way to turn it off, but [scientists] obviously I haven’t found what it is.

For doctors tasked with diagnosing and treating the long Covid, the disease has often left them with as many unresolved questions as their patients. A study, published in the Lancet, identified 203 symptoms associated with the disease affecting almost all 11 organ systems in the body.

“It’s certainly not as confusing as it started out, but it’s still a puzzle,” says Melissa Heightman, respiratory consultant who runs the UK’s oldest post-Covid clinic based at University College Hospital, London.

Health authorities around the world are investing huge sums in funding research into the disease, giving hope that some of the secrets of the long Covid will soon be revealed.

The UK’s National Institute for Health Research has spent £ 50million on long-term Covid studies, while the US National Institutes of Health has pledged a total of $ 1.15 billion in funding from research over the next four years.

A team led by Heightman is conducting the largest study of its kind on more than 4,500 Covid long-haul aircraft who have never been admitted to hospital. It will analyze diagnostic tests, such as MRIs, examine the effectiveness of at least three existing drug treatments, and monitor patient rehabilitation through a symptom-tracking app.

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“What was truly disconcerting was the large number of young patients in their 30s and 40s who were previously fit and healthy and, despite initially suffering from mild acute illness, saw their lives derailed by this condition. “says Heightman.

Steven Deeks, a professor of medicine at the University of California at San Francisco, who studies long-term Covid, believes this particular cohort of patients “is likely to have an answer to the fundamental conundrum” of the disease.

There are different “symptom buckets,” Deeks explains, which researchers are trying to narrow down, for example looking at inpatients and outpatients. The next step is to analyze the different groups of symptoms, which range from heart and lung problems to neurological problems and hormonal complications. “Long Covid is a catch-all term for several mechanisms,” Deeks explains.

“We’ll start to see from the studies what the biology is at play: some patients will have regular tissue damage, some patients will have inflammatory disease, and some may have had an autoimmune reaction,” he says.

Symptom clusters range from heart and lung problems to neurological problems and hormonal complications © Ernesto Benavides / AFP via Getty Images

The question of whether the vaccines protect against the long Covid, given the “breakthrough” infections seen in those who have been double stung, is also under investigation. “As Covid becomes rampant, this becomes the most important question of all,” adds Deeks.

In a recent positive development, the team behind the UK’s Zoe Covid tracking app find that the chances of a fully vaccinated person falling ill with Covid and facing persistent symptoms for more than four weeks have been halved. Between December 2020 and July this year, only 5% of the 592 double-bitten people with Covid showed symptoms after four weeks, compared to 11% among 2,762 unvaccinated people who tested positive.

“There seem to be breakthroughs, but obviously these things take time, and by the time it impacts patients, you wonder how long it will take” – Amy Durant © Perry Gibson, for the FT

Researchers are also investigating whether vaccination can provide a cure for the long Covid. According to Akiko Iwasaki, professor of immunobiology at the Yale School of Medicine, about 30% of sufferers experience improvement in symptoms after being vaccinated, while about 15% see their symptoms worsen.

“The vaccine generates robust immunity of antibodies and memory T cells against the spike protein, so if it changes the symptoms of the long Covid we can get a better idea of ​​how to help people,” Iwasaki explains – adding that his team and others are “working around the clock” to understand the pathology of the long Covid.

For Durant and the millions of longtime Covid sufferers around the world, whose symptoms have refused to go away, a solution cannot come soon enough.

“There seem to be breakthroughs, but obviously these things take time,” Durant says, “and as it spills over to patients, you wonder how long it will take.”

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