Jan. 6, 2023 — Even as the cause of long-term COVID remains puzzling, researchers are focusing on biomarkers — chemical compounds that can be detected and measured — that could help them better diagnose and treat the condition. The end goal: A simple test to help identify who has long-term COVID and whether treatment will help.
“The hope is that the specific markers discovered will inform how individual clusters (diseases) should be treated and managed to reduce or eliminate symptoms,” said david walterPhD, Co-Director The Mass General Brigham COVID Innovation Center in Boston.
Biomarkers are often used to identify and track disease. They range from simple measurements like blood pressure or blood sugar levels to autoantibodies that cause rheumatoid arthritis and enzymes that can indicate liver disease. Since the maddening array of symptoms of COVID includes fatigue, shortness of breath, chest pain and dizziness, having one or more biomarkers can help better define and diagnose it.
Michael Peluso, MD, who has been treating COVID-19 and long-term COVID patients at San Francisco General Hospital since the start of the pandemic, said the “game-changing” biomarker will be “finding something that you can intervene today, see Marker Levels.” change, and know it will have long-term effects.”
Researchers know that patients should not expect a single diagnostic test or study indicator. Several things seem to be associated with various symptoms. Scientists and doctors predict that they will establish different clinical subtypes of long COVID.
Many research teams are recovery plan, a $1.15 billion NIH long-term COVID project. NIH funded 40 research projects Study the role of metabolism, genetics, obesity, antibodies, inflammation, diabetes and more.
NIH team divides long COVID into Symptom group and are looking for the cause of the disease in each cluster. These clusters are:
- Viral Persistence: When the COVID-19 Virus Stays in Some People
- Autonomic dysfunction: changes in the ability to regulate heart rate, body temperature, breathing, digestion, and sensation
- Sleep disturbances: changes in sleep patterns or ability to sleep
- Cognitive impairment: confusion or brain fog
- Exercise intolerance/fatigue: changes in a person’s activity and/or energy levels
This recovery study It is expected to start in early 2023.First clinical trial will test antiviral drug Paxlovid — and it’s already showing some Validity of earlier studies – Against placebos.
Many researchers are gathering evidence that viruses hiding in patients are driving long-term COVID. This could make the virus itself or parts of it a biomarker for long-term COVID.
Walt of Mass General used Sensitivity test It can find smaller viral fragments than traditional tests.In a sample of about 50 patients, he 65% of long-term COVID patients found They had some of the spike protein from the SARS-CoV-2 virus in their blood. Although the study is small and preliminary, he thinks the presence of the spike protein in the blood is a clue.
“If no virus was present, there would be no spike protein, because the spike protein has a very short lifespan after someone eliminates a viral infection,” Walter said. “There has to be continued production of the spike protein from the active virus for the spike to continue to spread.”
A private research collaboration in California is looking for virus persistence in organ tissue. PolyBio Research Foundation researchers study complex chronic inflammatory diseases such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and now chronic COVID, which often produce the same symptoms.
Michael Van Elzakker, Ph.D., a co-founder of the group and a member of the Division of Neurotherapeutics at Massachusetts Brigham General Hospital in Boston, focused on the possibility of viral reservoirs — places where viruses can hang out and evade the immune system. If it’s there, VanElzakker said, his team wants to find it and figure out what it’s doing.
“All successful pathogens somehow evade the immune system,” he said. “They can’t find the little niche they do well in.”
Micro clot – Small blood clots – are another sign of long COVID. A group of researchers — #Teamclots On Twitter – researching them. One theory is that inflammation promotes the formation of blood clots, which damage tiny blood vessels and block oxygen delivery. A possible trigger: the spike protein.
sign of inflammation itself can be used as a biomarker. Peluso and colleagues find higher levels of inflammation in chronic COVID patients in 2021 Chemicals called cytokines. Measuring these cytokines could help explain long-term COVID, Peluso tells a conference Online Recovery Program November update.
Likewise, Yale researchers reported in August that cortisol— stress hormones – Both were below normal in chronic COVID patients.
The constant emergence of new variants of COVID complicates research. Much of the early research was done before the Omicron variants appeared. Walter said he found less spike protein in the Omicron long COVID samples — closer to 50%, not 65% — and the researchers found fewer clots in the Omicron patients, who also have less severe disease.
Like some other scientists focused on long-term COVID, Dr. Mohamed Abdel-Mohsen started working on another virus, in his case HIV. It can sometimes damage the lining of the gut, causing what’s known as leaky gut.Abdul-Mosen Associate Professor, Center for Vaccines and Immunotherapy At the Wistar Institute in Philadelphia, it is thought that long-term COVID patients may also suffer from leaky gut syndrome.
Abdel-Mohsen and colleagues found that Evidence suggests microbes have leaked from the guts of COVID-19 patients and caused inflammation elsewhere in the body, possibly including the brain. But he said it was possible to treat the condition with medication. Examining evidence of this leakage could provide not only biomarkers but therapeutic targets as well.
“There are many steps that can be taken to intervene and hopefully reduce symptoms and improve the quality of people going through (with COVID),” he said.
While research into biomarkers is in its early stages, the hope is to find one that points to a treatment.
“TThe holy grail of biomarkers is actually surrogate markers,” Peluso said in a RECOVER briefing in November. “What surrogate markers mean is you identify the marker, you determine the level of the marker, and then you do something to change it. Changing levels of biomarkers can lead to changes in clinical outcomes. “
In other words, a statin-like drug that lowers levels of bad cholesterol — and in turn reduces stroke and heart attack rates.
