Long Covid: Mysterious long-term corona consequences - A drug gives hope

Created: 2022-11-09 05:16

By: Pamela Dörhöfer

Are the complications due to the infection?

It is often impossible to say with certainty.

© istock

Some people still suffer from after-effects months after recovering from corona disease - the long Covid syndrome - but a drug gives hope.

Frankfurt – Among the many unpleasant properties of the corona virus, this is one of the particularly unpleasant ones: an infection can result in long-term symptoms even after the acute illness – even if it was rather mild.

Many people who have survived Covid-19 - the World Health Organization WHO assumes up to 17 million for Europe alone - no longer feel really healthy for weeks, months or years.

And some may never be again;

You don't know that exactly, after all, experience only goes back to 2020.

The WHO is already warning of the enormous burdens that Long Covid could impose on healthcare systems worldwide.

More than 200 symptoms are now associated with Long Covid.

Long Covid after corona infection - diabetes and heart muscle inflammation

Those affected get out of breath easily, suffer from persistent coughing or headaches and body aches, diffuse symptoms such as sleep disorders, exhaustion and weakness up to leaden tiredness, some also from depressive moods or concentration and memory problems, the so-called "brain fog".

Others subsequently develop diseases such as diabetes, heart muscle inflammation or even a stroke, and it has also been discussed whether Covid-19 promotes the development of Alzheimer's and Parkinson's.

At times one might think that this viral infection would be capable of causing seemingly all common diseases.

Long-Covid: Are complications always caused by corona infections?

But are the complications really always due to the infection?

It is often impossible to say with certainty.

Because a number of complaints also occur frequently independently of Corona, a clear assignment is difficult.

As much research as there is on Long Covid, there is still a lack of comprehensive understanding, and assessments are often far apart.

This runs through almost all aspects of the disease and starts with the frequency.

The information ranges between five percent and up to 50 percent after going through Covid disease.

The WHO estimates that in the first two years of the pandemic in Europe, more than 16 percent suffered or are still suffering from long-term effects.

Long Covid after Corona: Apparently less common at Omikron

Studies suggest that long covid is less likely to occur after infection with an omicron variant than after one with earlier variants.

The next difficult question is who is at increased risk.

Health problems in the past could be factors - and in the end the severity of the course.

A study from Scotland, based on data from almost 100,000 people, came to the conclusion that people who had to be treated in hospital for their corona infection suffered most from Long Covid.

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As neuroscientist David Putrino of Mount Sinai Health System New York explains in the Washington Post: "It has always been the case that those who are sicker are more likely to have long-term sequelae." But even if only a small percentage of mild cases Long Covid develops, this represents “a massive problem for public health”, says the doctor – simply in view of the large number of infections.

Long Covid Syndrome: Long-term consequences are not an exclusive feature of Corona

The fact that recovery from an infection can sometimes take months is not an exclusive feature of Sars-CoV-2.

Influenza can also be accompanied by weeks of fatigue, heart muscle inflammation or diabetes.

Epstein-Barr virus infection, like Covid-19, can cause permanent exhaustion;

the technical term for this is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Some experts even suspect that Long Covid can be traced back to a reactivation of dormant Epstein-Barr viruses in the body.

A special feature of the long-term consequences of an infection with Sars-CoV-2, however, is that they have so many faces.

Scientists are therefore increasingly inclined to assume that there are several types of Long Covid.

"We need to understand that Long Covid is not just one thing," says David Putrino.

Long Covid - Chronic fatigue syndrome after corona infection

These forms can be roughly divided into severe exhaustion, concentration and memory problems, diseases caused by blood clots, lung damage and secondary diseases such as diabetes.

The chronic fatigue syndrome ME/CFS has emerged as one of the most common forms of Long Covid, which tends to occur after mild to moderate courses of Covid.

Two thirds of those affected are women between the ages of 20 and 60.

Lung damage, on the other hand, can be a consequence if people with severe courses had to be treated in a clinic;

for the same group, the risk of cardiovascular diseases such as heart attack, stroke and heart failure is also said to be significantly increased, according to a recently published study by a team from Queen Mary University London.

Long Covid: Defense cells are permanently stimulated

So far, however, the big problem in diagnosing Long Covid has been the lack of biomarkers - values ​​in the blood or certain structures that could provide certainty in a tissue examination, for example.

It is not uncommon for long Covid to be physically undetectable.

That is why intensive research is being carried out into such biomarkers, which could then also be used as a basis for the development of targeted drugs.

One seems to have been tracked down in the meantime: researchers at Yale University (USA) discovered exhausted T cells in the blood of those affected, which suggests that these defense cells are permanently stimulated, for example by existing corona viruses or reactivated other viruses such as Epstein Barr or herpes .

Fatigue and fatigue are common symptoms of Long Covid.

©PantherMedia

Long Covid after corona infection: Different causes lead to different symptoms

It is also fundamental for a targeted therapy to find the underlying mechanisms of the disease.

There are already several approaches to this, and it is becoming apparent that the different forms of Long Covid also have different causes.

The most harmless: Symptoms that last only a few weeks could be due to the fact that the body simply needs time to recover.

However, this does not explain longer-lasting symptoms.

In some of those affected, inflammatory processes are likely to be the reason - which in turn can have various causes: such as an excessive immune reaction, which can also be accompanied by the formation of autoantibodies, which then attack their own tissue.

Long Covid: Many different tissues and organs can suffer

Another theory is that it activates mast cells - cells of the body's defenses - which then release chemical messengers such as histamine, which can trigger a variety of symptoms.

Freely circulating virus RNA, i.e. fragments of the Sars-CoV-2 genome in the bloodstream, is also under discussion as a trigger for inflammation.

In a study published at the end of September, researchers from China put forward the thesis that the innermost layer of the blood vessels – the endothelium – is damaged by an excessive immune response;

this would also explain why many different tissues and organs can be affected.

Another possible mechanism discussed is the formation of tiny clots that disrupt blood flow and deprive tissues in the body of oxygen.

Long Covid: effects on the brain?

The explanation that seems particularly obvious is also on the list of possible long-Covid causes: a chronic infection caused by viruses that remain in the body because it cannot eliminate them.

Against this background, vaccination is also being discussed as a means of alleviating the disease.

It does not offer protection against Long Covid, but studies indicate a reduction in risk.

As a "therapeutic" vaccination, however, the successes have been mixed.

The doctor Claudia Ellert, who herself has been suffering from Long Covid for two years, explains in the medical portal DocCheck: "It's more like 50 percent nothing happens, 20 percent it gets worse and 30 percent better." Worth mentioning is also that the vaccination itself can trigger ailments similar to those of Long Covid.

Long Covid: Brain affected by long-term corona effects?

The effects on the brain occupy a special position.

One of the key questions here is whether the problems stem directly from the virus;

a strong activation of immune cells in the brain would also be possible.

Carl Samudyata of Sweden's Karolinska Institute writes in The Conversation magazine that his team's study found that the virus cut synapses between brain cells in laboratory experiments using brain organoids (man-made structures similar to those found in young children's brains).

Other studies, on the other hand, tend to emphasize the psychological component.

One of them comes from the University Medicine Essen;

Here the researchers found that the neurological examination was normal in 80 percent of the patients examined, but that previous psychiatric illnesses such as depression or an anxiety disorder are said to have significantly increased the risk of long Covid.

Long Covid: hopes for a drug against long-term corona effects

People with “academic qualifications or from the administrative and teaching area” were also more frequently represented in “our cohort” than professions with physical activity.

Two very recent studies from the USA and from Hamburg came to similar results - the latter recognized a risk factor for Long Covid in the expectation of symptoms.

Since the search for the mechanisms has provided plausible explanations, but little concrete evidence and biomarkers, there are still no specific drugs with which the symptoms can be treated in a targeted manner.

Therefore, a veritable potpourri of drugs is currently being tried out.

These include drugs that work against inflammation and excessive reactions of the immune system, such as antihistamines or cortisone, antiviral agents or blood thinners against microthrombosis, and blood washing is also being tested as a therapy.

Corona long-term effects - More than one treatment approach for Long Covid sought

Hopes also rest on the use of the not yet approved drug BC007, which was actually developed to treat heart failure and was tested at the University Hospital Erlangen in a patient with glaucoma - where it then turned out that it works against Long Covid, as well as fr. de reported.

The researchers suspect that the drug is able to neutralize certain autoantibodies in the blood.

But the same applies here: there is probably not just one therapy.

David Putrino of Mount Sinai Health System New York says: “Finding a cure for Long Covid is like finding a cure for cancer.

We don't have a unique cure for cancer, we have many targeted treatments." (Pamela Dörhöfer)