Scientists unlock causes of post-COVID chronic fatigue

Posted: 9th February 2022

Scientists studying COVID-19 patients have identified vital biological mechanisms that can act as early-warning signs that a patient will develop ‘Long Covid’. The authors say that the presence of some autoantibodies, pre-existing Type 2 diabetes, SARS-CoV-2 RNA levels in the blood, and Epstein-Barr virus DNA were all associated with a higher risk of developing long covid. The paper could improve the diagnosis and treatment of long-covid and implications for other chronic conditions, including Lyme disease.

Between 40-70% of all COVID-19 patients will experience chronic effects known as Post-Acute Sequalae (PASC). Symptoms include brain fog, a loss of taste and smell, and chronic tiredness (fatigue). But why? “Long COVID is causing significant morbidity in survivors of COVID-19, yet the pathobiology is poorly understood,” said study co-author Dr Jason Goldman.

To learn more about the potential causes of Long Covid, scientists analysed swab samples from 309 patients with confirmed cases of COVID-19 at different points in time. Information on cells was combined with patient data and clinical outcomes to provide researchers with a complete picture. “Our study pairs clinical data and patient-reported outcomes with deep multi-omic analyses to unravel important biological associations that occur in patients with PASC,” said Goldman.

A high viral load usually caused by extensive exposure to COVID-19 was “strongly associated” with long COVID symptoms that could appear months after initial infection.

The researchers also discovered that the Epstein Barr virus, typically present but dormant in most humans, was “reactivated” early on during COVID-19 infection. The researchers identified this as a significant risk factor, says Dr Yapeng, co-author of the paper. “This may be related to immune dysregulation during COVID-19 infection,” he suggests.

The study also highlighted that patients with high autoantibodies, those that recognise parts of the body, are more likely to develop Long-COVID. “Many patients with high autoantibodies simultaneously have low (protective) antibodies that neutralize SARS-CoV-2, and that’s going to make them more susceptible to breakthrough infections,” said Daniel Chen, co-author of the paper.

The findings could play an essential role in identifying patients at high risk of developing Long Covid and could have practical implications for developing new medicines and treatments. “Certain findings such as the low cortisol state in patients with long COVID have potential to translate rapidly to the clinic,” said Goldman. He’s excited about the future. “Our results form an important foundation for the development of therapeutics to treat long COVID.”

More broadly, the findings could help scientists to gain new insights into other post-acute conditions, including Lyme disease, say the authors. “These findings are also helping us frame our thinking around other chronic conditions, such as post-acute Lyme syndrome,” says co-author Dr Jim Heath.

In both Lyme disease and COVID-19, early diagnosis is critical for the best treatment. At Biocentaur, we offer a range of genetic tests to diagnose Lyme disease and chronic fatigue syndrome. Our PaldiSpot test can detect the presence of Borrelia, Babesia and Bartonella genospecies in a patient’s DNA sample, providing accurate information to improve treatment and outcomes.

You can read the full paper, Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae, here.

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