A lot has happened in science since the World Health Organization (WHO) declared COVID-19 a global pandemic in March 2020: there are vaccines, treatments, and medicines, so the disease isn’t so scary anymore.
While most people fully recover from COVID-19, others can still suffer from it. Chronic weakness, headaches, and memory problems, as well as hair loss and loss of libido are among the long list of symptoms categorized under the imprecise term “COVID-19.”
More than 65 million patients suffer from COVID-19 disease
In an article in Nature Microbiology, the authors estimate that at least 65 million people worldwide suffer from persistent or long-term coronavirus. “I still think this number is very low,” says Akiko Iwasaki, an immunologist at Yale University in the US, who recently participated in a German Academy of Sciences hypothetical panel on Germany Leobudina.
Experts agree that there are still more questions than answers, but with the data collected, Iwasaki and other researchers have been able to identify four main causes that cause many biological changes in the body, which explain the wide variety of symptoms of COVID-19 disease. .
SARS-CoV-2 will not go away
The first could be chronic inflammation, caused by remnants of SARS-CoV-2, the coronavirus that causes COVID-19, which may end up taking up residence somewhere in the body. These groups of viruses multiply over and over again, keeping the immune system on constant alert.
“More and more studies are being published showing that both viral antigens and viral RNA may still be circulating in the body months after the acute phase of infection,” Iwasaki says.
COVID-19 leads to autoimmunity
A severe infection can cause immune responses that not only attack the virus you want to fight, but also the body’s own cells. It’s a known relationship, according to Iwasaki. “Therefore, it is possible that autoimmunity could be another cause of persistent virus.”
An example of this could be myalgic encephalomyelitis, commonly known as chronic fatigue syndrome (ME/CFS). What appears to be simple fatigue is actually a serious neurological condition that has been known for decades, but whose cases have increased as a result of the pandemic.
“In the summer of 2020, we launched an observational study to see if ME/CFS might be a consequence of COVID-19. The answer is ‘yes,’” says immunologist Carmen Schebenbogen, who studies fatigue syndrome at a hospital in Berlin.
Reactivate other viruses
“The third hypothesis we tested is reactivation of latent viruses, such as Epstein-Barr virus (EBV) or other herpesviruses,” Iwasaki says. These remain in the body without causing problems until a COVID-19 infection sufficiently weakens the immune system.
“We were able to observe this reactivation in part of the patients,” says Iwasaki. This is probably another reason why people get ME/CFS, Scheibenbogen adds.
Permanent damage in severe cases of COVID-19
In explaining the fourth hypothesis the researchers are investigating, Iwasaki notes that the more severe the symptoms of COVID-19, the more likely it is to cause permanent damage, which may be behind the prolonged symptoms of persistent COVID-19.
“These four biological processes can occur individually, one after the other, or together,” says the immunologist. However, it is important to differentiate them in order to treat those affected properly. Because this is the question that worries researchers: How do we help COVID-19 patients?
Vaccination reduces the risk of continuing to contract the virus
“Persistent virus is another reason to get vaccinated,” epidemiologist Michael Edelstein of Bar-Ilan University in Ramat Gan, Israel, sums up. Vaccination prevents the most severe cases and thus reduces the possibility of permanent damage. “A meta-analysis shows that the risk of persistent coronavirus infection [en personas vacunadas] It drops between 25 and 30 percent,” Edelstein figured.
But he admits that it is not the final solution to the problem. Some people even develop symptoms similar to those of persistent coronavirus when vaccinated, which is something Iwasaki and his team are preparing a study on.
COVID-19 is not a psychosomatic disease
Despite all the questions that remain, there is one sure conclusion: There is no psychological cause for prolonged COVID symptoms, although they can lead to psychological consequences. “The immunological features described can predict persistent virus with 96 percent certainty,” Iwasaki says of the results of a yet-to-be-reviewed study in which she was involved.
It concludes that “there is no reason to include psychosomatic illness among the causes”. Even researchers considered it counterproductive: it would only distract doctors and those affected by seeking help and appropriate treatment.
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