Researchers at the University of Alberta have identified two proteins that may serve as markers to identify patients with long-term COVID-19 infections. This discovery could lead to treatments that improve the quality of life for millions of people suffering from debilitating diseases.
“As we learn more about what is happening with long-term COVID-19 infections, we are helping patients recover from the most debilitating disease called chronic fatigue syndrome, which causes extreme fatigue and other disabling symptoms. “We wanted to help patients with high symptoms,” says the immunologist. Shoklollah Elahi, professor at the Mike Petryk School of Dentistry at the University of California, announced three breakthroughs aimed at improving our understanding of how long it takes for coronavirus infections to develop and who is susceptible. led the research.
After being infected with SARS-CoV-2, most people feel sick for one to two weeks and then recover. However, about 10% have long-term complications that can last for months or even years. These complications can be widespread, with symptoms such as chronic fatigue, severe pain, difficulty breathing, difficulty sleeping, cardiovascular problems, and cognitive problems commonly referred to as “brain fog,” and can affect all types of organs. affect.
In the first two studies, recently published in the Journal of Autoimmunity and Frontiers in Immunology, researchers studied two sets of subjects. These include 78 patients with severe and long-term symptoms of COVID-19 and 58 people who were infected with SARS-CoV-2 but did not become infected and fully recovered. Any complications.
obvious signs
Elahi and his team looked at different immune cells and proteins in the blood of study participants. They found that the long-term coronavirus group had higher levels of immune cells called neutrophils and monocytes, which cause inflammation, and fewer protective lymphocytes. They also had more worn-out or exhausted killer T cells, a key part of the immune system’s defense against infections.
The researchers also found that patients with long-term COVID-19 infection had higher concentrations of various proteins associated with systemic inflammation, particularly galectin-9 and artemin, in the blood. Elevated galectin-9 levels in patients are associated with increased inflammation and brain fog, so Elahi says these two proteins could help solve the long-standing coronavirus mystery. In the case of Artemin, higher levels cause widespread pain, more severe pain, and cognitive impairment.
Researchers observed that galectin-9 was released by stressed neutrophils, the most abundant white blood cells, in patients with long-term COVID-19 infection. As Elahi’s group reported in a previous study on HIV infection, this released galectin-9 can affect a variety of immune cells and promote chronic inflammation.
They also found that long-term coronavirus infection dysregulated red blood cell production, resulting in large numbers of immature red blood cells in the blood of these patients. Normally, immature red blood cells are present in the bone marrow but not in the blood of healthy people. It is these immature red blood cells in the blood that suppress the immune system and contribute to elevated levels of artemin in the plasma of patients with long-term COVID-19 infection.
Severe infections do not necessarily lead to longer coronavirus outbreaks
Elahi points out that the severity of the initial infection does not affect the likelihood of long-term symptoms of the coronavirus. In fact, most people with long-term COVID-19 infections initially had only mild infections that did not require intensive care or hospitalization.
The researchers also found that women are disproportionately affected by long-term coronavirus infections, with women three times more likely than men to develop the condition.
In a third study published last week in The Lancet Microbe, Elahi’s team found that systemic SARS-CoV-2 was present in the blood of long-term coronavirus patients tested 12 months after infection. It said there was no sign that the virus was still present, disputing previous claims that the virus was still around. It is present in the blood of people infected with the new coronavirus for a long time.
So, if it’s not the virus itself, what causes the novel coronavirus infection to last longer? Thanks to the information provided by galectin-9 and artemin, Elahi says he has an idea of what’s going on.
“These two proteins are thought to be elevated due to chronic inflammation in patients with long-term COVID-19 infection, although we know that some patients develop gastrointestinal symptoms such as diarrhea during the early stages of the disease. , but not everyone,” he points out. “I think people who have gastrointestinal lesions are more likely to develop long-term COVID-19 infection.”
Gastrointestinal problems cause damage to intestinal tissue, causing leaky intestinal tract. This means that trace amounts of microorganisms from the intestines entering the bloodstream can cause chronic inflammation in patients with long-term COVID-19 infections. The research team found that these patients had elevated levels of protein markers associated with leaky gut.
Elahi says this is actually good news because these intestinal problems can be treated. “There are drugs that can be used for leaky gut, so I think that might be a solution for patients with long-term COVID-19 infection.”
Professor Elahi said that in previous research, his team found that some patients with long-term COVID-19 infections were deficient in sarcosine and serine, two amino acids that have anti-inflammatory and neuroprotective effects. He added that he had discovered it. Both are sold as dietary supplements and can be purchased at health food stores or online.
“Some patients who have taken it have reported signs of improvement.”
Elahi said U of A is recognized for excellence in research related to health and well-being and is a great environment to work in.
“The most important thing when conducting human research is having the resources and infrastructure in place to recruit patients. In particular, Dr. Mo Osman and his team at the University of Alberta Hospital have been instrumental in clinical evaluation and patient recruitment. .”
Elahi also thanked the long-standing coronavirus community on Facebook, which helped him identify and access patients for research.
“Fundamentally, as scientists, whatever we do, we have to take it from the lab to the bedside and see if we can benefit the patient. That’s our goal. is.”
This research was primarily funded by a grant from the Canadian Institutes of Health Research. Funding was also provided by the Li Ka-shing Institute for Virology. The researchers also thank the research volunteers who provided samples and assisted with the study.
