Unraveling the Persistence of SARS-CoV-2: A Study on Post-Acute COVID-19 Sequelae

A recent study sheds light on the persistent effects of SARS-CoV-2, particularly focusing on the post-acute sequelae of COVID-19 (PASC), commonly known as long COVID.

Here’s a detailed summary:

Background PASC poses a significant challenge in the medical community, with symptoms like fatigue, anosmia, memory loss, gastrointestinal distress, and shortness of breath lingering in some individuals long after the acute phase of COVID-19​​. The World Health Organization reports that about one-quarter of COVID-19 patients experience symptoms 4-5 weeks post-infection, with about 10% having symptoms even after 12 weeks​​.

Study Focus and Methodology The study aimed to identify biomarkers for PASC by analyzing plasma samples from a cohort of 63 individuals, including those diagnosed with PASC and those who had recovered from COVID-19. The researchers measured the concentration of SARS-CoV-2 antigens and cytokines in these samples​​​​.

Key Findings

  1. Persistent SARS-CoV-2 Spike Protein: The study found the SARS-CoV-2 spike antigen in a majority of PASC patients, even up to 12 months post-diagnosis. This suggests the presence of an active, persistent viral reservoir within the body. The detection of the spike antigen at multiple time points in many patients underscores its potential as a biomarker for PASC​​​​.
  2. Gender Disparity in PASC: Consistent with other studies, a significant proportion of the PASC patients in this cohort were female, aligning with findings that women are more affected by persistent symptoms post-SARS-CoV-2 infection​​.
  3. Temporal Fluctuations in Antigen Levels: There were notable temporal fluctuations in antigen levels among PASC patients, emphasizing the importance of longitudinal sampling. For a subset of patients, these fluctuations indicated the persistent presence of circulating antigen​​.
  4. Potential Viral Reservoirs: The presence of circulating spike protein supports the hypothesis of active viral reservoirs in the body. This is corroborated by other studies that have identified SARS-CoV-2 RNA and specific protein expression in various tissues, including the gastrointestinal tract, which might contribute to the persistence of the virus and PASC symptoms​​.
  5. Subtle Changes in Inflammatory Markers: The study observed subtle changes in circulating inflammatory markers in PASC patients, suggesting that these changes might be more pronounced within specific tissues. This finding indicates the need for further investigation into cytokine levels over time in larger cohorts​​.

Conclusion The detection of the SARS-CoV-2 spike protein in PASC patients provides strong evidence for its use as a biomarker. This finding enhances the potential for accurately identifying PASC patients and developing effective treatment strategies. The study highlights the importance of understanding the persistent effects of SARS-CoV-2 for better management of long-term COVID-19 sequelae​​.

Read More: https://www.medrxiv.org/content/10.1101/2022.06.14.22276401v1.full.pdf

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