Melbourne: About 5-10 percent of people with coronavirus infection experience long-term COVID, with symptoms lasting for three months or more. Researchers have proposed several biological mechanisms to explain long-term COVID. However, in an article published in the latest Medical Journal of Australia, we argue that in most, if not all, people, long Covid appears to be linked to longer persistence of the virus in the body.
From the relatively early period of the pandemic, there has been recognition that in some people, the SARS-CoV-2 virus, or at least its remnants, can persist in various tissues and organs for long periods of time. This principle is known as 'viral persistence'. The long-term presence of virus remnants in some people's bodies is well documented, but what is less certain is whether any live virus persists for long periods of time and, if so, whether it can cause long-term COVID. Is the reason for. This distinction is important because live viruses can be targeted by specific antiviral methods whereas 'dead' virus residues cannot.
Viral persistence has two important implications. When it occurs in some severely immunocompromised people, it is thought to be the source of a new and quite different-looking form, such as JN.1. Second, it has the potential to cause symptoms even after acute illness in many people in the broader population. In other words, prolonged infection can lead to long-term Covid.
What does the research say?
There are no studies that confirm that persistent infection with the virus causes long-term COVID, but collectively several recent major papers suggest this. In February, a study published in the journal Nature found that many people with mild COVID symptoms continued to shed the virus's genetic material, so-called viral RNA, from their respiratory tract for longer periods of time. People with persistent secretion of this viral RNA had a higher risk of having long-term Covid. Other major papers revealed replication of viral RNA and proteins in the blood of patients years after their initial infection. This indicates that the virus may be replicating for a long time in some hidden parts of the body, possibly including blood cells.
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Viral RNA detected
Another study detected viral RNA in ten different tissue sites and blood samples one to four months after acute infection. The study found that people with persistently 'positive' viral RNA had a higher risk of long Covid (measured four months after infection). The same study also gave clues about where the virus persists in the body for a long time.
The gastrointestinal tract is considered to be a major hiding place for long-term viruses. Formal proof that a virus capable of replicating can persist in the body for years is still unclear. This is because it is technically challenging to isolate live virus from places inside the body where it remains 'hidden'. In the absence of this, we and other scientists argue that the overall evidence now warrants action.
Now what needs to be done next?
The obvious answer is to accelerate trials of known antivirals for long-term Covid prevention and treatment. This should include diabetes medicine metformin etc. This has potential dual benefits in the context of long-term Covid. These include its antiviral properties which have demonstrated surprising effects against long-term Covid. It has also been considered as a potential therapy in the treatment of fatigue-related impairments. However, there should be establishment of clinical trial platforms for development and rapid testing of new drugs. Science has provided many exciting therapeutic options, but translating these into usable forms in the clinic is a major hurdle that requires support and investment from governments.
Understanding and Preventing Long Covid
The notion of 'prolonged infection' is quite strong in long Covid. This can help to understand the situation in the eyes of the wider community and raise awareness among the general public as well as medical professionals. This can help to raise awareness of the importance of reducing re-infection rates in the community. Needed Not just the first COVID infection, but every subsequent infection poses a risk for long-term COVID.
Long-term COVID is common and is not limited to people at high risk of severe acute illness, but affects all age groups. In one study, the greatest effects were seen in people aged 30 to 49 years. So, for now, we all need to reduce our exposure to the virus with whatever means available. This includes staying in well-ventilated indoor spaces, keeping windows open, and more sophisticated ways of making indoor air safe include monitoring and filtering air quality in spaces that do not have easy natural ventilation. Could be.
Corona treatment is necessary
In places where you are not sure about the quality of indoor air, especially in crowded areas, use a high-quality mask (one that fits snugly and doesn't let air in easily, such as N95 types) Mask) can be used. Getting a medical checkup is also a way to know when you are infected. If infection is detected during testing, treatment can be provided.
Along with this, you can be vigilant about keeping people around you safe with masks, staying at home as much as possible and ventilating places. The booster dose of anti-Covid vaccine is also an important preventive measure. Vaccines reduce long-term Covid and its subsequent complications. Hopefully one day there will be better treatments for long term Covid. But in the meantime, growing awareness of the biomedical basis of long-term COVID should prompt physicians to take patients more seriously.
As per agency input
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