Science

Long Covid: worth reporting

As a science journalist, Long Covid is a topic well worth keeping an eye on – and not just because it is interesting, important, and affecting people in your work, family or social spheres. It may well have broader implications for what some now call post-infection syndromes.

Twenty, fifteen, ten years ago, if you came down with the post-infection syndrome labelled ME/CFS, you could expect to get little medical insight, support and sympathy from your healthcare professionals, family, and friends. Sufferers were widely regarded as malingerers or attention-seekers, exaggerating small symptoms and refusing to do things to improve their health, like engage in daily exercise.

Over time, with some robust and heroic campaigning, by patients ill-equipped to do the hard yards such that campaigning requires, views have shifted. Not only about the palpable reality of the condition, but also about its impact: in 2018, some careful mining of big data found that “… a prevalence rate of 857/100,000 for ME/CFS is not unreasonable; therefore, it is not a rare disease, but in fact a relatively common one” with costs 50% higher than those of lupus and multiple sclerosis.

Although ME/CFS’s triggers have not been conclusively demonstrated, it “has been associated with several infectious agents including Epstein–Barr Virus, Q fever, influenza, and other coronaviruses”.

The burden of Long Covid on society (never mind the severe and debilitating impact on individuals) is enormous. As of 31 January 2022, the Office of National Statistics in the UK reported that some 1.5 million people in that country were “experiencing long COVID symptoms, with 65% of those reporting a negative impact on their day-to-day activities. In the USA and UK, millions are taking long-term absence from the workforce due to long COVID”. The toll in the USA may be as high as 23 million.

Sharp, accurate reporting on Long Covid around the globe will help to drive funding for the kind of complex research necessary to understand the condition, to find ways to prevent the damage that results in Long Covid, and develop treatments that improve quality of life for sufferers. The hope is that such research will also shine a light on the potential long-term consequences of other infections, whether from bacteria or a range of viruses, and perhaps ultimately help those who suffer from conditions like ME/CFS, too.

Abstract About 10% of people infected by severe acute respiratory syndrome coronavirus 2 experience post COVID-19 disease. We analysed data from 968 adult patients (5350 person-months) with a confirmed infection enroled in the ComPaRe long COVID cohort, a disease prevalent...

As the COVID Human Genetic Effort consortium (https://www.covidhge.com/), we have studied genetic and immunological determinants of life-threatening COVID-19 pneumonia, multisystem inflammatory syndrome (MIS-C), resistance to SARS-CoV-2 infection and ‘COVID toes’, and here we present our efforts to investigate post-acute COVID-19...

The efficacy of ivermectin in preventing hospitalization or extended observation in an emergency setting among outpatients with acutely symptomatic coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is unclear. METHODS We conducted a...

In the early days of the COVID-19 pandemic, urologist and clinical epidemiologist Kari Tikkinen found his schedule full of cancelled surgeries, so he had some time to kill. “Do whatever you feel is most useful,” his boss at the University...

Multi-organ impairment associated with Long COVID is a significant burden to individuals, populations and health systems, presenting challenges for diagnosis and care provision. Standardised assessment across multiple organs over time is lacking, particularly in non-hospitalised individuals. Objective To determine the...

Multiple COVID-19 vaccines, representing diverse vaccine platforms, successfully protect against symptomatic COVID-19 cases and deaths. Head-to-head comparisons of T cell, B cell, and antibody responses to diverse vaccines in humans are likely to be informative for understanding protective immunity against...

Virus-like particle (VLP) and live virus assays were used to investigate neutralizing immunity against Delta and Omicron SARS-CoV-2 variants in 259 samples from 128 vaccinated individuals. Following Delta breakthrough infection, titers against WT rose 57-fold and 3.1-fold compared to uninfected...

COVCOG 2: Cognitive and Memory Deficits in Long COVID
17th March 2022, Curated by Mandi Smallhorne

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been often characterized as a respiratory disease. However, it is increasingly being understood as an infection that impacts multiple systems, and many patients report neurological symptoms. Indeed, there is...

Since its first emergence in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has evolved into a global pandemic. Whilst often considered a respiratory disease, a large proportion of COVID-19 patients report neurological...

Abstract Objective To study the association between covid-19 vaccines, SARS-CoV-2 infection, and risk of immune mediated neurological events. Design Population based historical rate comparison study and self-controlled case series analysis. Setting Primary care records from the United Kingdom, and primary...

The omicron variant (B.1.1.529) of SARS-CoV-2 has demonstrated partial vaccine escape and high transmissibility, with early studies indicating lower severity of infection than that of the delta variant (B.1.617.2). We aimed to better characterise omicron severity relative to delta by...

Waning of vaccine protection against coronavirus disease 2019 (Covid-19) and the emergence of the omicron (or B.1.1.529) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to expedited efforts to scale up booster vaccination. Protection conferred by...

Abstract There is strong evidence for brain-related abnormalities in COVID-19. It remains unknown however whether the impact of SARS-CoV-2 infection can be detected in milder cases, and whether this can reveal possible mechanisms contributing to brain pathology. Here, we investigated...

Abstract BACKGROUND The B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified on November 25, 2021, in Gauteng province, South Africa. Data regarding the seroprevalence of SARS-CoV-2 IgG in Gauteng before the fourth wave of...

Abstract Despite a clear role in protective immunity, the durability and quality of antibody and memory B cell responses induced by mRNA vaccination, particularly by a 3rd dose of vaccine, remains unclear. Here, we examined antibody and memory B cell...

Key Points Question Does adding ivermectin, an inexpensive and widely available antiparasitic drug, to the standard of care reduce the risk of severe disease in patients with COVID-19 and comorbidities? Findings In this open-label randomized clinical trial of high-risk patients...

First report from the German COVID-19 autopsy registry
17th February 2022, Curated by Mandi Smallhorne

Autopsies are an important tool in medicine, dissecting disease pathophysiology and causes of death. In COVID-19, autopsies revealed e.g., the effects on pulmonary (micro)vasculature or the nervous system, systemic viral spread, or the interplay with the immune system. To facilitate...

Abstract Background Deaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of...

Summary The SARS-CoV-2 Omicron variant largely escapes neutralizing antibodies elicited by vaccines or infection. However, whether Omicron triggers humoral responses that are cross-reactive to other variants of concern (VOCs) remains largely unknown. We use plasma from 20 unvaccinated and seven...

A number of existing strains of SARS-CoV-2, as well as other future variants that could arise, have the potential to escape the immune system’s cytotoxic T cell response in some portion of the population. That’s the conclusion of a new...

Long-term cardiovascular outcomes of COVID-19
7th February 2022, Curated by Mandi Smallhorne

Abstract The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to...

ABSTRACT During the coronavirus disease 2019 pandemic, a complex mix of political pressure, social urgency, public panic, and scientific curiosity has significantly impacted the context of research and development. The goal of this study is to understand if and how...

Summary What is already known about this topic? Face masks or respirators (N95/KN95s) effectively filter virus-sized particles in laboratory settings. The real-world effectiveness of face coverings to prevent acquisition of SARS-CoV-2 infection has not been widely studied. What is added...

The overseers of the preprint server SocArXiv have withdrawn a paper which claims that treating Covid patients with ivermectin dramatically reduces their odds of hospitalization, calling the work “misleading” and “part of an unethical program by the government of Mexico...

Paper overestimated risk of COVID-19 to endangered apes
2nd February 2022, Curated by Mandi Smallhorne

A Springer Nature journal has retracted a 2021 article with dire news for mountain gorillas in Rwanda’s Volcanoes National Park about the prospects of extinction on the spikes of SARS-CoV-2 after finding a fatal error in their model of the...

The T cell immune response against SARS-CoV-2
1st February 2022, Curated by Mandi Smallhorne

Abstract The adaptive immune response is a major determinant of the clinical outcome after SARS-CoV-2 infection and underpins vaccine efficacy. T cell responses develop early and correlate with protection but are relatively impaired in severe disease and are associated with...

Abstract As the SARS-CoV-2 pandemic enters its third year, vaccines that not only prevent disease, but also prevent transmission are needed to help reduce global disease burden. Currently approved parenteral vaccines induce robust systemic immunity, but poor immunity at the...

Abstract Background Long-term complications after COVID-19 are common, but the potential cause for persistent symptoms after viral clearance remains unclear. Objective To investigate whether gut microbiome composition is linked to post-acute COVID-19 syndrome (PACS), defined as at least one persistent...

Long-COVID symptoms less likely in vaccinated people, Israeli data say
25th January 2022, Curated by Mandi Smallhorne

Data from people infected with SARS-CoV-2 early in the pandemic add to growing evidence suggesting that vaccination can help to reduce the risk of long COVID1. Researchers in Israel report that people who have had both SARS-CoV-2 infection and doses...

Highlights: • T cells of vaccinees recognize SARS-CoV-2 variants including Omicron. • RBD memory B cells recognition of Omicron is reduced. • A median of 11 CD4 and 10 CD8 spike epitopes are recognized in vaccinees. • Average preservation >...

Summary ▪In this narrative review, we summarise the vast and burgeoning research on the potential and established indirect impacts on children of the COVID-19 pandemic. We used a community child health lens to organise our findings and to consider how...

Most people in the UK agree with the scientific consensus on key issues such as vaccination and climate change and believe that the internet has improved the public’s understanding of science, finds a new report from the Royal Society.1 The...

Abstract Some reproductive-aged individuals remain unvaccinated against COVID-19 due to concerns about potential adverse effects on fertility. We examined the associations of COVID-19 vaccination and SARS-CoV-2 infection with fertility among couples trying to conceive spontaneously using data from an internet-based...

Nervous system consequences of COVID-19
20th January 2022, Curated by Mandi Smallhorne

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered a respiratory pathogen, myriad neurologic complications—including confusion, stroke, and neuromuscular disorders—manifest during acute COVID-19. Furthermore, maladies such as impaired concentration, headache, sensory disturbances, depression, and even psychosis may persist for...

Abstract Importance Pediatric SARS-CoV-2 infections and hospitalizations are rising in the US and other countries after the emergence of Omicron variant. However data on disease severity from Omicron compared with Delta in children under 5 in the US is lacking....

Abstract Fake news and misinformation spread quickly and virulently during the height of the COVID-19 pandemic, potentially outpacing the spread of the virus itself across the globe. This study aimed to develop a greater understanding of how individuals make sense...

Abstract The COVID-19 pandemic presented a unique opportunity to answer the critical question: How does media use aid (or subvert) emotion- and problem-focused coping with significant life stressors? Based on a national survey (N = 564) conducted on March 20–25,...

Abstract Objectives We aimed to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves in the Western Cape, the contribution of undiagnosed prior infection to differences in outcomes in a context of high seroprevalence due to prior infection,...

Summary Background and aims Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the clinical significance of these individual micronutrients in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted...

Abstract Abstract Background Viral load (VL) is one determinant of secondary transmission of SARS-CoV-2. Emergence of variants of concerns (VOC) Alpha and Delta was ascribed, at least partly, to higher VL. Furthermore, with parts of the population vaccinated, knowledge on...

Abstract Cross-reactive immune responses to SARS-CoV-2 have been observed in pre-pandemic cohorts and proposed to contribute to host protection. Here we assess 52 COVID-19 household contacts to capture immune responses at the earliest timepoints after SARS-CoV-2 exposure. Using a dual...

Abstract Survivors of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection frequently experience lingering neurological symptoms, including impairment in attention, concentration, speed of information processing and memory. This long-COVID cognitive syndrome shares many features with the syndrome of cancer therapy-related cognitive...

Summary What is already known about this topic? COVID-19 vaccines are highly effective against COVID-19–associated hospitalization and death. What is added by this report? Among 1,228,664 persons who completed primary vaccination during December 2020–October 2021, severe COVID-19–associated outcomes (0.015%) or...

Abstract Skeletal muscle-related symptoms are common in both acute coronavirus disease (Covid)-19 and post-acute sequelae of Covid-19 (PASC). In this narrative review, we discuss cellular and molecular pathways that are affected and consider these in regard to skeletal muscle involvement...

Covid-19: Vaccination during pregnancy is safe, finds large US study
7th January 2022, Curated by Mandi Smallhorne

A US study of 46 079 pregnancies has found that vaccination against covid-19 was safe and did not increase the risk of preterm birth or small for gestational age babies. Pregnant women and those planning to get pregnant are included in...

Abstract The SARS-CoV-2 Omicron1 Variant of Concern (B.1.1.529) has spread rapidly in many countries. With a spike that is highly diverged from that of the pandemic founder, it escapes most available monoclonal antibody therapeutics2,3 and erodes vaccine protection4. A public...

Summary In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies...

Abstract The SARS-CoV-2 Omicron BA.1 variant emerged in late 2021 and is characterised by multiple spike mutations across all spike domains. Here we show that compared to the Delta variant, Omicron BA.1 confers very significant evasion of therapeutic monoclonal and...

ABSTRACT Background The SARS-CoV-2 Omicron variant of concern (VOC) almost completely replaced other variants in South Africa during November 2021, and was associated with a rapid increase in COVID-19 cases. We aimed to assess clinical severity of individuals infected with...

Summary The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in southern Africa has been characterised by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were driven by the...