You may have recovered from COVID-19 a few months ago and still be in poor health.
You feel dizzy and your heart beats faster when you stand up. Even doing some everyday activities can leave you feeling drained. A good night’s sleep used to give you a boost of energy, but not anymore.
This is a symptom of long-term covid-19, right? Perhaps the problem is not so simple.
A recent paper published in “Frontiers in Immunology” (Frontiers in Immunology) pointed out that mild or even asymptomatic new crowns may activate multiple viral reservoirs that the body has been fighting, which may trigger symptoms of chronic fatigue syndrome. Chronic fatigue syndrome is similar to long-term COVID-19.
Researchers have found that herpes viruses, such as the Epstein-Barr virus that causes mononucleosis, can spread in unvaccinated COVID-19 patients. People with chronic fatigue syndrome have a stronger antibody response, a sign that the immune system is working hard to fight off a stubborn virus in the body.
These non-coronaviruses may be to blame for chronic fatigue syndrome. Chronic fatigue syndrome is also known as “myalgic encephalomyelitis”. This unexplained condition with no clear cause can cause symptoms such as fatigue, brain fog, dizziness when moving, and poor sleep quality.
Many long-term COVID-19 patients are experiencing symptoms that could be described as chronic fatigue syndrome, experts say. In an October study, researchers hypothesized that the new crown sometimes suppresses the immune system, causing dormant viruses in the body to be reactivated and spread due to the stress of the new crown. The symptoms caused by these viruses are common in chronic fatigue syndrome and long-term It is very common in the new crown disease.
Therefore, in some cases, “long-term covid-19” is not a completely new condition, but a post-viral disease with symptoms crossed with chronic fatigue syndrome, similar to patients infected with Ebola virus, 2003-2004 After the original SARS virus and other viruses.
As Dr. Anthony Fauci, a well-known American infectious disease expert, said in 2020, the long-term new crown “may be a post-virus syndrome related to the new crown.”
“We haven’t tested and treated latent virus yet”
Alba Miranda Azzola, co-director of the long-term COVID-19 clinic at the Johns Hopkins University School of Medicine, told Fortune that the virus may have activated at least some of the latent viruses in long-term COVID-19 patients. Symptoms of chronic fatigue syndrome.
But her clinic does not check for viral reactivation in long-term COVID-19 patients. She doesn’t think it’s necessary to put patients on antiviral drugs or antibiotics, which can have unwanted side effects, just because the viruses might trigger these symptoms in patients.
“We don’t have enough evidence to support this treatment,” she said.
Azzola said that doctors have prescribed this treatment for long-term new crown patients, but the patient’s condition has not improved much. She recently asked a colleague in the field of infectious diseases whether it would be standard practice to detect and treat latent virus in long-term COVID-19 patients.
“We have not tested for and treated latent virus,” her colleagues said.
Dr. Neil Goldstein, a pulmonologist at National Jewish Health in Denver who directs the hospital’s long-term COVID-19 clinic, said the role of latent viruses in long-term COVID-19 is uncertain. That’s because this new condition is complex and variable.
At present, there is no unified definition of long-term COVID-19. He pointed out that hundreds of possible symptoms have been identified, and there is no single explanation for all of them.
Goldstein said: “There may be some correlation between the latent virus and the long-term new crown, but it is difficult for us to determine the cause and effect relationship between the two. The situation may be the opposite, and the long-term new crown causes the virus to be activated, not the virus. After being activated, it caused a long-term covid-19.”
Dr. Panagis Galliasatos, an associate professor in the Department of Pulmonary and Critical Care Medicine at Johns Hopkins University, who is engaged in the treatment of long-term patients with new crowns, usually does not test patients for latent virus status, because most patients are sensitive to COVID-19. The treatment drug used in his clinic responded well.
“If a patient doesn’t respond to a treatment, maybe we’ll be testing something else,” he said.
Galliasatos said it is highly likely that the coronavirus is causing a decline in the immune system in “many people”.
“I think it’s the immune deficiency that’s causing these viruses to reappear. If there’s an immune deficiency, it’s temporary,” he said.
The October study noted that scientists still aren’t sure whether viruses such as Epstein-Barr virus simply trigger chronic fatigue syndrome or continually produce more symptoms. Researchers are also not sure what role latent viruses, possibly including the SARS-CoV-2 virus itself, play if they have some impact in the development of long-term COVID-19.
not many options at the moment
Because we know so little about long-term COVID-19 and chronic fatigue syndrome, experts say it doesn’t matter which condition a patient has, at least for now. Although the symptoms of both conditions can be treated, there are no specific drugs because the causes of both conditions are still unknown.
“That’s the main reason I wouldn’t order a test,” Azola said, citing the practice of testing for antibodies that may be present in long-term COVID-19 patients for latent virus. “There are currently no medications for chronic fatigue syndrome. There are medications that can help manage symptoms and improve quality of life, but they do not cure these conditions.”
Describing both conditions could be significant if, in the future, researchers can show that residual viruses in the body cause the disease and find ways to eradicate them, Goldstein said.
Many of Azola’s patients had been diagnosed with chronic fatigue syndrome due to infection with Epstein-Barr virus or H1N1 influenza virus before being infected with the new crown. After these patients were infected with the new crown, their symptoms of chronic fatigue syndrome became more severe, she said.
“They remembered the treatments that worked for them and learned how to pace themselves and avoid what I call the coronavirus roller coaster, where you move too much when you feel good and overwhelm your body for the next few days,” she said. Can identify with that and implement strategies that have worked for them before.”
Galliasatos of Johns Hopkins University hopes that the new year will see breakthroughs in the field of long-term new crowns, including a better understanding of long-term new crowns by the end of 2023, and the development of Special therapeutic drugs.
Stanford University is recruiting subjects for a study. The study is based on a theory similar to that of the October study, namely that the reservoir of SARS-CoV-2 virus left in the human body after acute infection with the new crown is the cause of the long-term new crown. The study will try to determine whether the antiviral drug ritonavir can reduce or eliminate viral reservoirs, thereby alleviating long-term symptoms of COVID-19.
“We’re slowly moving into the trial-therapeutic phase,” Azzola said. (Fortune Chinese Website)
Translated by: Liu Jinlong
Reviewer: Wang Hao
You had COVID a few months ago and recovered—but things still aren’t quite right.
When you stand up, you feel dizzy, and your heart races. Even routine tasks leave you feeling spent. And what was once a good night’s sleep no longer feels refreshing.
Long COVID, right? It may not be so simple.
A mild or even an asymptomatic case of COVID can cause reservoirs of some viruses you’ve previously battled to reactivate, potentially leading to symptoms of Chronic Fatigue Syndrome—a condition that resembles long COVID, according to a recent study published in the journals Internal Front Immunology.
Researchers found herpes viruses like Epstein-Barr, one of the drivers behind mono, circulating in unvaccinated patients who had experienced COVID. In patients with Chronic Fatigue Syndrome, antibody responses were stronger, signaling an immune system struggling to fight the virus
Such non-COVID pathogens have been named as likely culprits behind Chronic Fatigue Syndrome, also known as myalgic encephalomyelitis. The nebulous condition with no definitive cause leads to symptoms like fatigue, brain fog, dizziness when moving, and unrefreshing.
The symptoms of many long COVID patients could be described as Chronic Fatigue Syndrome, experts say. Researchers in the October study hypothesized that COVID sometimes leads to suppression of the immune system, allowing latent viruses reactivated by the stress of COVID to recirculate Symptoms that are common in Chronic Fatigue Syndrome and long COVID.
Thus, “long COVID” in some may not be an entirely new entity, but another post-viral illness—like ones seen in some patients after Ebola, the original SARS of 2003-2004, and other infections—that overlaps with Chronic Fatigue Syndrome .
As top US infectious disease expert Dr. Anthony Fauci said in 2020, long COVID may “very well might be a post-viral syndrome associated with COVID-19.”
‘We’re still not doing that’
It’s possible that COVID is reactivating latent viruses in at least a portion of long COVID patients, causing Chronic Fatigue Syndrome symptoms, Dr. Alba Miranda Azola, co-director of the long COVID clinic at Johns Hopkins University School of Medicine, told Fortune.
But her clinic doesn’t check for the reactivation of viruses in long COVID patients. She doesn’t think the possibility of such viruses causing symptoms in patients is worth giving those patients antivirals or antibiotics, which can lead to undesirable. side effect
“We don’t have enough evidence to support that treatment,” she said.
Other physicians who have prescribed such treatments for long COVID patients, and those patients didn’t see much improvement, Azola added. She recently asked an infectious disease colleague if it was standard practice to test for, and treat, latent viruses COVID patients in long .
“We’re still not doing that,” she recalled him saying.
Dr. Nir Goldstein, a pulmonologist at National Jewish Health in Denver, who runs the hospital’s long COVID clinic, said it’s not yet clear what role latent viruses play in the long COVID. That’s because the nascent condition is such a complex and varied disorder.
A consensus definition for long COVID hasn’t been universally agreed upon. Hundreds of possible symptoms have been identified, he points out—and no single explanation can account for them all.
“There may be an association, but it’s very hard to know the causation,” Goldstein said. “It could be the other way around—it could be that long COVID causes reactivation, not that reactivation causes long COVID.”
Dr. Panagis Galiasatos, an assistant professor at Johns Hopkins’ pulmonary and critical care division who treats long COVID patients, doesn’t routinely test his patients for latent viruses, given that most respond well to treatments that his clinic uses.
“If a patient doesn’t respond to treatment, maybe we’ll test for other things,” he said.
There is a strong possibility that COVID is weakening the immune systems of “a good deal of people,” Galiasatos added.
“I do think the immunodeficiency—when it’s there, it’s transient—allows those viruses to reemerge,” he said.
Scientists are still unsure if viruses like Epstein-Barr merely initiate Chronic Fatigue Syndrome or keep symptoms going, the October study points out. Similarly, researchers are still unsure what, if any, role latent viruses—including, 2-VRS-potentially, itself—play in the development of long COVID.
Few options, for now
With so little known about both long COVID and Chronic Fatigue Syndrome, it doesn’t really matter which a patient has, experts say—at least not right now. While the symptoms of both can be treated, there’s no specific drug for either because the cause—or causes—remain up in the air.
“It’s the main reason why I don’t even order the test,” Azola said of antibody tests for possible latent viruses in long COVID patients. “There’s no treatment targeting Chronic Fatigue Syndrome. There certainly are treatments that can help with symptom management and improve quality of life, but they’re not curative.”
Delineating the two conditions could matter in the future, Goldstein said, if researchers can prove that the conditions are caused by residual viruses and develop a way to eradicate them.
Azola has several patients who were diagnosed with Chronic Fatigue Syndrome before COVID, after Epstein-Barr virus or H1N1 flu infections. They caught COVID, and now their chronic fatigue symptoms are much worse, she says.
“They remember the things that worked for them before, learning how to pace themselves, staying out of what I call the corona-coaster—when they’re feeling good, doing a lot, then crashing for days,” she said. ‘re able to identify with that and implement strategies that have worked for them in the past.”
Galiasatos, from Johns Hopkins, hopes that the new year brings with it long COVID breakthroughs, including a deeper understanding of the condition and tailored treatments—potentially by the end of 2023.
Stanford University is recruiting for a study based on a theory similar to the one in the October study—that long COVID is caused by a lingering reservoir of the SARS-CoV-2 virus, which causes COVID, after acute infection. It will attempt to Determine if the antiviral drug Paxlovid alleviates long COVID symptoms by reducing or eliminating that viral reservoir.
“We’re starting to move into the trial-treatment phase slowly,” Azola said.
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