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Grace Browne
Three years later, pandemic mania turned into a rumbling hum. We go back to sweating each other in nightclubs, spitting out birthday candles and sharing company handshakes. mostly, thanks to vaccines and treatments.
The same cannot be said for the long covid, the mysterious life-limiting disease that persists after a first covid infection. treat patients,” says Linda Geng, co-director of the Post-Acute Covid-19 Syndrome Clinic at Stanford University. The same as the French population.
Only now, more than 3 years after the pandemic, has a consensus begun to take hold on how long covid will last. And it turns out that what it is is a lot of things. It is most likely a collection of diseases that fall under a giant umbrella. This means that there will also be no one-size-fits-all treatment.
What triggers covid for a long time for you may not be what triggers it for another. Maybe your long covid is because your immune formula becomes opposite to you, attacking your system, a phenomenon called autoimmunity. That’s a theory. Or the virus fragments remain in your body long after the initial infection, causing your immune formula engine to be depleted. Another theory is that SARS-CoV-2 causes lasting damage to certain organs or tissues. It is possible for a Covid infection to awaken latent viruses. that its framework has already found, such as the Epstein-Barr virus, that it causes mononucleosis.
All of those theories have supporting evidence, and possibly wouldn’t be mutually exclusive; For some people, those things can also happen at the same time. The idea that for a long time Covid has other reasons can also help the wide variety of symptoms, which can succeed in 200.
On this basis, researchers seek to kill two birds with one stone: to test remedies that can mitigate the long Covid while giving weight to certain hypotheses, and to begin to perform the puzzling condition. “The truth is that there is such an emergency, we have to do those things in parallel,” Geng says. “It’s about building the boat while we’re sailing it, but we have to sail it because other people want help. “
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But the jumble of symptoms makes designing clinical trials that much more challenging. Not everyone else revels in all symptoms, and these can vary in severity and duration. Also, there’s no consensus on how to delineate for long Covid, says Steven Deeks, a physician and infectious disease specialist at the University of California, San Francisco. “There’s no magic biomarker, there’s no X-rays, there’s no testing. “For this reason, it is difficult to know who to involve in a clinical trial. Current and prolonged diagnoses of covid pictures through exclusion: discovering that symptoms cannot be explained through cause. However, researchers are making progress.
Akiko Iwasaki, an immunologist at Yale University, has been conducting a long-standing randomized controlled trial of 100 covid patients to determine whether Pfizer’s antiviral drug, Paxlovid, designed to treat symptomatic covid, can really help treat covid for a long time. — a theory that has anecdotes from patients. The rationale for the trial is based on the viral reservoir hypothesis: that Paxlovid can eliminate all persistent remnants of SARS-CoV-2 that were controlled to persist despite the body’s immune response.
Iwasaki already knows that Paxlovid wouldn’t possibly help everyone, but the test will shed light on the other people he can only help. Because the test is randomized, the team hopes it will naturally come with other people whose long Covid is triggered through other biological mechanisms. Patients will be divided into organizations, one organization will receive Paxlovid for 15 days and the other will receive a placebo.
Researchers will be on the lookout for immune signatures carried by other people with long-standing covid, such as depleted T cells or circulating SARS-CoV-2 spike proteins. Iwasaki and his team plan to measure immunological biomarkers before, during and after treatment. And read about which biomarkers were not unusual for other people who felt better after treatment. “It’s not just about what percentage of other people will benefit,” Iwasaki says. work. “
Other ongoing trials focus on mechanisms of choice. Some researchers are reading low doses of naltrexone, a drug used to treat opioid addiction, which can treat prolonged covid by hindering inflammation in the picture. In the United Kingdom, a trial called Stimulate-ICP plans to use a blood thinner called rivaroxaban to treat microclots. In the blood, as some claim, they cause prolonged Covid by blocking the source of oxygen to form tissues.
According to Amitava Banerjee, professor of clinical information science at University College London who is leading the Stimulate-ICP trial, the study is ongoing and has recruited about 500 people, the researchers hope to recruit at least a few thousand. Banerjee says the drugs being tested probably don’t deal with the underlying mechanisms of long covid, but rather the mechanisms of the main symptoms: They treat microclots, not their causes.
Iwasaki hopes that if his team is successful, their studies can also shed light on other long-neglected chronic diseases. “and other similar diseases,” says Iwasaki.
What is very important is that for a long time Covid does not run the fate of many other chronic diseases and ends up being very neglected, sometimes partly due to the very complexity of discovering its root causes. lives, we can’t the long Covid, says Geng. ” There are still many, many, many other people who are suffering, can’t work, can’t live their lives in general. “
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