As millions of people recover from COVID-19, an unanswered question is the extent to which the virus can “hide” in supposedly recovered people. If so, can some of the persistent symptoms of COVID-19 be or pose a threat of transmission?infection to others even after recovery?
I am a physician-scientist of infectious diseases at the University of Virginia, where I treat inflamed patients and conduct studies on COVID-19. Here I will briefly review what is known about chronic or persistent COVID-19.
Chronic or persistent infection continues for months or even years, during which time the virus occurs frequently, although in many cases at low levels. Often these infections occur in a privileged immune site.
There are a few positions within the framework that are less available for the immune formula and where it is difficult to eliminate all viral infections. These come with the formula of the central nervous system, testicles and eyes. It’s the evolutionary merit of having a loved one. The immune region is that it protects a brain, such as from breaking through inflammation that occurs when the immune formula fights an infection.
An immune system that he likes is not only complicated for the immune formula to penetrate, but also limits the proteins that accumulate inflammation. testicles The result is a complicated truce where inflammation is limited but the infection continues to worsen.
But there’s a way for a virus to hide in the frame and reappear later.
A latent viral infection occurs when the virus is provided on an inflamed but asleep mobile and does not multiply; In a latent virus, the entire viral genome is provided and an infectious virus can occur if latency ceases and infections are triggered. in the human genome, such as HIV, for example, or exist in the nucleus in the form of a self-replicative DNA fragment called episoma.
A latent virus can reactivate and produce infectious viruses, and this can happen months or decades after the initial infection. Perhaps the most productive example is chickenpox, which, supposedly eliminated through the immune system, can reactivate and cause shingles decades later. and shingles is now prevented by vaccination. Being inflamed with a virus capable of generating a latent infection is being inflamed for the rest of your life.
Latent infection (left) occurs when a cell phone is inflamed and the virus has inserted its genetic code into our human DNA. The immune formula stumbles upon this cell phone as if it were inflamed. HIV infection can go from dormant to active if the inflamed mobile produces new viruses.
Herpes viruses go through the most common viral infections that identify latency.
It is a giant circle of virus relatives whose genetic material, or genome, is encoded through DNA (not RNA like the new coronavirus). Herpes viruses come with not only herpes simplex viruses 1 and 2, which cause oral and genital herpes, but also chickenpox. Other herpes viruses, such as the epstein Barr virus, which causes mononucleosis, and cytomegalovirus, which is a specific challenge in immunodeficient people, can also arise after latency.
Retroviruses are some other non-unusual circle of virus relatives that identify latency through a different mechanism than herpes virus. Retroviruses like HIV, which causes AIDS, can insert a copy of their genome into human DNA that is a component of the human genome. , the virus can exist indefinitely in a latent state in inflamed humans, since the virus genome is copied at the moment when DNA replicates and a cell divides.
Viruses that identify latency in humans are difficult or highly unlikely to eliminate for the immune system; in fact, latency, there would possibly be little or no viral protein production in the inflamed cell, making the infection invisible to the immune system. do not identify a latent infection.
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In a small study, the new coronavirus was detected in semen in a quarter of patients for an active infection and in just under 10% of patients who allegedly recovered. In this study, viral RNA was detected, and it is not yet known whether this RNA came from viruses that were still infectious or died in semen; and if he’s alive, if the virus can be transmitted sexually. There are so many unanswered vital questions.
Ebola is a very different virus from SARS-C0V-2, but serves as an example of viral patience at immune sites. In some people, Ebola survives in privileged immune sites for months after acute disease is resolved. Ebola survivors have been documented to have persistent infections. testicles, eyes, placenta and central nervous system.
WHO recommends that surviving Ebola males review the virus every 3 months. They also recommend that couples refrain from having sex for 12 months after recovery or until their sperm is twice as negative for Ebola. As noted above, we want to know more about new persistent coronavirus infections before we can similar recommendations.
COVID-19 recovery is delayed or incomplete in many people, with symptoms such as coughing, shortness of breath and fatigue. These constitutional symptoms are unlikely to be caused by viral patience because the symptoms don’t come from immune sites they like.
Other sites where a coronavirus has been detected are the placenta, intestines, blood, and, of course, the airways. In women who have a COVID-19 pregnancy, the placenta develops abnormalities in the mother’s blood vessels that feed the placenta; however, its importance in the fetus. fitness remains to be determined.
The new coronavirus can also infect the fetus in the placenta. Finally, the new coronavirus is also provided in the blood, hollow nasal space and palate up to a month or more after infection.
There is evidence in development to recommend that SARS-CoV-2 can infect similar immune sites and, from there, cause persistent, but not latent, chronic infections. It is too early to know the extent to which these persistent infections affect a person’s health, such as the pregnant mother, or to what extent they contribute to the spread of COVID-19.
Like many things in the pandemic, what is unknown today is known tomorrow, so stay vigilant and be careful not to get the infection or, worse, pass it on to others.
William Petri, Professor of Medicine, University of Virginia
This article has been republished from The Conversation, a Creative Commons license. Read the original article.
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