COVID doesn’t just infect you—it can reactivate a virus that’s been dormant in your body for years

You got COVID a few months ago and recovered—but things are still not going well.

When you stand up, you feel dizzy and your heart beats fast. Even routine tasks make you feel tired. And what was once a good night’s sleep no longer feels so refreshing.

Long COVID, right? It may not be that simple.

A mild or even asymptomatic case of COVID can cause reservoirs of certain viruses you’ve previously fought to reactivate, potentially leading to Fatigue Syndrome symptoms. chronic—a persistent COVID-like condition, according to a recent study published in a magazine Borders in Immunology.

Researchers have found herpes viruses like Epstein-Barr, one of the causes of mono, circulating in unvaccinated patients who have had COVID. In patients with Chronic Fatigue Syndrome, the antibody response is stronger, signaling the immune system is trying to fight the remaining viruses.

Such non-COVID pathogens have been implicated as the likely culprit in Chronic Fatigue Syndrome, also known as encephalitis. Ambiguity with no apparent cause leads to symptoms such as fatigue, brain fog, dizziness when moving, and poor sleep.

Experts say the symptoms of many persistent COVID patients could be described as Chronic Fatigue Syndrome. Researchers in the October study hypothesized that COVID sometimes leads to suppression of the immune system, allowing latent viruses to be reactivated by the stress of COVID to recirculate—the virus associated with symptoms common in Chronic Fatigue Syndrome and Persistent COVID.

Thus, “lasting COVID” in some people may not be an entirely new entity, but another post-viral illness — like those seen in some patients after Ebola, SARS 2003-2004 and other infections — overlaps with Chronic Fatigue Syndrome.

As America’s leading infectious disease expert, Dr. Anthony Fauci said in 2020Long-term COVID could be “most likely a post-viral syndrome associated with COVID-19.”

‘We haven’t done it yet’

Alba Miranda Azola, co-director of the long-term COVID clinic at Johns Hopkins University School of Medicine, said it’s possible that COVID is reactivating latent viruses in at least part of long-term COVID patients, causing symptoms. Symptoms of Chronic Fatigue Syndrome. Asset.

But her clinic does not test for viral reactivation in patients with longstanding COVID. 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 side effects. unexpected.

“We don’t have enough evidence to support that treatment,” she said.

Azola adds, other doctors have prescribed such treatments to patients with long-standing COVID, and those patients have not seen much improvement. She recently asked an infectious disease colleague whether testing and treating latent viruses in patients with long-standing COVID-19 would be the standard approach for testing and treatment.

“We haven’t done that yet,” she recalls him saying.

Dr Nir Goldstein, a pulmonologist at National Jewish Health in Denver who runs the hospital’s extended COVID clinic, said the role of the latent virus in persistent COVID is still unclear. That’s because the neonatal condition is a complex and diverse disorder.

A consensus definition for persistent COVID has not yet been agreed globally. He points out that hundreds of possible symptoms have been identified—and no one explanation can explain them all.

“There may be a connection, but it is difficult to know the cause,” Goldstein said. “It could be the other way around—maybe prolonged COVID causes reactivation, not reactivation causing persistent COVID.”

Panagis Galiasatos, assistant professor in the Johns Hopkins pulmonology and intensive care division who treats long-time COVID patients, doesn’t regularly test his patients for the latent virus, because most respond well to the treatments his clinic uses.

“If a patient doesn’t respond to treatment, maybe we’ll try other things,” he said.

Galiasatos added that there is a high chance that COVID is weakening the immune systems of “a lot of people”.

“I really think that immunodeficiency — when it’s there, it’s fleeting — allows those viruses to re-emerge,” he said.

The October study indicated that scientists are still uncertain whether viruses like Epstein-Barr simply initiate Chronic Fatigue Syndrome or cause symptoms to continue. Likewise, researchers are still uncertain what role latent viruses, if any, including SARS-CoV-2 itself, potentially itself, play in the development of the virus. prolonged development of COVID.

Few options, now

With so little known about both persistent COVID and Chronic Fatigue Syndrome, experts say it doesn’t really matter which patient has — at least not right now. While the symptoms of both can be treated, no specific medication because the cause — or causes — remains.

“That’s the main reason I don’t even order the test,” Azola said of antibody tests for potential viruses that may be present in patients with long-standing COVID. “There are no treatments that target Chronic Fatigue Syndrome. There are certainly treatments that can help control symptoms and improve quality of life, but they don’t cure the disease.”

Delineating the two conditions could be important in the future, says Goldstein, if researchers can demonstrate that the conditions are caused by residual virus and develop a way to eliminate them.

Azola has several patients diagnosed with Chronic Fatigue Syndrome before COVID, after infection with Epstein-Barr virus or H1N1 flu. She said they had contracted COVID and now their chronic fatigue symptoms are much worse.

“They remember what has worked for them before, learn to regulate their own pace, stay away from what I call a roller coaster — when they feel good, get things done,” she says. , then collapsed for days,” she said. “They can identify that and implement strategies that have worked for them in the past.”

Galiasatos, from Johns Hopkins, hopes that the new year will bring lasting breakthroughs in COVID, including a deeper understanding of the condition and appropriate treatments—likely by next year. end of 2023.

Stanford University is recruiting for a study based on a theory similar to the one in the October study—that persistent COVID is caused by a residual reservoir of the SARS-CoV-2 virus, which causes COVID, after an acute infection. It will attempt to determine if the antiviral drug Paxlovid alleviates persistent COVID symptoms by reducing or eliminating the reservoir of the virus.

“We’re slowly starting to transition into an experimental treatment,” Azola said.


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