Feature in GMX Germany

September 23, 2022

Article originally published in German and has been translated below.

Rob spoke with Maria Berentzen of GMX.

Long Covid: It's being researched and these are the beacons of hope

There are first clues as to the mechanisms that trigger long covid and the associated exhaustion.
The hormone cortisol seems to play a special role as a biomarker for long covid.
Intensive research is being carried out into a wide variety of treatment options.

Intensive research is being carried out into Long Covid and treatment options. But those affected are still waiting in vain for a remedy that will cure the disease. Long Covid is not uncommon: The World Health Organization estimates that at least 17 million people in Europe are affected by Long Covid. The most common symptom is severe exhaustion. Long Covid, however, can manifest itself through a variety of symptoms, ranging from headaches, sleep disorders and concentration problems to paralysis. What is the current status of research?

Other viral diseases can also lead to severe exhaustion (fatigue). It occurs particularly in chronic fatigue syndrome (ME/CFS). Is there a link between ME/CFS and Long Covid?

"Indeed, striking similarities have been found between ME/CFS and Long Covid," says Dr. Rob Swanda . The American biochemist conducted research at Cornell University in New York and is working intensively on the corona pandemic and Long Covid. Even with chronic fatigue syndrome, those affected are still waiting in vain for effective treatment.

What exactly is known about this?

Mitochondrial impairment is known to occur in ME/CFS. These can be referred to simply as the energy power plants of the cells and they play an important role in the body's energy metabolism. "With ME/CFS, the mitochondria in our cells don't work as efficiently and produce less energy," says the expert. Researchers assume that this explains the chronic fatigue. "This link is also being studied in Long Covid." A number of studies have been published to date. "But more research is urgently needed."

Is there actually enough research on Long Covid?

There are now a number of studies on Long Covid. However, they are often not representative because they only include the data of a few people affected. Long Covid is a relatively new topic for research. "It is imperative that we study this disease with large and representative data to unveil the unknowns and find treatments for the millions affected," said Dr. Rob Swanda. In order to really understand what Long Covid does in the body, the cooperation of different disciplines is required. In addition, more money must be made available to enable more intensive research, says Swanda. The World Health Organization also requires this.

What is known about biomarkers involved in Long Covid?

There are first indications of important biomarkers: "We now know that the cortisol level is low in Long Covid," says Swanda. The body releases this hormone at a certain rhythm throughout the day. Cortisol levels are highest early in the morning. "The hormone is closely linked to inflammation and immune responses," says the expert. "When cortisol levels aren't balanced, the inflammatory and immune responses aren't balanced either."

A study on this was recently published. Low cortisol levels were measured in all of the people with Long Covid who were examined. In addition, dormant viruses were activated in some of the patients examined. These were varicella-zoster viruses and Epstein-Barr viruses, which can cause herpes infections and glandular fever. This can make those affected even weaker.

What are the current treatment options?

There is currently no treatment for Long Covid whose effectiveness has been officially tested and confirmed. "Several small studies have been done to find out what can relieve the symptoms," says Swanda. For example, steroids, anticoagulants and dietary supplements were used. So far, however, there has been no resounding success. "Therefore, further research is absolutely necessary," says Swanda.

The US project Recover is currently the most heavily funded research project with 1.15 billion dollars. However, progress is slow. So far there is at least some evidence, but no effective treatment. In addition, Long Covid can cause a variety of very different symptoms in addition to the very severe exhaustion that many of those affected suffer from. According to Swanda, an additional challenge will therefore be to match the respective treatment as precisely as possible to the individual symptoms.

What about the German hopeful BC 007?

In Germany, there has recently been a lot of talk about the active ingredient BC 007. It was supposed to be used against heart disease - but there is evidence that it can also reduce the symptoms of Long Covid. In the eye clinic of the University Hospital Erlangen, it was given to a long-Covid patient by infusion. As a result, the Long Covid symptoms he was suffering from went away. These included tiredness, loss of taste and poor concentration. However, clinical studies are needed to find out whether the drug is actually suitable for treating Long Covid. It will probably take some time before more is known about this.

About the expert:

Dr. Rob Swanda is a biochemist of Cornell University in New York. He conducts intensive research on mRNA and cell metabolism. He has also dealt intensively with mRNA vaccines against the corona virus , the pandemic itself and Long Covid. He also regularly publishes tweets on his Twitter account.

Sources used:

World Health Organization: At least 17 million people in the WHO European Region experienced long COVID in the first two years of the pandemic; millions may have to live with it for years to come