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      Early clues regarding the pathogenesis of long-COVID

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          Abstract

          Intense investigation into the predictors and determinants of post-acute sequelae of SARS-CoV-2 infection (PASC), including ‘long COVID’, is underway. Recent studies provide clues to the mechanisms that might drive this condition, with the goal of identifying host or virus factors that can be intervened upon to prevent or reverse PASC.

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          Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis

          Kjetil Bjornevik, Marianna Cortese, Brian C. Healy … (2022)
          Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. We tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses, including the similarly transmitted cytomegalovirus. Serum levels of neurofilament light chain, a biomarker of neuroaxonal degeneration, increased only after EBV seroconversion. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.
          Article 0 comments Cited 541 times – based on 0 reviews     Review now
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            Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae

            Yapeng Su, Dan Yuan, Daniel G. Chen … (2022)
            Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk-factors for PASC and their biological associations are poorly resolved. We executed a deep multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data, and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific autoantibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.
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              Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection

              Chansavath Phetsouphanh, David R. Darley, Daniel B. Wilson … (2022)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Trends Immunol
                Journal ID (iso-abbrev): Trends Immunol
                Title: Trends in Immunology
                Publisher: Elsevier Ltd.
                ISSN (Print): 1471-4906
                ISSN (Electronic): 1471-4981
                Publication date PMC-release: 8 March 2022
                Publication date (Electronic): 8 March 2022
                Affiliations
                [1 ]Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
                Author notes
                [* ]Correspondence: Steven Deeks, MD, 1001 Potero Ave., San Francisco, CA 94110
                Article
                Publisher Item ID: S1471-4906(22)00047-3
                DOI: 10.1016/j.it.2022.02.008
                PMC ID: 8901423
                PubMed ID: 35272932
                SO-VID: 72bb02e5-aea8-4fa4-adda-0d4b810ff340
                Copyright © © 2022 Elsevier Ltd. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                Subject: Spotlight

                ScienceOpen disciplines: Immunology
                Keywords: sars-cov-2,post-acute sequelae of sars-cov-2 (pasc),post-acute covid syndrome (pacs),long covid,immunology,pasc, post-acute sequelae of sars-cov-2 infection,pacs, post-acute covid syndrome,sars-cov-2, severe acute respiratory syndrome coronavirus 2,covid-19, coronavirus disease 2019,ebv, epstein-barr virus,ifn, interferon
                Data availability:
                ScienceOpen disciplines: Immunology
                Keywords: sars-cov-2, post-acute sequelae of sars-cov-2 (pasc), post-acute covid syndrome (pacs), long covid, immunology, pasc, post-acute sequelae of sars-cov-2 infection, pacs, post-acute covid syndrome, sars-cov-2, severe acute respiratory syndrome coronavirus 2, covid-19, coronavirus disease 2019, ebv, epstein-barr virus, ifn, interferon

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