A constellation of persisting symptoms thought to accompany 10 to 20 per cent of infections, Long Covid is known to affect nearly every organ system in our bodies – and there remains no universally established treatment or cure. Photo / 123RF
A constellation of persisting symptoms thought to accompany 10 to 20 per cent of infections, Long Covid is known to affect nearly every organ system in our bodies – and there remains no universally established treatment or cure. Photo / 123RF
Nearly four years into the pandemic, leading researchers say we remain troublingly far from understanding one of its most worrying legacies: Long Covid.
Ahead of a major conference kicking off today, they’ve issued another urgent call for funding for more research focused on a condition expected to becomea significant health burden in New Zealand.
A constellation of persisting symptoms thought to accompany 10 to 20 per cent of infections, Long Covid is known to affect nearly every organ system in our bodies – and there remains no universally established treatment or cure.
That’s despite efforts by scientists around the world to unravel its root causes.
Dr Martin Kraeter, a research fellow at Germany’s Max Planck Institute and a visiting speaker at the Australasian Cytometry Society’s Queenstown conference, suspected the answer might be found within our cells.
Back in his Erlangen laboratory, Kraeter and colleagues have been analysing cells as they flow through the bloodstreams of Covid-19 patients.
“We’ve seen in patients with Covid-19 and Long Covid that they have lots of red blood cells that don’t deform properly anymore,” he told the Herald.
“That means they can’t take up oxygen and makes the blood more sticky - or more like honey than water – and we’re still seeing this in some of the patients in our study cohort, long after they’ve recovered from the primary disease.”
The virus-triggered problems his group observed in blood flow might help explain metabolic symptoms like fatigue that come with Long Covid, along with many others – yet the picture remains extraordinarily complex.
Of a range of current hypotheses scientists have for Long Covid, most involve the immune system going haywire, leaving people with a frighteningly wide spectrum of ongoing symptoms.
“As far as the illness is concerned, we now know that the virus can cause disruption to our immune, neurological, nervous and metabolic systems,” conference convenor and leading University of Auckland immunologist Dr Anna Brooks said.
“Symptoms can vary greatly between individuals impacted. However, the most commonly reported are neurological, metabolic or related to the nervous system, including autopilot functions, breathing, heart rate, blood pressure and digestion.”
Its driving mechanisms possibly included dormant viruses in our bodies being “reactivated” through a loss of immune control or dysfunction, or the virus lingering in the body for prolonged periods.
Another was Covid-19 damaging the nervous system, blood cells and the powerhouse mitochondria which produce energy within all our cells.
“Research just published has indeed shown that Sars-CoV-2 can disrupt mitochondria, and this perhaps might be the leading cause of fatigue and exertion intolerance,” Brooks said.
An important, elegant study pinpointing mitochondrial dysfunction in the heart, kidney, liver & lymph nodes after #SARSCoV2 exposure and its clearance in 2 experimental models and peoplehttps://t.co/OPGVtDAlGk Sets up potential for #LongCovid treatment that needs to be assessed pic.twitter.com/CdbCRlB7o8
Another study, published in leading journal Nature, showed that even two years after infection with the virus, people could be left with Long Covid-related conditions like lung problems, blood clots, fatigue and digestive disorders.
In New Zealand, as many as one in five participants in a recent study reported Long Covid symptoms after their initial infection - yet because the condition wasn’t formally tracked here, it was unclear just how many Kiwis were living with it right now.
“The best way to get a handle on the burden would have been to use the systems we had in place, such as the Covid tracking system, to log or self-identify ongoing symptoms beyond three months,” Brooks said.
“Although not perfect, it would’ve at least allowed us to better understand the impacts.”
Otherwise, she said, we could only turn to data reported by clinicians, at a time many Long Covid patients were still struggling to get help, despite guidelines introduced for doctors last year.
“I’ve had feedback from people who’ve had to shop around for doctors willing to make a diagnosis, and some have given up trying,” she said.
“Now that there’ll be no consistent protections in place at healthcare facilities, those suffering from Long Covid will be even less likely to seek medical care, due to the risks.”
Brooks added that, unlike Australia and other countries, there’d been no Government funding for researching the biomedical impacts of infection in New Zealand, which was likely to have a unique profile.
Dr Martin Kraeter, of Germany’s Max Planck Institute, is visiting New Zealand for a Queenstown conference. He’s pictured with fellow Long Covid researcher and immunologist Dr Anna Brooks at her University of Auckland laboratory.
To date, she said, most of that work had been crowd-funded.
“Our research is focused on characterising immune dysfunction, with the aim of developing diagnostic tools to enable clinical diagnoses and therapeutic targets,” she said.
“Already, we’ve established a number of international collaborations to fast-track this work, but the lack of funding to follow up on promising leads, at the pace required, is frustrating.
“And this work isn’t merely researching - we are chasing down every possible lead and connecting up with international researchers wherever possible.”
Meanwhile, she said Covid-19 should be treated as a virus to be concerned about, with regular awareness campaigns.
“It’s disappointing, however, that vulnerable people have ultimately been left behind,” she said.
“I’d hope to see healthcare providers realise this and implement measures to reassure vulnerable patients that seeking medical care will not put them at risk.”
In June, the charitable group ME Support made its own call for more action from the Government.
That included more funding for research and support groups, and a review to measure the scale of the burden, investigate barriers and enable more training for clinicians.
Dr Martin Chadwick, the Ministry of Health’s first chief allied health professions officer, acknowledged Long Covid was “understandably distressing” for those who develop it.
Along with creating new guidelines, the Government had introduced clinical codes and funded two studies into Long Covid’s impact here, he said.
“Currently, the best pathway for people with Long Covid to access care is as they would for other chronic conditions, through their GP, who can refer them on to specialist care if required,” he said.
“Because Long Covid can present with a wider variety of symptoms, the specialist care required will vary from patient to patient.”
Jamie Morton, a specialist in science and environmental reporting for the New Zealand Herald, has spent the last decade writing about everything from conservation and cosmology to climate change and Covid-19.
