A new paper in Oxford Open Immunology, published by Oxford University Press, examines previous findings in the field of neuroimmunology suggesting possible treatment strategies for patients with long-term symptoms of COVID-19.
Although COVID-19 was originally thought to be a short-term illness lasting anywhere from one to three weeks, it is clear that significant numbers of patients will experience symptoms beyond that, with some patients suffering from health problems for more than 12 weeks. In fact, more than 80% of patients originally admitted to the hospital reported at least one symptom that persisted beyond the first month.
The symptoms of Long COVID can vary widely, including coughing, mild fever, fatigue, chest pain, shortness of breath, headache, cognitive difficulties, muscle pain and weakness, gastrointestinal discomfort, rashes, metabolic disorders, depression and other mental illnesses. In the context of other disorders and syndromes, these symptoms appear to be strongly related to a challenge to the immune system. Even mild infections and inflammations can lead to depression or prolonged fatigue.
Since a number of causes have been suggested to explain the persistence of these long-term COVID symptoms – from the presence of persistently low viral load and reinfection, to changes in immune cell activity and tissue damage caused by the initial infection – the researchers here examined findings in the Obtained from several large-scale studies in recent decades on chronic fatigue syndrome, fibromyalgia, depression and other mental disorders exhibiting immune abnormalities.
Researchers at King’s College London argue here that several possible avenues might be relevant to understand the persistence of long-COVID, such as glial cell involvement and the permeability of the blood-brain barrier. They also suggest strategies for treating the symptoms. Some of the symptoms of COVID, depression, and other mental health problems are related to chronic, highly inflammatory conditions. Therefore, current treatment strategies for patients with depression include anti-inflammatory drugs. Psychosocial factors are also very important in regulating our immune activation. It is clear that strategies to combat a patient’s stress levels with increased social support, exercise, and an adapted diet can also be helpful in treating long-term symptoms associated with COVID-19.
“We propose to leverage what we have learned over the years about communication between the brain and the immune system and the contribution of the immune system to the development of symptoms of long COVID in other conditions,” said the head of the paper, author Valeria Mondelli. “This will likely accelerate our understanding of the mechanisms underlying Long COVID and the identification of effective treatments.”
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