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Long-COVID can hide in the body for years in scores of locations – Sept 2023

SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)

Nature Immunology Sept 2023 https://doi.org/10.1038/s41590-023-01601-2
Amy D. Proal, Michael B. VanElzakker, Soo Aleman, Katie Bach, Brittany P. Boribong, Marcus Buggert, Sara Cherry, Daniel S. Chertow, Helen E. Davies, Christopher L. Dupont, Steven G. Deeks, William Eimer, E. Wesley Ely, Alessio Fasano, Marcelo Freire, Linda N. Geng, Diane E. Griffin, Timothy J. Henrich, Akiko Iwasaki, David Izquierdo-Garcia, Michela Locci, Saurabh Mehandru, Mark M. Painter, Michael J. Peluso, …E. John Wherry

Table of Contents


Millions of people are suffering from Long COVID or post-acute sequelae of COVID-19 (PASC). Several biological factors have emerged as potential drivers of PASC pathology. Some individuals with PASC may not fully clear the coronavirus SARS-CoV-2 after acute infection. Instead, replicating virus and/or viral RNA—potentially capable of being translated to produce viral proteins—persist in tissue as a ‘reservoir’. This reservoir could modulate host immune responses or release viral proteins into the circulation. Here we review studies that have identified SARS-CoV-2 RNA/protein or immune responses indicative of a SARS-CoV-2 reservoir in PASC samples. Mechanisms by which a SARS-CoV-2 reservoir may contribute to PASC pathology, including coagulation, microbiome and neuroimmune abnormalities, are delineated. We identify research priorities to guide the further study of a SARS-CoV-2 reservoir in PASC, with the goal that clinical trials of antivirals or other therapeutics with potential to clear a SARS-CoV-2 reservoir are accelerated.

Locations in the body


Research suggesions

Major areas of opportunity for research into a SARS-CoV-2 reservoir in PASC

  • Which PASC cell and tissue types harbor SARS-CoV-2 RNA or protein?
    • Is there a preference for persistence in certain cell or tissue types?
  • Is SARS-CoV-2 RNA identified in PASC samples transcriptionally active, translating, replicating or infectious?
  • Is the presence of a SARS-CoV-2 reservoir sufficient to drive PASC symptoms?
    • Are SARS-CoV-2 RNA and proteins also identified in samples collected from post-COVID-19 individuals without PASC?
    • If yes, what factors differentiate SARS-CoV-2 persistence in PASC from persistence in asymptomatic individuals?
  • Do particular classes of symptoms tend to be driven by the location of the reservoir—for example, dyspnea from a lung reservoir or gastrointestinal symptoms from a gut reservoir?
  • Do measurements of SARS-CoV-2 protein or antibody responses in body fluids correlate with SARS-COV-2 persistence in tissue?
  • Can the transcriptional program of circulating immune cells be used as a biosensor of SARS-CoV-2 persistence in tissue?
  • Does T cell exhaustion correlate with SARS-CoV-2 persistence in PASC?
  • Are neutralizing antibody responses qualitatively different in patients with PASC?
  • By what mechanisms can SARS-CoV-2 evade immune detection?
    • Do such mechanisms differ by cell or tissue type, or by viral variant?
    • Do viral mutations and selection contribute to persistence?
  • Can the spike protein travel via EVs into the bloodstream?
  • Does a SARS-CoV-2 reservoir or protein contribute to fibrin/ amyloid microclotting, platelet activation or related vasculature issues in PASC?
  • Does a SARS-CoV-2 reservoir in PASC correlate with the reactivation of other pathogens such as herpesviruses?
  • Does a SARS-CoV-2 reservoir in PASC correlate with changes in human endogenous retrovirus activity?
  • Can a SARS-CoV-2 reservoir alter the local transcriptome or epigenome?
  • Does a SARS-CoV-2 reservoir in PASC correlate with the disruption of microbiome composition or activity?
    • If so, is disruption a cause or consequence of PASC?
  • Is a SARS-CoV-2 reservoir associated with host epithelial barrier breakdown in PASC?
    • Does this facilitate the translocation viral protein or bacterial/fungal organisms into blood?
  • Can SARS-CoV-2 persistence or the reactivation of other latent pathogens lead to cross-reactive antibody responses in PASC blood or tissue?

 Download the PDF from VitaminDWiki

VitaminDWiki - Long-COVID is now the biggest COVID concern - many studies

60+ VitaminDWiki pages have LONG-HAUL or LONG-COVID in the title

Items found: 60
Title Modified
Long COVID with Neuro-Cognitive symptoms had especially low vitamin D levels – Sept 2023 19 Sep, 2023
The ONLY Solution to Long COVID (Vitamin D) - video and transcript Sept 2023 12 Sep, 2023
Long-COVID can hide in the body for years in scores of locations – Sept 2023 09 Sep, 2023
One in five people with long COVID can no longer work (Doctors in this case) - Sept 2023 02 Sep, 2023
Number of people with long COVID could be vastly underestimated - Aug 2023 01 Sep, 2023
Long-COVID associated with 37 poor genes (no Vitamin D genes) – July 2023 03 Aug, 2023
COVID, Long-COVID and Vitamin D in children - Review April 2023 09 Jul, 2023
Fasting may reduce inflammation and long-COVID - June 2023 11 Jun, 2023
The US believes you have long-COVID if you have more than 12 points (no treatment yet) - May 2023 25 May, 2023
COVID, Long COVID, and Vitamin D – May 2023 06 May, 2023
2nd COVID infection increases the risk of Long-COVID - 2022 22 Jan, 2023
Vitamin D might also help the Long-COVID older adult – Jan 2023 07 Jan, 2023
Long-COVID fatigue reduced by Vitamin C and l-Arginine in one month– RCT Nov 2022 24 Nov, 2022
Adrenal, Long-COVID and Vitamin D - several studies 31 Oct, 2022
Long Covid, Short Magnesium - Chambers April 2022 30 Oct, 2022
Fatigue and other long-haul problems appear to be associated with low Magnesium - Chambers Oct 2022 30 Oct, 2022
Long-COVID symptoms in 10 Percent of women 3 months after infection (22 countries) – Oct 2022 29 Oct, 2022
Long-COVID is now the biggest COVID concern - many studies 16 Oct, 2022
Epstein-Barr Virus probably causes Long-COVID, CFS, and MS - many studies 02 Oct, 2022
Anti-oxidants and Long-Covid (Mg, Glutamate, Butyrate, etc) – Sept 2022 02 Oct, 2022
Chronic Fatigue Syndrome and long-haul COVID-19 26 Sep, 2022
Over Two Million Americans Aren’t Working Due to Long-COVID - Aug 2022 27 Aug, 2022
Long-COVID: often had not been hospitalized - May 2022 25 Aug, 2022
COVID virus persists in most body tissues (Long-COVID) - 2022 23 Aug, 2022
Long-COVID in VitaminDWiki 16 Aug, 2022
LONG-COVID may be permanent in 1 in 200 of people infected – July 2022 06 Aug, 2022
Long-Haul more prevalent among seniors - June - 2022 26 Jun, 2022
Long-Haul can now be claimed a work disability in the UK – June 2022 24 Jun, 2022
Half as much Long-Haul with Omicron - June 2022 19 Jun, 2022
Half as much Long-Haul with Omicron - June 2022 19 Jun, 2022
COVID Spike persists in Long Haul - June 2022 18 Jun, 2022
COVID Long-Haul prevalence increases with time: 50% at 4 months - meta June 2022 17 Jun, 2022
COVID and Magnesium - hypothesis, clinical trials, Long-Haul - Oct 2021 10 Jun, 2022
Mass disabling events: Polio, WWII, HIV, and COVID Long-Haul - June 2022 06 Jun, 2022
1 in 5 Americans who got COVID had Long-Haul for a while - CDC May 2022 27 May, 2022
Long-Haul COVID after 3 months – only 5 percent had even 30 ng of Vitamin D – April 2022 04 May, 2022
Hypothesis: 2 long-haul COVIDs: had mild symptoms and had needed ICU - April 2022 15 Apr, 2022
COVID Long-Haul at 49 weeks: overactive immune system, type O blood - March 2022 07 Apr, 2022
Children have less severe COVID, but just as much long-haul as adults - April 2022 06 Apr, 2022
Dietary Recommendations for COVID Long-Haul – March 2022 20 Mar, 2022
Mild Long-Haul 4.2 X more likely if type O blood - preprint March 16, 2022 20 Mar, 2022
Long-Haul COVID is somewhat less of a problem if vaccinated – Nov 2021 18 Mar, 2022
COVID long-haul: 1 million in US too sick to work, many cannot get compensation - March 2021 09 Mar, 2022
COVID Long-Haul NYT - Feb 2022 19 Feb, 2022
COVID Long-Haul fought by probiotics - Jan 2022 29 Jan, 2022
COVID Long-Haul predicted by 4 factors (Epstein-Barr virus, etc) – Jan 24, 2022 26 Jan, 2022
Some COVID-19 infection become COVID Long-Haul - Nov 2020 15 Dec, 2021
Long-haul after breakthrough COVID – Nov 2021 11 Dec, 2021
Long-haul, VAERS, Ivermectin, vaccines, etc. Drs. Seheult, Patrick: Video with table of contents - Sept 17, 2021 21 Sep, 2021
Your Brain on Covid-19 Long-Haul, Dr. Galland video and transcript - Aug 1, 2021 07 Aug, 2021
Long-haul COVID-19 blood tests at Mayo include vitamin D (but no results published) – July 2021 20 Jul, 2021
Most people with Long-Haul COVID-19 have low Vitamin D – July 2021 15 Jul, 2021
‘Long haul’ COVID rehab worse than cancer rehab, CDC – July 2021 13 Jul, 2021
Long-Haul COVID-19 occurred to 1 in 20 who had been asymptomatic (a study of 2 million with COVID-19) – June 2021 15 Jun, 2021
COVID-19 Long haul - excellent graph - systematic review May 26, 2021 26 May, 2021
COVID-19 vaccines look good in the short term, but probably not good for the long term 29 Apr, 2021
Long-haul COVID-19 - another hint that Vitamin D should help - Dec 2020 16 Apr, 2021
Probably fewer long-haul COVID-19 problems when rejuvenated immune system (Vitamin D, etc.)– Dec 2020 21 Feb, 2021
Long-haul fatigue, etc. common after viral infections (SARS1,2, MERS, Swine, 1918,...) 21 Feb, 2021
Long-distance truck drivers more likely to get COVID-19 (perhaps UVA)- July 2020 12 Aug, 2020

VitaminDWiki comment: Virus protects itself by turning off the Vitamin D Receptor - which can be easily turned back on

VitaminDWiki - 33 studies in both categories Virus and Vitamin D Receptor

This list is automatically updated

VitaminDWiki - Vitamin D Receptor activation can be increased in 14 ways

Resveratrol,  Omega-3,  MagnesiumZinc,   Quercetin,   non-daily Vit D,  Curcumin, intense exercise, Butyrate   Ginger,   Essential oils, etc  Note: The founder of VitaminDWiki uses 10 of the 14 known VDR activators

Attached files

ID Name Comment Uploaded Size Downloads
20080 Reservoir locations.jpg admin 09 Sep, 2023 18:00 204.78 Kb 63
20079 Reservoir ToC.jpg admin 09 Sep, 2023 18:00 53.83 Kb 53
20078 SARS-CoV-2 reservoir_CompressPdf.pdf PDF 2023 admin 09 Sep, 2023 18:00 312.98 Kb 24