COVID Long-Haul predicted by 4 factors (Epstein-Barr virus, etc)
Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae
Cell January 24, 2022DOI:https://doi.org/10.1016/j.cell.2022.01.014
Highlights
Longitudinal multiomics associate PASC with autoantibodies, viremia and comorbidities
Reactivation of latent viruses during initial infection may contribute to PASC
Subclinical autoantibodies negatively correlate with anti-SARS-CoV-2 antibodies
Gastrointestinal PASC uniquely present with post-acute expansion of cytotoxic T cells
T1 = clinical diagnosis;
T2 = acute disease;
T3 =2-3 months post onset of initial symptoms
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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Su, Y., Yuan, D., Chen, D.G., Ng, R.H., Wang, K., Choi, J., Li, S., Hong, S., Zhang, R., Xie, J., Kornilov, S.A., Scherler, K., Pavlovitch-Bedzyk, A.J., Dong, S., Lausted, C., Lee, I., Fallen, S., Dai, C.L., Baloni, P., Smith, B., Duvvuri, V.R., Anderson, K.G., Li, J., Yang, F., Duncombe,
C.J., McCulloch, D.J., Rostomily, C., Troisch, P., Zhou, J., Mackay, S., DeGottardi, Q., May, D.H, Taniguchi, R., Gittelman, R.M, Klinger, M., Snyder, T.M, Roper, R., Wojciechowska, G., Murray, K., Edmark, R., Evans, S., Jones, L., Zhou, Y., Rowen, L., Liu, R., Chour, W., Algren, H.A, Berrington, W.R., Wallick, J.A., Cochran, R.A., Micikas, M.E., the ISB-Swedish COVID19 Biobanking Unit, Terri Wrin, Petropoulos, C.J., Cole, H.R., Fischer, T.D., Wei, W., Hoon, D.S.B., Price, N.D., Subramanian, N., Hill, J.A, Hadlock, J., Magis, A.T., Ribas, A., Lanier, L.L., Boyd, S.D., Bluestone, J.A., Chu, H., Hood, L., Gottardo, R., Greenberg, P.D., Davis, M.M., Goldman, J.D., Heath, J.R
VitaminDWiki titles with LONG-HAUL (16 as of Jan 2022)
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VitaminDWiki titles with EPSTEIN or EBV (13 as of Jan 2022 )
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Study was reported in the New York Times
New Research Hints at 4 Factors That May Increase Chances of Long Covid
"Still, Dr. Deeks said: “They’ve identified these four major factors. Each is biologically plausible, consistent with theories that other people are pursuing, and importantly, each is actionable. If these pathways get confirmed, we as clinicians can actually design interventions to make people better. That is the take-home message.”
"Of patients reporting three or more symptoms, 95 percent had one or more of the four biological factors identified in the study when they were diagnosed with Covid-19, Dr. Heath said."
"The most influential factor appeared to be autoantibodies, which were associated with two-thirds of the cases of long Covid, Dr. Heath said. Each of the other three factors showed up in about a third of the cases, he said, and there was considerable overlap, with several factors identified in some patients."
"That some patients had reactivated Epstein-Barr virus also made sense, Dr. Nath said, because other diseases have reawakened that virus, and its reactivation has been linked to conditions like chronic fatigue syndrome, which some cases of long Covid resemble, and multiple sclerosis. Dr. Deeks said it might be possible to give antivirals or immunotherapy to patients with reactivated Epstein-Barr virus.""
Study was reported in WSJ - Jan 31, 2022
The New Clues About Who Will Develop Long Covid
Another study found 5 COVID symptoms predicted Long-Haul - Jan 2022
Immunoglobulin signature predicts risk of post-acute COVID-19 syndrome