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BBC News: Long Covid blood clues could prompt future trials

People with long Covid have evidence of continuing inflammation in their blood, which could help understanding of the condition and how it may be treated, a UK study suggests.

By Philippa Roxby

Extracts

The UK's largest long Covid study, led by Imperial College London, followed up 650 hospital patients with severe Covid. Six months later, 426 said they still had at least one long Covid symptom while 233 had completely recovered.

And those with long Covid showed evidence of a continuing and active pattern of inflammatory proteins in their blood. The researchers said the presence of these chemicals in the blood, which are usually a sign of the body fighting off infection, was unusual when the initial infection occurred so long before…

The researchers behind the study, in Nature Immunology, also found some proteins in the blood of those with long Covid could be linked to their specific symptoms. For example, those with gastrointestinal symptoms had increased levels of a marker called SCG3, previously linked to impaired communication between the gut and the brain.

This could help divide Long Covid patients into different sub-groups and be useful for designing clinical trials, especially for treatments targeting immune responses and inflammation, the researchers said. Imperial College London clinical-research fellow Dr Felicity Liew said the findings suggested inflammation “could be a common feature of long Covid after hospitalisation, regardless of symptom type”.

The researchers will continue to look for the signs of inflammation as the symptoms improve and disappear, as they do for most people with long Covid. Dr Liew said she hoped the study would also lead to identification of new treatments for the long-lasting symptoms of other illnesses found to affect people in the same way.

University of Edinburgh honorary professor of immunology and infectious disease Prof Eleanor Riley said the data “should usher in a series of clinical trials for treatment of long Covid” using several licensed drugs targeting inflammation. She said the study findings opened up new avenues for the investigation of the very poorly understood myalgic encephalomyelitis, or chronic fatigue syndrome, (ME/CFS), because many of the symptoms appeared to overlap.

ME Association Comment

“This new research into the role of the immune system in Long Covid provides further evidence of low level inflammation and a link to ME/CFS – where this type of immune system research has also found evidence of low level inflammation.

“Professor Eleanor Riley, who has been involved with the UK ME/CFS Biobank research into immune system dysfunction in ME/CFS, is spot on when she says that these findings should now be used as a basis to assess the use of anti-inflammatory drugs in both Long Covid and ME/CFS.

“A small number of clinical trials of anti-inflammatory drugs have been carried out in ME/CFS with negative findings. However, these trials were not of a very high standard. They are summarised and referenced in the ME Association ME/CFS/PVFS Clinical & Research Guide  (also known as the ‘Purple Book').”

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.

Dr Charles Shepherd

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