Scientists from the University of Arkansas for Medical Sciences (UAMS) have identified a potential cause of the long-lasting symptoms of COVID-19. Those who experience these symptoms are known as COVID long haulers. The study was published in the journal, The Public Library of Science ONE (PLOS ONE).
The study was led by Dr. John Arthur M.D., professor and chief of the Division of Nephrology in the UAMS College of Medicine, Department of Internal Medicine. At the core of the team’s research was a discovery of a particular antibody that shows up in the weeks following a COVID-19 infection. The antibody, according to Arthur, was responsible for “attacking and disrupting a key regulator of the immune system.
What Do We Know About COVID Long Haulers?
Also known as long COVID, COVID long haulers are people who experience lasting health effects following a COVID-19 infection. These health effects are present long after the infection has left the body. This means if tested, a person with long COVID would test negative for the virus, but could still be severely impacted by other health conditions.
Nearly 30% of people who become infected with COVID-19 will experience symptoms of long COVID. These symptoms can range from fatigue and brain fog to shortness of breath and other respiratory problems. Other common symptoms experienced by COVID long haulers include extreme tiredness, muscle or joint pain, and problems with memory and concentration.
Some COVID long haulers experience symptoms that were not previously associated with the virus, which has made the phenomenon even more worrisome. This, combined with the potential link between COVID and Alzheimer’s, has made understanding long COVID a top priority.
Currently, there is no known cure for COVID long haulers. That said, all is not lost when it comes to fighting long COVID. Recent data suggests that nearly half of people with long COVID have reported an improvement in their symptoms after being vaccinated. Vaccines also provide individuals with extremely high protection against COVID-19, which can help prevent long COVID in the first place.
To date, the cause of COVID long haulers has not been identified. However, the discovery by Arthur and his team at UMAS helps sheds important new light on the molecular-level mechanisms behind it.
Has UMAS Found The Cause of COVID Long Haulers?
The antibody observed by the UMAS team was found to attack a specific enzyme known as the angiotensin-converting enzyme 2 (ACE2). ACE2 is an enzyme attached to the membrane of cells located in the intestines, kidneys, testis, gallbladder, and heart. The ACE2 enzyme helps regulate the body’s response to the virus by metabolizing a peptide that activates the immune system. The antibody that was found to attack ACE2 interferes with its work, which Arthur believes to be the “prime suspect” in the cause of COVID long haulers.
“Everything that we’ve found is consistent with this antibody as the instigator of long COVID, so it’s an exciting development that merits further study,” Arthur said.
“If we show that the whole hypothesis is right, that this interference of ACE2 really does cause long COVID, then it opens up many potential treatments,”
Researchers tested plasma from 67 patients with known COVID-19 infection and 13 with no known history of infection. The goal was to look for the presence of ACE2 antibodies to see if there was any correlation between those with COVID and those with ACE2. In 81% of blood samples from patients in Arkansas and Oklahoma with a history of COVID-19, the samples had the antibody that attacked the ACE2.In participants with no history of COVID-19, no antibodies were created to attack the ACE2 enzyme.
“If we show that the whole hypothesis is right, that this interference of ACE2 really does cause long COVID, then it opens up many potential treatments,” Arthur said. “If our next steps confirm that this antibody is the cause of long COVID symptoms, there are medications that should work to treat them. If we get to that phase of research, the next step would be to test these drugs and hopefully relieve people of the symptoms they’re having.”
About the Study
The research team was developed quickly over the spring of 2021 by the UMAS Translational Research Institute. The goal behind the initial research group was to test the hypothesis that developed between Arthur and a fellow professor Dr.Terry Harville. Harville is a professor with the Department of Pathology and medical director of the Histocompatibility and Immunogenetics Laboratories. Together, Arthur and Harville discussed the possibility of ACE2 as the potential cause of COVID long haulers.
Along with Arthur and Harville, three other researchers, Karl Boehme, Ph.D., Craig Forrest, Ph.D., and Shana Owens, Ph.D., were credited with the creation of the test used in the study. Their departments are the Department of Microbiology and Immunology respectively.
The team also includes College of Medicine researchers Christian Herzog, Ph.D., Department of Internal Medicine; Josh Kennedy, M.D., Department of Pediatrics; and Juan Liu, Ph.D., from the Department of Pathology.
“This is true team science,” Arthur said. “We put together a great group of investigators that had never worked together to produce these very exciting results.”
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