Long Covid discovery reveals it’s actually five different illnesses – and could lead to a cure

By Staff 7 Min Read

Imperial College London-led research sheds light on what is causing Long Covid symptoms as scientists insist ‘people aren’t imagining this’

Scientists have started to unlock the mysteries of Long Covid – and have identified five different forms of the illness.

British researchers have shed light on why, in some people who caught the Covid-19 virus, the immune system continues to attack itself and cause debilitating fatigue and brain fog. The team led by Imperial College London tracked 660 hospitalised Covid patients and detected telltale proteins in blood samples that indicate what is happening to the body.

The most in depth ever study of the little-understood syndrome indicates some existing drugs for conditions such as arthritis could work against Long Covid – and will now become the focus of new human trials.

Lead investigator Prof Peter Openshaw, of Imperial, said: “People aren’t imagining this. It is something which is genuinely happening to them. With one in ten infections leading to Long Covid and an estimated 65 million people around the world suffering from ongoing symptoms, we urgently need more research to understand this condition. At the moment, it’s very hard to diagnose and treat. This study, which includes detailed clinical data on symptoms and a raft of inflammatory blood plasma markers, is an important step forward and provides crucial insights into what causes Long Covid.”

Around two million Brits are thought to suffer with lasting Covid symptoms. The new study, published in the journal Nature Immunology, suggests that in some sufferers a small amount of the virus remains and cannot be cleared. This triggers ongoing inflammation throughout the body which leads to exhaustion and other symptoms.

In a second subtype of Long Covid the study suggests the initial infection reactivates another pre-existing virus that had been lying dormant in the body, such as herpes or the Epstein-Barr virus. In a third group of patients Covid-19 triggers an autoimmune illness where the body’s natural defence system malfunctions and continues to attack healthy tissues. A fourth subtype was caused by thrombosis where blood clotting occurs throughout the circulatory system. A fifth subtype called ‘vascular dysfunction’ sees the normal relaxation and contraction of blood vessels malfunctions.

Researchers stress these five subtypes are not mutually exclusive and patients can experience a combined form of Long Covid. All are linked to the main Long Covid symptoms of fatigue, brain fog, anxiety and depression, reduced lung function and stomach problems.

Licensed drugs already target some of these mechanisms which researchers say should now be tested on Long Covid patients in new trials. They include drugs called IL-1 antagonists, such as anakinra, which is commonly used to treat rheumatoid arthritis, as well as another drug class called JAK inhibitors, used to treat severe rheumatoid arthritis and some cancers.

Professor Openshaw said: “Covid-19 will continue to have far reaching effects long after the initial infection has passed, impacting many lives. Understanding what’s happening in the body, and how the immune system responds, is key to helping those affected.

“This work provides strong evidence that Long Covid is caused by post-viral inflammation but shows layers of complexity. We hope that our work opens the way to the development of specific tests and treatments for the various types of Long Covid and believe that a ‘one size fits all’ approach to treatment may not work.”

The mystery syndrome affects as many as one in ten people who catch Covid-19 and is placing a huge burden on the NHS. The Mirror has previously reported how Long Covid sufferers have lost their jobs and been left destitute due to debilitating symptoms including crippling fatigue and dementia-like brain fog.

NHS England estimates that around 400,000 Long Covid sufferers have significant disability and would benefit from specialist care at Long Covid clinics. Lack of capacity means that only a fraction of this patient population are accessing it.

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