Can long COVID be crushed?

Alex Eben Meyer

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There are many lingering fears about the COVID-19 pandemic, and at the top of the list is the fear that those infected may never fully recover from the virus. But Akiko Iwasaki—Sterling Professor of Immunobiology and Molecular, Cellular and Developmental Biology—and her colleagues have unearthed clues about the unique biology of long COVID. Those clues might help them to eradicate the virus.

People experiencing long COVID may have a range of symptoms, including weakness, fatigue, breathing difficulties, and “brain fog.” These symptoms can last months or even longer. Currently, there are no proven treatments or cures, despite the millions who report having the condition.

Iwasaki and her group studied data from 275 volunteers in New Haven and New York City, of which 152 had long COVID. Participants in each group were similar in regard to sex breakdown (female-male), but those with long COVID were, on average, older than those without. And the researchers also found key biological characteristics among those whose COVID symptoms never abated.

In particular, they found changes in some immune cells—cells that fight diseases in our bodies. For example, the long COVID group had higher levels of total non-conventional monocytes, which play an important role in chronic inflammation and autoimmunity. They also found that COVID long-haulers had lower levels of cortisol, a hormone tied to stress, blood pressure, and the immune system. (The findings appeared in the September edition of Nature.)

“What I am really excited by is ongoing research to look at randomized clinical trials coupled with biological analyses,” says Iwasaki. She and her group will study potential treatments, seek to fully understand the biological underpinnings of the disease, and use mouse models and other approaches to find out how and why long COVID impacts the human body. They will pursue the work with collaborators such as Yale’s Harlan Krumholz ’80, the Harold H. Hines, Jr. Professor of Medicine and principal investigator of the Paxlovid trial for long COVID.