Scientists at Brigham and Women’s Hospital and Massachusetts General Hospital have discovered that the presence of the SARS-CoV-2 spike protein in plasma could be a hallmark of long COVID. These results show that the virus can persist in the body of patients suffering from prolonged symptoms.
The data, published in June on the medRxiv prepress server, revealed that of the 37 participating patients with persistent symptoms, 65% had detectable levels of viral antigens in their plasma samples. The most common of these was the tip protein, which was detected in 60% of all long COVID models. Meanwhile, spike protein was absent in the plasma of patients who did not experience prolonged symptoms of COVID-19.
The study included a total of 63 patients who had recovered from COVID-19. To look for long biomarkers associated with long COVID, blood samples were collected at least twice during the year after each participant’s first positive hyssop test. Findings have yet to be reviewed in pairs.
Long COVID-19, more technically called post-acute sequelae of COVID-19, refers to symptoms that persist, recur, or appear months after the patient has eliminated the initial infection. These symptoms are very varied, ranging from persistent tiredness or cough to diarrhea, rashes and alterations in a woman’s menstrual cycle. In some cases, long COVID may even manifest as depression and anxiety or cognitive problems such as brain fog.
Although anyone infected with coronavirus can have long-term COVID, those with a serious illness, as well as unvaccinated patients, may have a much higher risk. As such, the U.S. Centers for Disease Control and Prevention points to immunization as an effective way to prevent post-acute symptoms.
To work in conjunction with coronavirus vaccinations, several companies are developing drugs to target different long-term symptoms of COVID-19. The clinical biotechnology company Axcella Health has an ongoing Phase IIa study to evaluate its long-term COXID candidate AXA1125. In preclinical studies, the Axella candidate showed promise in reducing markers of insulin resistance, inflammation, and fibrosis. Preliminary data from clinical trials are expected to arrive by the end of the year.
He joins Axcella PureTech of Boston, which opted for its LYT-100-VOC (deupirfenidone), an anti-inflammatory and antifibrotic agent, for the treatment of persistent respiratory symptoms after COVID-19. However, the company announced last month that its candidate had not reached the main goal of Phase II and could not demonstrate a significant benefit over placebo. LYT-100 has not been developed for a long time and has been devoted exclusively to idiopathic pulmonary fibrosis.
In addition, a recent trial has found that thromboprophylaxis, using mainly Johnson & Johnson Xarelto (rivaroxaban), can significantly reduce the incidence of fatal venous thromboembolism, cardiovascular death, and other cardiac complications after recovery from COVID-19. The drug was also largely safe for this indication, as it did not cause bleeding episodes and only caused allergic reactions in 1% of receptors.
Takeda’s Trintellix (vortioxetine), a known antidepressant, is also being tested as a treatment for post-COVID-19 cognitive problems. The Phase II randomized, double-blind, placebo-controlled trial is expected to enroll about 200 participants and quantitatively assess cognitive function by testing the digit symbol substation. The study is expected to be completed by the end of the year.
Also in Phase II assessments are Genentech Esbriet (pirfenidone), which is being tested for pulmonary fibrosis after COVID-19. With about 150 patients, the trial will compare the test drug with a placebo and compare the induced changes in forced vital capacity and pulmonary fibrosis. The study was expected to be completed last month, although no data are available.