There’s hope for treating long covid

Anew study published recently in Science makes a compelling case that people with long covid have a chronic imbalance in their immune response. This is an important new piece to a vexing puzzle.

One of the challenges with diagnosing and treating long covid is the dozens of ways it can manifest: brain fog, extreme fatigue, shortness of breath, heart palpitations and headaches. Finding a common biomarker across people suggests a path to a diagnostic test, and could lead to new treatment strategies.

The virus has issued one of its regular reminders that it’s not going anywhere: Hospitalizations and deaths in the U.S. have been ticking up since early November, and wastewater data suggest the country is experiencing the biggest peak in cases in more than a year.

The most recent Centers for Disease Control and Prevention data showed that 8.8 million people in the U.S. were living with long covid in 2022; nearly 1,500 people died from it last year.

Scientists at the University of Zurich followed 113 people with covid over the course of a year to understand on a molecular level the differences between those that did and did not develop long covid. They found that people with long covid had elevated levels of proteins involved in the “complement” system, a part of our immune response that tags foreign microbes for disposal.

Typically, the complement system revs up when we’re exposed to a virus or bacteria and then relaxes when the threat is eliminated. During that resting state, it plays a key role in sweeping away dead or damaged cells.

But when that part of our immune response is constantly triggered, it can cause inflammation, cell and tissue damage, and, increased blood clotting—all symptoms found in people with long covid

The next step will be confirming the findings in a larger patient group. From there, a diagnostic company needs to develop a test for the proteins implicated in a dysregulated complement system.

The good news is that drugs that try to calm down an overactive complement system are already on the market and in development for other conditions.

At a recent Senate hearing, Rachel Beale, a long covid advocate, told lawmakers that she has been frustrated with the lack of progress in finding tests and treatments and made a plea for continued resources to push the science forward.

Three years into her condition, Beale has resigned herself to making peace with her situation, she said. “It makes me sad to think about my future. This may be as healthy as I get.”