CLEVELAND, Ohio—Scientists struggle to solve the mystery In the long run of Covid, it’s hard to ignore that most of the people who suffer from the disease are in common. Symptom – weak fatigue.
Researchers speculate up to 85% People with prolonged covid experience severe fatigue that makes them unable to perform or manage simple daily tasks. Even showering, report some patients, is simply too taxing.
What most people don’t realize is that, long before Covid, some patients reported similar symptoms of persistent, debilitating fatigue, brain fog, muscle aches and exercise intolerance following various illnesses, injuries or infections. These conditions are collectively called These include chronic diseases associated with infection and myalgic encephalomyelitis/chronic fatigue syndrome. But until recently, they were largely dismissed by the medical community, devoting few resources to understanding their causes.
Then came covid, and Science began to pay more attention.
“Over the past decade, most well-studied viral or bacterial pathogens have been linked to the development of chronic symptoms in a subset of infected patients.” he said. Amy ProalMicrobiologist at Polybio Research Foundation In a conversation with International Asylum Center. She cited syndromes caused by the Ebola, Zika and dengue viruses, including M/CFS. Long-term Covid is now believed to be the latest on that list, and patients and doctors hope that increased investment in understanding and treating long-term Covid will pay off for others with chronic illnesses after the infection.
“While the development of prolonged COVID is sometimes portrayed as novel or mysterious, it is actually a well-known phenomenon,” Proyal said.
The disease is often ignored
However, a 2015 report by the Institute of Medicine An estimated 836,000 to 2.5 million Americans suffer from myelgic encephalomyelitis/chronic fatigue syndrome, a disease that the community of doctors and researchers who study and treat, and many of their patients, had trouble taking seriously before the outbreak. Patients were informed of their symptoms. All in their heads, They may feel better if they are unmotivated or just start exercising more.
Part of the problem is the lack of medical education for the disease. Less than a third of medical schools include ME/CFS-specific information, and only 40% of medical textbooks include information about the condition. The IOM report continues: “There is a lack of awareness among health care providers about the diagnosis and treatment of the condition and doubts about whether it is actually a valid medical condition… Many providers believe it is a mental/psychiatric illness.” Or at least it has a psychological/psychological component. “
New virus, same disease?
For most of its history, ME/CFS lacked a clear definition and diagnostic criteria. There wasn’t just one coherent theory about what happened. The result was a lack of buy-in from the medical and scientific communities, financially tying the hands of researchers and impoverishing patients. To verify their authenticity Signs.
But the long-standing emergence of COVID has begun to change all that. Waves of people suddenly reporting similar symptoms and the scale of the problem quickly brought the urgency of a solution into sharp focus, prompting the US government to spend billions of dollars to understand the disease and develop potential treatments.
The many parallels between chronic covid and ME/CFS have led some to question whether chronic covid is simply another post-infectious fatigue, but for obvious reasons and millions of research cases.
For those who have devoted their lives to unraveling the mysteries of ME/CFS, this is a huge boon to research and an opportunity to finally uncover the biological causes that have so far been missed.
The most constructive thing to come out of a prolonged COVID is that a large investment in research will teach lessons that can be applied after a prolonged COVID to ME/CFS, other post-infectious and post-injury syndromes, and possibly beyond. he said. Long Covid researcher Anthony Komaroff, Harvard Medical School.
The immune system of the brain is damaged
According to Komaroff, there is now strong evidence that the flu-like symptoms of fatigue, muscle aches, brain fog and loss of appetite that are shared by ME/CFS and long-term covid patients are a heightened response in humans. Conserving energy during illness or injury.
“When we are infected or injured, our immune system is called into action to fight the infection and heal the injury. This takes a lot of energy, and your body only has so many energy molecules,” Komaroff said. Normally, this response is protective, but in chronic COVID or ME/CFS patients may continue to experience symptoms months or years after the infection is believed to be gone, he said.
Five years ago, Komaroff theorized that this so-called “fatigue response” was the result of the activity of a few, very tiny neurons “whose purpose in life is to produce symptoms when you’re sick.” He got sick,” he said.
These groups of neurons reside in a part of the brain called the hypothalamus and another region called the brainstem, which are areas that control sleep, mood and appetite. According to Komaroff, neurons sit in the brain until they are activated by pain or injury, producing this coordinated pain signal.
“It was a good theory, but until then there was no evidence A year or two ago,” Komaroff accepted.
But after that, four different papers were published in the journal Nature The latest In September, such clusters of neurons not only exist in the brains of mice, but can also be detected when they are stimulated. Produce symptoms.
Although he knows the findings are in mice, not humans, he is encouraged. “Most things we find true are a “The mouse brain, that’s true for humans,” Komaroff said. It’s only a matter of time before we can confirm.
The role of inflammation
But if Komaroff’s theory is correct, it also begs the question of why some people continue to experience these symptoms long after the infection has cleared. Why does the brain think it still needs to protect you if the infection is gone?
Komaroff believes inflammation has something to do with it.
“For example, if you have inflammation in the lining of your gut, we know that symptoms go up the vagus nerve to your brain and activate the brain’s immune system,” he said. “It basically means to the mind, there’s a risk elsewhere in the body and you have to prepare for it.”
What is unknown is the source of that swelling; As a result of the leftovers The covid virus is hidden in different tissues of the bodyBy activating other latent viruses such as Epstein-Barr or herpes, the natural balance of viruses and bacteria in the body is thrown from the inside and the immune system is producing inflammatory molecules even in the absence of threat.
It could be one or all of these things, Komaroff said.
“It’s unlikely that it’s exactly the same process in every person,” he said. “All these things are not only plausible, but possible.”
And that’s what makes understanding chronic COVID and ME/CFS so challenging right now. Researchers have identified Seven factors contribute to their growth, none of which are mutually exclusive;
“They’re all connected, and patients can have one or more issues at the same time,” Proal said. “…but we don’t think the same thing is happening to every patient.”
Researchers are searching for biomarkers that can be used to identify and diagnose patients with chronic COVID and ME/CFS, and different research groups are investigating different treatment options. Some are still offering antiviral treatments that target viral reservoirs that may be found in the body or brain. Others are developing treatments that can silence the immune system in the brain that triggers the fatigue response, Komaroff said.
It remains to be seen whether any of these treatments will improve symptoms. Those results are still months or years away, however Komaroff believes that answers will come.
“I have a lot of faith in him. “I really think you should be patient.”