Presence of Autoantibodies Most Predictive of Long COVID in Study

LHCS (also termed Post Acute Sequele of COVID-19, or PASC) is becoming more prevalent as the pandemic continues.

LHCS is an often debilitating syndrome characterized by a multitude of symptoms such as prolonged malaise, headaches, generalized fatigue, sleep difficulties, smell disorder, decreased appetite, painful joints, dyspnea, chest pain and cognitive dysfunction. The incidence of symptoms after COVID-19 varies from as low as 10% to as high as 80%. LHCS is not only seen after the COVID-19 infection but it is being observed in some people that have received vaccines (likely due to monocyte activation by the spike protein from the vaccine). A puzzling feature of the LHCS syndrome is that it is not predicted by initial disease severity. Post-COVID-19 frequently affects mild-to-moderate cases and younger adults that did not require respiratory support or intensive care.

Predicting LHCS is now possible following a recent deep molecular investigation into 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data and patient-reported symptoms.   The investigation found that the presence of autoantibodies in peripheral blood at initial diagnosis was the chief of four risk factors predicting if a patient would experience long COVID.

Other significant early predictors of prolonged COVID symptoms were having type 2 diabetes, SARS-CoV-2 RNAemia, and Epstein-Barr virus (EBV) viremia (where the virus enters the bloodstream and can access the rest of the body), Yapeng Su, PhD, of the Institute for Systems Biology (ISB) in Seattle, and colleagues wrote in their study.

Having EBV viremia suggested that latent EBV has been reactivated, the authors noted.

"The most important post-acute sequelae [that is conditions that are consequences of a disease] of COVID is the presence of autoantibodies," James R. Heath, PhD, president of ISB and a bioengineering professor at the University of Washington, Seattle, said in an interview. "It's about two times more important than the others."

Heath and co-authors said early detection of this and other variables could prompt earlier aggressive treatment in patients susceptible to long COVID and ward off lingering symptoms.

"These predictive measures of long COVID can also help to better inform patients of their possible disease course," study co-author Daniel G. Chen said in an interview. "We were also able to partially resolve the immunological underpinnings of some post-acute sequelae of COVID in a way that suggested potential therapies, and the timing of those therapies."

For example, he continued, the use of antivirals very early in the infectious course may mitigate the later development of long COVID. "This will, of course, have to be explored in an appropriately designed clinical trial.

"We also identified biomarkers of certain types of long COVID, such as neurological sequelae. Those biomarkers can help define the condition, which is a first step towards developing treatments."

Study Findings

With COVID patients monitored for 2 or 3 months, the study findings of the international "multiomic profiling" analysis include:

  • Subclinical patient autoantibodies that reduce anti–SARS-CoV-2 antibodies suggest there is immune dysregulation during COVID-19 infection.
  • Reactivation of latent other viruses during initial infection may be contributing to long COVID.
  • Gastrointestinal postacute sequelae of COVID presents with a unique postacute expansion of cytotoxic T cells.
  • SARS-CoV-2–specific and cytomegalovirus-specific CD8+ T cells displayed unique dynamics during recovery from infection.

So, what’s the good news?

The good news is that there are treatment options that can act as anti-inflammatories and can help with symptoms and recovery

  • High dose Omega 3 fatty acids
  • Vitamin D and C
  • Curcumin
  • Nigella Sativa
  • Melatonin
  • Kefir
  • Probiotic yoghurt and/or Bifidobacterium Probiotics together with Prebiotics
  • Quercetin

Talk to your pharmacist also about the role of anti-histamines for LCHS which may reduce mast cell activation.  Some doctors have also prescribed steroids and anti-viral medications with great success.



‘Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae’, Yapeng Su et al, Cell, Jan 2022