NEW YORK — Individuals suffering from long COVID exhibit abnormal hormone and immune system responses, according to a new study. This discovery is enabling doctors to more easily detect and treat long COVID cases by identifying the specific abnormalities that might increase a person’s susceptibility to this lingering condition.
Physicians from the Mount Sinai Health System in New York developed an algorithm that can identify long COVID with 96 percent accuracy. The blood of long COVID patients showed immunity and hormonal dysfunctions distinct from the general population, highlighted by atypical T-cell activity.
The condition also seemed to reactivate several dormant viruses, including Epstein-Barr and other herpes viruses. Additionally, these patients exhibited reduced cortisol levels, a hormone associated with stress.
“These findings are important—they can inform more sensitive testing for long COVID patients and personalized treatments for long COVID that have, until now, not had a proven scientific rationale,” says Principal Investigator David Putrino, PhD, Director of the Abilities Research Center at Icahn Mount Sinai, in a media release.
“This work is so exciting because it is one of the first to show us clear, measurable differences in blood biomarkers of people with long COVID compared with people who recovered fully from an acute infection and a group of people who have never been infected with SARS-CoV-2 (the virus that causes COVID-19). This is a decisive step forward in the development of valid and reliable blood testing protocols for long COVID.”
“These findings show us that people with long COVID are living with a disease process that is observable using the blood testing protocols laid out in the study, but also varies from patient to patient depending on their specific medical history,” says Dr. Putrino.
“This means that physicians must listen to their patients and perform a wide variety of physiological and lab tests, while adopting a highly personalized approach to the medical management of long COVID. There is no ‘silver bullet’ for treating long COVID, because it is an illness that infiltrates complex systems such as the immune and hormonal regulation. Complex illnesses require complex treatment solutions and we need more rapid research to better understand long COVID and discover new and promising therapies.”
In 2020, a team from the Mount Sinai Health System first recognized long COVID symptoms when patients reported lingering issues even after the virus had cleared. These symptoms encompassed cognitive impairment (often referred to as “brain fog“), extreme fatigue, shortness of breath, and chronic pain.
According to the Centers for Disease Control and Prevention, one in 13 U.S. adults experienced long COVID symptoms lasting more than three months post-infection. For their recent study, Mount Sinai clinicians examined 271 patients from The Mount Sinai Hospital, Mount Sinai Union Square, and Yale School of Medicine between January 2021 and June 2022.
These participants were categorized into three groups: those who never contracted COVID, those who had recovered from the virus, and those displaying active long COVID symptoms for a minimum of four months post-infection.
On average, patients in the last group exhibited long COVID symptoms for about 12 months after their initial infection. All participants had to fill out questionnaires detailing their symptoms, medical histories, and quality of life.
The team also collected blood samples from every participant. Clinicians then identified and compared blood markers across the groups. Subsequently, they deployed machine learning algorithms (a branch of AI) to discern which biomarkers the algorithm could reliably associate with long COVID.
“We are excited to see such clear differences in the immune phenotypes in people with and without long COVID. These markers need to be validated in larger studies, but provide a first step in dissecting the disease pathogenesis of long COVID,” adds co-Principal Investigator Akiko Iwasaki, PhD, the Sterling Professor of Immunobiology and of Molecular, Cellular & Developmental Biology at Yale School of Medicine.
Long COVID has 7 persistent symptoms
COVID researchers have been studying long COVID for almost as long as the viral itself. While some teams have identified more than 200 symptoms with a link to long COVID, one study argues there are typically only seven which patients persistently experience for weeks, months, and possibly years.
The seven long COVID symptoms are:
- Rapid heartbeat
- Hair loss
- Chest pain
- Joint pain
- Shortness of breath
“Despite an overwhelming number of long COVID symptoms previously reported by other studies, we only found a few symptoms specifically related to an infection from SARS-CoV-2, the virus that causes COVID-19,” says corresponding author Chi-Ren Shyu, director of the MU Institute for Data Science and Informatics, in a university release.
South West News Service writer Pol Allingham contributed to this report.