A hyperactive inflammatory response could be the cause of many prolonged cases of Covid, according to a new study. Looking at proteins circulating in the blood, scientists from the Allen Institute and the Fred Hutchinson Cancer Center in the US found a set of molecules associated with inflammation that were only present in a subset of patients with long-term Covid and were not seen in those who recovered from their disease.
Of the 55 patients with long-term Covid, about two-thirds had persistently high levels of certain signals of inflammation. The researchers also looked at blood samples from 25 people who had Covid but recovered and from 25 volunteers who had never had Covid. Those without long Covid did not show the same signs of inflammation in the blood.
Scientists have seen previous links between inflammation and prolonged Covid, but the new study, published in the journal Nature Communications, is the first to track the persistence of these inflammatory markers over time in the same patients. The findings have obvious implications, said Troy Torgerson, director of experimental immunology at the Allen Institute for Immunology.
Some types of anti-inflammatory drugs can relieve symptoms in some long-term Covid patients. But doctors need a way to know how long Covid patients can benefit from which treatment. “The big question was, can we define which long-term Covid patients have persistent inflammation versus those who don’t? That would be useful in terms of planning clinical trials and in terms of helping clinicians find targeted treatments for their patients,” Torgerson said.
Specifically, blood markers discovered in this subset of patients with “prolonged inflammatory disease of Covid,” as the researchers call it, point to a flavor of inflammation similar to that seen in autoimmune diseases such as rheumatoid arthritis. This kind of inflammation can be treated with an existing class of drugs called JAK inhibitors, at least in rheumatoid arthritis (it hasn’t been tested for Covid for a long time yet.
The researchers also hope to narrow down their molecular signature of “inflammatory long Covid” to a few markers that could be used in the clinic to sort this subset of long Covid patients from the rest.
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