Can vaccines be the biggest barrier to protection against protracted COVID?

Together, scientists around the world have developed strategies to attack the so-called Long COVID or Prolonged COVID, this debilitating disease that leaves patients struggling with symptoms for several months after being infected with the SARS-COV-2 virus. The main symptoms that persist after illness are mental confusion, permanent fatigue, and difficulty breathing, among others.

Although there are still no effective drugs, studies are underway to try to mitigate this spread of disease caused by the new coronavirus. Among the most advanced are one by UK scientists seeking to administer monthly doses of COVID-19 vaccines to chronically ill patients.

The trial is led by David Strain, Senior Clinical Professor, University of Exeter School of Medicine, and is based on a preliminary study which showed that after vaccination, symptoms decreased.

Last Friday, those funding the study gave the green light to the trial, which is due to end at the end of this year. In this course, the 40 participants suffering from prolonged COVID-19 will receive at least two more inoculations, said Strain Al Mail on Sunday.

If the results of this trial are satisfactory, scientists they will be able to advance in the recruitment of thousands of additional patients, for a new stage of research.

“Many saw dramatic improvement a few days after his jab. Their fatigue disappeared, they were able to walk more without feeling short of breath. Some said it was the closest to normal they had felt since first catching COVID-19. In a previous study, we saw that it lasted about a month after the first dose, but then the symptoms returned. The same pattern was seen when people tried their second jab. We want to know if, over time, offering regular doses can make this change permanent “, explained the scientist.

Experts believe about one in ten people who contract COVID-19 will suffer from prolonged symptoms such as shortness of breath, muscle pain, and problems with thinking and concentrating, known as brain fog. According to the Office for National Statistics, nearly 400,000 Britons they say they have been showing symptoms since they contracted the virus around the start of the pandemic.

Despite this, the exact causes and processes that allow most to fully recover from infection are still unknown, while others are not. An article published in the medical journal The Lancet in May, written by Strainand Ondine Sherwood of the LongCovidSOS campaign group, who interviewed more than 900 long-term patients said more than half saw their symptoms improve after receiving their first dose of the vaccine, and there was a particularly strong response in patients who received the Pfizer or Moderna drugs. However, patients noted that the positive change was temporary and only lasted a few weeks.

“The plan would be to recruit patients whose symptoms are so severe that their lives are severely limited by the disease. Those, for example, who cannot go to work or cook their children’s breakfast in the morning because they are feeling very tired, ”explained Strain. Volunteers will receive one vaccine and the following month another.

This British trial will be the first in the world to use a COVID-19 vaccine for purposes other than protecting people from the virus itself.

Preliminary tests carried out in the United Kingdom contrasted with the responses of the majority of those consulted in a survey carried out in Spain of people who suffer from long-term COVID and have been vaccinated. The results of the investigation into the effects of coronavirus vaccination on people affected by persistent COVID-19, launched by the Spanish Society of General Practitioners and Family Physicians (SEMG) and the group of affected COVID Long Acts, have pointed out that the majority of these affected (55%) did not improve or feel the same after vaccination against COVID-19. However, more than half of the cases showed no effect and 18% got worse (which may be due to possible side effects of the inoculant or worsening of their symptoms) and the remainder, 26% of participants, reflected that it improved with certain doses of the vaccine.

At the XXVII National Congress of General and Family Medicine held in June, the preliminary results of the survey, collected later in a statement, on people who had the disease more than 4 weeks ago, but continuing along with the symptoms, were presented.

The UK study will divide the patients into two groups, the first of which will consist of patients who have been hospitalized with severe symptoms and who could possibly have suffered severe damage to vital organs such as the lungs or heart.

The other group will be the one that causes the most confusion among physicians, since these are patients whose disease was initially mild, but then persisted or even worsened. These patients make up the majority of people with long-term COVID.

Regarding the causes of prolonged COVID, Danny Altmann, Immunologist at Imperial College London, said that “there is still no real consensus on what is behind it” and that there are several theories, one of which indicates that the symptoms are caused by reservoirs of the virus that remain in some areas of the body after infection.

“What we may be seeing is that the inoculations give the immune system an extra boost, allowing it to reach the pockets of the body where the virus has been hiding,” he explained.

The other theory indicates that the virus would destabilize the immune system, as some studies suggest that COVIDD-19 could affect the mitochondria, the powerhouse of cells that provides them with energy. Experts say it can cause the immune system to malfunction and attack healthy cells. Similar mitochondrial dysfunction has been observed in patients with chronic fatigue syndrome, which shares many symptoms with prolonged Covid.

For Strain, this is the most plausible theory and he argues that vaccines, even temporarily, turn off this overactive immune response. “It is possible that by focusing the immune system on the act of developing COVID-19 antibodies, it could restore failed cells. It is like shutting down a bad computer in the socket and restarting it ”.

Regarding the shortage of vaccines that already exist to protect people from contracting the disease, the scientist noted: “Once new vaccines are created, there will no longer be a need for the original vaccines, which were designed with initial variant of COVID-19 listen to it. These will be the vaccines that we will use in the trials. “

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The survey was conducted from March 23 to June 6. It was answered by 273 participants coming mainly from Madrid (25.3%), the Basque Country (12.5%) and Aragon (12.1%), followed by Catalonia (11.7%), Andalusia (10.3 %) and the Valencian Community (8.4%).

Another demographic of interest was median age, between 30 and 60 years, although the other age groups between 18 and 22 years, and those over 70 years, 84.2% (230) consist of women, coinciding with the profile of those affected by the persistent COVID-19 of the previous one survey carried out in 2020 by the SEMG on the persistent symptoms of COVID-19 and disability, with 1,834 participants, including 79% of women, with an average age of 43 years.

Majority healthcare professional profile

Regarding the professional profile of this survey, the majority (67%) are made up of the healthcare professionals group, a pioneer in vaccination and very exposed to contagion in the first wave due to the lack of personal protective equipment; currently 96% (262) of those surveyed continue to have persistent symptoms. Of these 262 patients, the majority were infected in March 2020 (53.1%: 139 people) and October (12.2%: 32 people), coinciding with the start of the two strongest waves of the pandemic (March -April and October-November). ).

Another data, in agreement with the participating health population, indicates that the most commonly administered vaccines were messenger RNA from Pfizer (69.9%), Moderna (15.1%) and only 12.8% from AstraZeneca.

Temporary or long-lasting effect?

From the study, it emerges that in a certain percentage of patients the vaccine may improve, however, “Much knowledge is lacking in relation to COVID-19 and especially in relation to persistent COVID-19, and we cannot yet say that the improvements or worsening observed after vaccination are permanent or simply temporary.”.

With information from Medscape

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