The federal COVID-19 public health emergency recently ended, yet millions of people in the U.S. and globally continue to grapple with long COVID. Over 65 million individuals worldwide are estimated to have this condition, which triggers various symptoms following a SARS-CoV-2 infection. Despite three years since the onset of persistent symptoms, no definitive biomarker exists to diagnose long COVID.
Exploring Blood-Related Symptoms
Originally, COVID-19 was understood as primarily affecting the respiratory system. Resia Pretorius, a physiology professor at Stellenbosch University, noticed similar symptoms in the blood of COVID patients akin to those seen in diseases like diabetes and lupus following years of studying blood clotting patterns. “From sample one, severe clotting pathology was evident,” Pretorius states.
Working with collaborators, Pretorius initially focused on acute COVID blood effects before delving into long COVID blood analyses. The spike protein alters soluble clotting proteins into insoluble microclots, initiating the condition. While some individuals break down these microclots within weeks, others retain them, potentially damaging blood vessels and obstructing blood flow to organs.
Potential for a Long COVID Biomarker
Due to the absence of a reliable long COVID test, understanding and treating the disease is challenging. Pretorius highlights that clinicians often dismiss patients with normal standard blood tests, missing the underlying issues. Her collaboration aims to devise a better test for elevated microclots.
David Putrino from Mount Sinai Health System hopes the research extends beyond COVID, addressing other post-viral illnesses. “Standard blood panels capture a narrow scope of physiology,” Putrino explains. Their work shows how microclots and hyperactivated platelets interfere with bodily functions, emphasizing the need for mainstream testing.
All tested long COVID patients exhibit microclots and hyperactivated platelets, contrasting with those unaffected by COVID. Putrino envisions microclots as potential biomarkers, raising questions of treatment efficacy once detected.
Unique Challenges in Testing and Funding
Pretorius faces obstacles in devising clinical methods to detect unique proteins constituting long COVID clots. Crowdfunding funded the acquisition of a flow cytometer, necessary for transitioning from academic fluorescent microscopy to clinical methodologies. “Crowdfunding expedited research in desperate times,” she reveals.
Despite these advancements, Hannah Davis from the Patient Led Research Collaborative expresses concern over prolonged suffering. Having experienced long COVID since March 2020, Davis argues for substantial financial investment in biomarker research. “Patient advocacy should not replace essential funding,” she insists.
This article reflects collaborative efforts between scientists and patients in the pursuit of understanding and addressing long COVID. Listen to Short Wave for further insights on Spotify, Apple Podcasts, and Google Podcasts.