SARS-CoV-2 persistent infection in the news

[mellowtigger]

There was lots of SARS-CoV-2 news during recent days, all related to persistent infection. These first few items lay out a progression of events, from immune system infection to bone marrow problems. (You may recognize that same story from the last pandemic of infection to persistence cured only by tinkering with the bone marrow, where T cells are a kind of lymphocyte which are a kind of peripheral blood mononuclear cell (PBHC), which is mentioned in today's articles.) It's followed by long term problems including viral shedding. It's scarce evidence, but it matches what I've already pointed out over these years of the new pandemic.

Read the tedious points and see the links...

1. "T4 apoptosis in the acute phase of SARS-CoV-2 infection predicts long COVID",
   https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1335352/full
   
   "Our observation raises the hypothesis that T4 cell death during the acute phase of SARS-CoV-2 infection might pave the way for long COVID. Mechanistically, T4 lymphopenia might favor phenomena that could cause sequelae, including SARS-CoV-2 persistence, reactivation of other viruses, autoimmunity and immune dysregulation."
2. "Altered mitochondrial respiration in peripheral blood mononuclear cells of post-acute sequelae of SARS-CoV-2 infection",
   https://www.sciencedirect.com/science/article/pii/S1567724924000072
   
   "Peripheral blood mononuclear cells (PBMC) mitochondrial respiration was measured ex vivo from participants... Mitochondrial dysfunction in PBMCs may be contributing to the etiology of PASC."
3. "Blood transcriptomics reveal persistent SARS-CoV-2 RNA and candidate biomarkers in Long COVID patients",
   https://www.medrxiv.org/content/10.1101/2024.01.14.24301293v1
   
   "We demonstrate systemic SARS-CoV-2 persistence for more than 2 years after acute COVID-19 infection. A 2-gene biomarker, including FYN and SARS-CoV-2 antisense RNA, correctly classifies Long COVID with 93.8% sensitivity and 91.7% specificity. Specific immune transcripts and immunometabolism score correlate to systemic viral load and patient-reported anxiety/depression, providing mechanistic links as well as therapeutic targets to tackle Long COVID."
4. "Chronic shedding of a SARS-CoV-2 Alpha variant in wastewater",
   https://link.springer.com/article/10.1186/s12864-024-09977-7
   
   "These data also suggest that humans and other animals can chronically shed SARS-CoV-2 over many months, which is associated with accumulation of adaptive mutations. Mutations associated with chronic infection may be useful to identify individuals who are chronically infected and to drive selection of appropriate therapeutics."

More important than all of those articles, however, is this one. This is the one to bookmark. This is the one to share. Doctors are finally putting their reputations on the line, stating unequivocally that persistence is real, even though we can't yet be sure how commonplace it is. This piece is a long and well-annotated "Personal View" (aka opinion) article in The Lancet about SARS-CoV-2 persistence. With this article now online, maybe there's no longer any need for sars2.org?

5. "Persistent SARS-CoV-2 infection: significance and implications",
   https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00815-0/fulltext
   
   "... at least 60 patients have now been described with conclusive evidence for persistent SARS-CoV-2 infections... This result is clear evidence for SARS-CoV-2 infection persistence, as evolution from a common ancestor requires ongoing viral replication... Despite its clinical and public health importance, persistent SARS-CoV-2 infection remains greatly understudied."

As always, stay safe out there.

Comments

[oracne]

Thanks for these.

[mellowtigger]

We'll know we've turned the proverbial corner when we can easily get a viral load test, like we did with the last pandemic virus, letting us know how active the infection is in our body at that particular moment, even at extremely low concentrations. Maybe then we'll get reliable drugs that keep that viral load down to "undetectable levels". I still remain hopeful that people exposed to the virus after they received full vaccine protection can escape viral persistence. It's anybody's guess how that'll turn out, though. This one has so many different ways of achieving persistence that it remains a cause for concern, regardless of prior protection.

[shimmerwine]

Someone at work, on the phone, mentioned she's had it 5 times. Not even 30. Can't imagine what's in store for them.