The biology of coronavirus COVID-19 - including research and treatments

Past COVID-19 infection provides some immunity but people may still carry and transmit virus
People infected with COVID-19 in the past are likely to be protected against reinfection for several months, a Public Health England (PHE) study has found, although experts cautioned those with immunity may still be able carry the virus in their nose and throat and therefore have a risk of transmitting to others.

PHE has been regularly testing tens of thousands of health care workers across the UK since June for new COVID-19 infections as well as the presence of antibodies, which suggest people have been infected before.

SIREN study leaders are clear this first report provides no evidence towards the antibody or other immune responses from COVID-19 vaccines, nor should any conclusions to be drawn on their effectiveness. The SIREN study will consider vaccine responses later this year.

PHE scientists working on the study have concluded naturally acquired immunity as a result of past infections provide 83% protection against reinfection, compared to people who have not had the disease before. This appears to last at least for 5 months from first becoming sick.

While the SIREN study will continue to assess whether protection may last for longer, this means people who contracted the disease in the first wave may now be vulnerable to catching it again.
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https://www.gov.uk/government/news/...but-people-may-still-carry-and-transmit-virus
 
NIH Director's Blog: Taking a Closer Look at COVID-19’s Effects on the Brain
While primarily a respiratory disease, COVID-19 can also lead to neurological problems. The first of these symptoms might be the loss of smell and taste, while some people also may later battle headaches, debilitating fatigue, and trouble thinking clearly, sometimes referred to as “brain fog.” All of these symptoms have researchers wondering how exactly the coronavirus that causes COVID-19, SARS-CoV-2, affects the human brain.

In search of clues, researchers at NIH’s National Institute of Neurological Disorders and Stroke (NINDS) have now conducted the first in-depth examinations of human brain tissue samples from people who died after contracting COVID-19. Their findings, published in the New England Journal of Medicine, suggest that COVID-19’s many neurological symptoms are likely explained by the body’s widespread inflammatory response to infection and associated blood vessel injury—not by infection of the brain tissue itself [1].
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https://directorsblog.nih.gov/2021/...look-at-the-effects-of-covid-19-on-the-brain/
 
March for Change yesterday had a Zoom discussion on Long Covid. The contributors were Layla Moran who chairs the APPG on Coronavirus, Danny Altmann a Professor of Immunology, Dr Nasreen Alwan, an Associate Professor in Public Health for Medicine at Southampton University and who has LC. Also, Dr Mike Galsworthy, a founder of Scientists for EU and @March_Change.

This is my summary and I apologise to the panel for any errors.

Layla Moran calls for:

  • A register of people who live with LC, based on symptoms and not on test results

  • Government investment in research, including the long term effect on children. LC has not been considered in assessing the risk to children of attending school
  • Welfare provision is required for those unable to work and compensation for those harmed by the disease during the course of their work (covered by the Telegraph)
She is concerned with quality of life issues for those who get LC but says that there is also a financial hit to the economy that politicians need to understand when making decisions.

Professor Altmann said that at the moment there is only speculation about the physiology of LC. First, there is simply the acknowledgement of its existence and counting of people who have it. He thinks that first making observations of the disease is a new way of doing medicine. He would look at: the damage done by the virus, as seen in MRI scans, to many organs; the immune system, as a "hand grenade" has been thrown into it; the possibility of autoimmunity resulting from the infection; lastly, whether there are reservoirs of infection still in the body e.g. in the gut.

He thinks that at a conservative estimate 10% of those infected, even those who were asymptomatic, may be left with LC, a UK estimate of 300,000 people, on a par with numbers of those with arthritis and he does not know what to tell people about the time line of the illness. In Wuhan they have observed the illness in those infected, which shows that this is a worldwide phenomenon and that doctors need to get together to understand how to treat it. There is the added difficulty of the number of medical specialities involved in understanding and treating the illness.

Dr Nasreen Alwan lives with and studies LC. She spoke of its fluctuating nature and of the loss of functional ability in the fatigue suffered but also the cognitive difficulties, muscle aches and heart problems. She sees significant disability, some people being able to work flexibly but others not able to meet their responsibilities. Patterns are emerging in patient led research.

A question was put to the panel regarding the similarities between LC and ME. Professor Altmann sees cross-fertilization of work on both as possible in the future and Dr Alwan said that LC research may benefit the "neglected ME community". Layla Moran sees a light shining on the ME community. GPs have not understood ME but now that they are likely to know someone with LC this may be transformative and research into ME may be taken more seriously. Medics make good advocates.
 
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Currently being announced on BBC news channel that 6 European countries have written to Pfizer/Biotech expressing concern that they have been warned of delays in the delivery of the vaccine.

This news is just coming in and the channel said they would be coming back with more information especially about how it referred to delivery in UK.



eta: just announced that CEO of Pfizer has reassured EU countries that current orders will not be delayed. Seems to be a developing story.

eta2: apparently modifications are required to Pfizer Belgian production plant
 
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Is there any move to monitor PwME who get a vaccine to see if we are particularly vulnerable to side-effects? I saw on the news yesterday that the very elderly and frail may be advised not to have it because of some adverse reactions (see here, for example).

There has of course always been concern about whether PwME should have flu jabs.

Now seems an ideal time to monitor! But is anyone doing it? Are any of our charities suggesting it?
 
Covid: 'Convalescent plasma no benefit to hospital patients'

A potential treatment for Covid using blood plasma does not reduce deaths among hospital patients, trials show.

The results are a blow to researchers and the NHS, which led the drive to collect plasma donations.

This arm of the Recovery trial, which is investigating a number of promising Covid treatments, has now been closed.

The Oxford researchers involved say they are "incredibly grateful" for the contribution of patients across the country.

Donations of plasma have been temporarily suspended, according to NHS Blood and Transplant.

There had been huge international interest in the role of convalescent plasma as a possible treatment for hospital patients with Covid-19.

The treatment involves blood plasma being taken from people who have recovered from the disease - which contains antibodies to coronavirus - and transfused into seriously ill patients.

It was hoped the plasma donation would give the recipient's struggling immune system a boost to fight off Covid.

The NHS had been urging people to donate, particularly men who are thought to have higher levels of antibodies in their blood.
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https://www.bbc.co.uk/news/health-55681051
 
That above post by Frankie seems to indicate the major area of concern. There seems to be a desire to obtain a special compensatory package not available to those with similar conditions. I would not want to have to draft that. How would it be known whether people caught the virus in the course of and as a result of employment, or whether they encountered it in the supermarket or some other venue? There seems a desire to ignore all the difficult questions.
 
Sasha said:
Is there any move to monitor PwME who get a vaccine to see if we are particularly vulnerable to side-effects? I saw on the news yesterday that the very elderly and frail may be advised not to have it because of some adverse reactions (see here, for example).

There has of course always been concern about whether PwME should have flu jabs.

Now seems an ideal time to monitor! But is anyone doing it? Are any of our charities suggesting it?
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It seems to be more serious than solely 'side effects' in the very old and/or frail.

"Norway expressed increasing concern about the safety of the Pfizer Inc. vaccine on elderly people with serious underlying health conditions after raising an estimate of the number who died after receiving inoculations to 29.

The latest figure adds six to the number of known fatalities in Norway, and lowers the age group thought to be affected to 75....."

https://www.bloomberg.com/news/arti...talities-among-people-75-and-older-rise-to-29

I don't envy anyone in the position of having to decide if they or a family member who fit this profile should or should not get vaccinated. I spent the first half of 2020 taking care of my 97 year old grandmother (she died in July from heart failure) so I can relate as during the final 2 months of my grandmother's life I had to make some very difficult decisions in regards to her medical treatment.
 
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Sasha said:
Very sorry to hear about your grandmother, @TrixieStix - that must have been a very difficult time.
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Thanks Sasha. I miss her terribly (she was the closest thing I had to a mother), but find comfort in the fact that she had a long and healthy life. She was extremely healthy right up until the very very end. She was very proud of the fact that she had perfect hearing, just about 20/20 vision, and all her own teeth :) may she rest in peace
 
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TrixieStix said:
Thanks Sasha. I miss her terribly (she was the closest thing I had to a mother), but find solace in the fact that she had a long and healthy life. She was extremely healthy right up until the very very end. She was very proud of the fact that she had perfect hearing, just about 20/20 vision, all her own teeth :) may she rest in peace
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She reminds me of a great aunt I had who died when she was 89.
She still chopped her own kindling, helped " old people" off of the local bus and simply fell asleep for the last time in her chair next to the fire.
 
Association of British Neurologists Guidance on Vaccination for COVID-19 and Neurological Conditions
Many patients and their families are approaching neurologists to ask about vaccination against COVID-19. In general, other than for severely allergic people, there is no good reason to be worried about vaccination. This document attempts to answer the questions that are commonly asked. People with more unusual medical problems should ask their GPs, who may refer you on to your neurologist. The government is rolling out vaccination and aiming to vaccinate those at greatest risk first (click here).
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Document, https://cdn.ymaws.com/www.theabn.or...eople_with_neurological_conditions_9.1.21.pdf
Linked to from https://www.theabn.org/page/covid-19_patients
 
Preprint: Early immune pathology and persistent dysregulation characterise severe COVID-19, Bergamaschi et al, 2021
In a study of 207 SARS-CoV2-infected individuals with a range of severities followed over 12 weeks from symptom onset, we demonstrate that an early robust immune response, without systemic inflammation, is characteristic of asymptomatic or mild disease. Those presenting to hospital had delayed adaptive responses and systemic inflammation already evident at around symptom onset. Such early evidence of inflammation suggests immunopathology may be inevitable in some individuals, or that preventative intervention might be needed before symptom onset. Viral load does not correlate with the development of this pathological response, but does with its subsequent severity. Immune recovery is complex, with profound persistent cellular abnormalities correlating with a change in the nature of the inflammatory response, where signatures characteristic of increased oxidative phosphorylation and reactive-oxygen species-associated inflammation replace those driven by TNF and IL-6. These late immunometabolic inflammatory changes and unresolved immune cell defects, if persistent, may contribute to “long COVID”.
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https://www.medrxiv.org/content/10.1101/2021.01.11.20248765v1

ETA: Separate thread started here, https://www.s4me.info/threads/prepr...severe-covid-19-bergamaschi-et-al-2021.18710/
 
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Article about the above study

Possibility of 'long Covid' could be established in patients soon after they are infected
New research suggests why some people experience longer-lasting symptoms of the virus.

THE LIKELIHOOD OF severe and “long Covid” may be established early on following infection, according to a new study.

The research provides insights into the role of the immune system in preventing, and in some cases increasing the severity of, coronavirus symptoms in patients.

It also suggests why some people experience long Covid.

According to the study, people who have asymptomatic or mild disease show a robust immune response early on during infection.

While those requiring admission to hospital have impaired immune responses and systemic inflammation – chronic inflammation that may affect several organs – from the time of symptom onset.

Scientists say persistent abnormalities in immune cells and a change in the body’s inflammatory response may contribute to long Covid.
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https://www.thejournal.ie/coronavirus-long-covid-diagnosed-early-infection-study-5328534-Jan2021/
 
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It may be that they, wrongly, feel that they are now out of danger, so their 'mood' has improved - they feel better as they feel less 'threatened'.

They may also feel, wrongly, that as they now, wrongly, consider that they are out of danger, they can do whatever they like again.

There are lots of 'reasons' why people may feel better after experiencing a ritual they have been told will make things all better.

This is probably why ritual are popular, even if people don't think enough to realise that's what they are.
 
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