USA: The RECOVER Initiative - Long Covid research

TSP: 10/6/24 - "How Metformin May Lower Long COVID Risk: Insights from NIH's Dr. David Goff"

'Dr. David Goff, Director of the Division of Cardiovascular Sciences at the NIH's NHLBI, and lead epidemiologist for RECOVER, discusses the study'

'Metformin inhibits protein translation which inhibits that process of viral replication inside the cells and that's one way in which metformin might work - both to help acute COVID but also to Long COVID - if the amount of virus in the body is important in driving the risk of Long COVID through mechanisms related to inflammation, immune activation, auto-antibodies and auto-reaction to those antibodies. Metformin has also been shown to have some direct anti-inflammatory effects to tamp down some of the inflammatory mediators that our cells create when we when we have an inflammatory stimulus like an infection.."

 

https://twitter.com/user/status/1846633258689216991

 

10/19/24, IDTV Week: "The Continued Battle Against COVID-19 | Jeanne M. Marrazzo"

5-minute interview with NIAID Director (transcript below)

Marrazzo: "Long COVID, I think of as one of the most challenging conditions of our time, right? We’re just starting to unravel the mystery of what Long COVID is about - it's pretty clear that for some cases there is persistence of the virus - so, targeting what might be a reservoir either a virus or viral antigens is one strategy that people are looking at. The other is looking at the immune response to the virus - is there this legacy immune response that's continuing to drive inflammation, T-cell exhaustion - all these things that are really coming together to make this syndrome what it is? It also I think is a testament to the fact that if you can avoid getting COVID, you should avoid getting COVID and you should avoid getting it multiple times if you can and you know that means obviously vaccines for the most part.

Host: "So, when it comes to the future down the line not only just with COVID but also new variants as you mentioned are there new technologies I mean what's the major push moving forward to mitigate”

Marrazzo: "So, the major push moving forward is embodied in part by the RECOVER-TLC program which we are taking forward in NIAID, it's RECOVER - Treat Long COVID - the idea behind this to leverage everything we're learning about the pathogenesis to design clinical trials that can be done rapidly - sort of like we did during COVID - so scale them up quickly, make sure you can effectively discard hypothesis once you have a candidate you think might help people - study it, study it and as many people as you need - if it doesn't work, it doesn’t work and move on. So, the tools to look at the immune response are much more sophisticated than they’ve ever been - with tools to detect the virus - in some of these hidden reservoirs for example, like the gut, the brain other places are more sophisticated than we’ve ever been, so we can't overpromise but we can't stop. we really have to keep pushing. I am always hopeful because we have amazing people who are really committed we and especially for Long COVID - there's a very engaged advocacy community of patients, providers who have really, I think, struggled to be heard as an entity so very important to engage them - very important to continue to listen to those concerns and to act accordingly."

 

Assuming many received this message yesterday, but sharing in case below on RECOVER-TLC submissions:

"The RECOVER-TLC Leadership Team would like to extend sincere thanks for submitting a potential intervention via the online submission portal.

We wanted to provide a brief update that we have received over 220 submissions thus far and are working to categorize them to help streamline review. NIAID has submitted a Request for Information (RFI) that is under review and will be posted soon. Within the RFI there will be a Form any individual can fill out who has interest in serving on an agent review working group.

As a reminder, agents will be reviewed on a rolling basis and every submitter will receive an email updating them on the status of their submission once the information is available. Additionally, the portal will remain open for the foreseeable future – there is not currently a deadline imposed for submissions."