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Improvement of immune dysregulation in individuals with long COVID at 24-months following SARS-CoV-2 infection, Matthews et al, 2024

Discussion in 'Long Covid research' started by John Mac, Apr 17, 2024.

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  1. John Mac

    John Mac Senior Member (Voting Rights)

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    Improvement of immune dysregulation in individuals with long COVID at 24-months following SARS-CoV-2 infection

    Abstract
    This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months.

    LC participants show elevated nucleocapsid IgG levels at 3 months, and higher neutralizing capacity up to 8 months post-infection. Increased spike-specific and nucleocapsid-specific CD4+ T cells, PD-1, and TIM-3 expression on CD4+ and CD8+ T cells were observed at 3 and 8 months, but these differences do not persist at 24 months.

    Some LC participants had detectable IFN-γ and IFN-β, that was attributed to reinfection and antigen re-exposure. Single-cell RNA sequencing at the 24 month timepoint shows similar immune cell proportions and reconstitution of naïve T and B cell subsets in LC and MC.

    No significant differences in exhaustion scores or antigen-specific T cell clones are observed. These findings suggest resolution of immune activation in LC and return to comparable immune responses between LC and MC over time.

    Improvement in self-reported health-related quality of life at 24 months was also evident in the majority of LC (62%). PTX3, CRP levels and platelet count are associated with improvements in health-related quality of life.


    https://www.nature.com/articles/s41467-024-47720-8
     
    John Mac, Apr 17, 2024
    #1
    Peter Trewhitt, RedFox, Sean and 1 other person like this.
  2. Hutan

    Hutan Moderator Staff Member

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    31 people with Long covid, with these people not necessarily primarily having fatigue - some primarily had breathlessness or chest pain. So, quite a mixed group, and then only 24 people were in the 24 month post-infection followup.

    It looks as though LC symptoms were not significantly different between the LC and MC groups at 24 months.
    However, on some of the measures, the 'matched controls' got worse, so that may have masked ongoing poor health in the LC group.
    By the 24 month mark, 26% of the controls had 'poor health' (up from 16% at 4 months) while 38% of the LC group had 'poor health' (down from 58% at 4 months).

    So, it's a bit hard to make much of the findings. It's a frustrating paper. We need information on LC recovery rates, but this paper doesn't help.
     
    Hutan, Apr 17, 2024
    #2
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  3. rvallee

    rvallee Senior Member (Voting Rights)

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    Those are actually some marked differences, and it's odd to have matched controls with significant health issues:

    [​IMG]

    The EQ-5D is a very poor instrument for this.
    I don't see how this leads to headlines that most problems resolve by 24 months. It seems to have been taken from this:
    Which is definitely not the same. And still 38% is quite significant.

    For sure this study doesn't really bring any clarity, mostly mud.
     
    rvallee, Apr 18, 2024
    #3
    Hutan, yannlk, RaviHVJ and 1 other person like this.
  4. Sean

    Sean Moderator Staff Member

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    Long COVID status was assigned if participants reported >1 persistent symptom of dyspnoea, chest pain, or fatigue/malaise at least 90 days after estimated date of initial infection.

    Not sure that qualifies as a robust definition of LC.
     
    Sean, Apr 18, 2024
    #4
    rvallee, EndME, Peter Trewhitt and 2 others like this.
  5. yannlk

    yannlk Established Member (Voting Rights)

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    It is so frustrating to continually see studies like this taken out of context and extrapolated by the media to feed the narrative that Long Covid is begign and short term.
     
    yannlk, Apr 19, 2024
    #5
    Sean, SNT Gatchaman, Trish and 3 others like this.

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