You may have heard the big, long COVID news that came out recently: a Scottish study reported that around half of people infected with SARS-CoV-2 they have not fully recovered six to 18 months after infection. That result echoes what many doctors and patients have been saying for months. Prolonged COVID is a serious problem and a large number of people are dealing with it.
But it is difficult to find treatments for a disease that is still so ill defined (Serial number: 7/29/22). A major research effort in the United States hopes to change that. And one of my companions, science newsnews director Macon Morehousetook a look at the process.
In the past two months, Morehouse has donated 15 vials of blood, two urine samples and one saliva sample. Technicians have measured her blood pressure, oxygen level, height, weight and waist circumference and counted how many times she could get up from sitting to standing in 30 seconds. Morehouse is not sick, nor is he collecting data for her health. She is doing it for science.
Morehouse is participating in a long COVID study at Howard University in Washington DC. She is part of a many-armed giant of a project with one eye on one thing: the long-term health effects of COVID-19. Launched last year by the National Institutes of Health, the RECOVER Initiative it aims to enroll some 60,000 adults and children. At the Howard site, Morehouse is volunteer number 182.
She is something of a unicorn among study participants: As far as she knows, Morehouse has never had COVID-19. Ultimately, about 10 percent of the participants will include people who have avoided the virus, says Stuart Katz, a cardiologist and leader of the RECOVER study at NYU Langone Health in New York City. Scientists continue to recruit volunteers, but “omicron made it more difficult to find uninfected people,” he says.
RECOVER scientists need participants like Morehouse so that researchers can compare them to people who developed COVID for a long time. That could reveal what the disease is and who it tends to attack. “Our goals are to define prolonged COVID and understand what your risk is for contracting [it] after COVID infection,” says Katz. His results could be a first step toward developing treatments.
tight timeline
During the first year of the pandemic, doctors noted that some COVID-19 patients developed long-term symptoms, including mental fogginess, fatigue, and chronic cough. In December 2020, Katz and other doctors and scientists met to discuss what was known. It turned out that the answer was not much. “This is a new virus,” she says. “Nobody knew what he could do.” Around the same time, Congress approved $1.15 billion for the NIH to study the long-term health consequences of COVID-19.
Fast-forward five months, and the agency had awarded nearly $470 million to NYU Langone Health to serve as the hub for its lengthy COVID studies. “It was all on a very, very compressed timeline,” says Katz. NYU then scrambled to craft a study plan focused on three main groups: adults, children/families, and finally, tissue samples from people who died after having COVID-19. It wasn’t your typical research project, says Katz. “We were commissioned to study a disease that did not have a definition.”
Today, RECOVER has enrolled just over half of a target 17,680 adults. Katz hopes to cross this finish line by spring 2023. The child-focused part of the project has more to go. The goal is to enroll about 20,000 children; so far, they have about 1,200, says Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and a member of the RECOVER executive committee.
Some scientists and patients have criticized RECOVER to move Too slow. As someone who has recovered from a long COVID, Katz says she gets it. “We started a year and a half ago and we still don’t have definitive answers,” he says. “For people who have been suffering, I can understand how disappointing this is.”
But for RECOVER, with more than 400 doctors, scientists and other experts involved, roughly 180 sites across the country enrolling participants, and a grant schedule that upended the usual order of events, the old adage about building the plane while it flies it fits, says Katz. . “We are working very, very hard to move forward as quickly as possible.”
looking for answers
Recently, other facets of the initiative have begun to shine. An analysis of electronic health records found that among people under the age of 21, children under the age of 5, children with certain medical conditions, and those who had severe COVID-19 infections may be increased risk of prolonged COVIDscientists reported in JAMA Pediatrics in August. And a different health record study suggests that Vaccinated adults have some protection against prolonged COVID, even if they had an advanced infection. The scientists published that finding this month on medRxiv.org in a study that has not yet been peer-reviewed.
These studies build on data that has already been collected. Most RECOVER studies will take longer, because scientists will follow patients for years, analyzing the data along the way. “These are longitudinal observational studies,” says Katz. “There is no intervention; we are basically trying to understand how long COVID is.”
Still, Katz hopes to see the first results later this fall. By then, scientists should have an official, albeit rough, definition of prolonged COVID, which could help doctors struggling to diagnose the disease. By the end of the year, Katz says RECOVER could also have answers about viral persistence, if coronavirus relics left in the body somehow restart symptoms.
The project has also recently spawned a clinical trials arm, which may launch this winter, says Kanecia Zimmerman, a pediatric critical care specialist leading this effort at the Duke Clinical Research Institute in North Carolina. One of the first planned trials will test whether an antiviral therapy that clears SARS-CoV-2 from the body helps patients with persistent symptoms.
Although RECOVER is a major effort to understand prolonged COVID, progress will require research and insights from a broad group of scientists, says Diane Griffin, a microbiologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore and a member of the COVID Long Research Initiative, which is not involved in the project. “The fact that we’ve invested in this big study won’t give us all the answers,” he says.
But information from study participants like Morehouse and the nearly 10,000 other adults who have already signed up for RECOVER will help. In the meantime, continued support for prolonged COVID research is crucial, says Griffin. “That’s the only way we’re going to eventually figure this out.”