Long COVID is when individuals experience symptoms long after recovering from the acute phase of COVID-19. Recent research suggests that lingering virus spike proteins may contribute to developing long COVID symptoms. As an acupuncturist who treats long COVID and autoimmune diseases, I am curious about a possible connection with the root cause of both conditions.
Autoimmune conditions like chronic fatigue syndrome and chronic Lyme disease display similar symptoms to long COVID: fatigue, joint pain, poor concentration, anxiety, and depression, to name a few. Money pouring into research on long COVID may help discover the underlying causes of some autoimmune diseases plaguing young people today. At a minimum, this research may shed light on new treatment options to manage symptoms.
Spike Proteins and Long COVID
According to a study published in the journal Nature, the spike protein of SARS-CoV-2, which enables the virus to enter human cells, can cause inflammation and autoimmune-like reactions in the body. In addition, researchers found that the spike protein alone, even without the virus, can damage cells and trigger an immune response.
The study also found that the spike protein can accumulate in specific tissues, including the spleen, heart, lungs, and bone marrow, leading to chronic inflammation and tissue damage. Additionally, the spike protein can cause abnormalities in blood vessels, which may contribute to developing blood clots, a common symptom of long COVID.
Lingering Viral Reservoirs
These findings suggest that spike protein in the body may be responsible for some of the persistent symptoms experienced by individuals with long COVID and autoimmune diseases even after clearing the virus. These proteins tend to accumulate in “viral reservoirs.
Viral reservoirs refer to sites in the body where viruses can persist and replicate for long periods, even in the presence of antiviral treatments or functional immune responses. These reservoirs can allow for the recurrence of viral infections, the transmission of viruses to other individuals, and the emergence of drug-resistant viral strains.
Medications for Long COVID
Currently, there are no specifically approved antiviral medications for treating long COVID. However, several small studies have tested some antiviral drugs used to treat acute COVID-19 for their potential efficacy in treating long COVID symptoms.
For example, a study published in The Lancet Respiratory Medicine evaluated the use of the antiviral favipiravir in individuals with persistent COVID-19 symptoms. The study found that treatment with favipiravir significantly reduced symptoms and improved quality of life. However, more extensive studies are needed to confirm these findings.
Researchers have investigated other drugs for their potential efficacy in treating long COVID, including Paxlovid (an antiviral), corticosteroids (which have anti-inflammatory properties), and monoclonal antibodies (which can target the spike protein of SARS-CoV-2 and block viral entry into cells).
Monoclonal Antibodies Versus Antivirals
The difference between monoclonal antibody therapy and antiviral medications such as Paxlovid is how the treatments prevent infection from progressing. Monoclonal antibody therapy is a treatment given by infusion that supplies the body with man-made antibodies to fight COVID-19. In January 2023, the FDA suspended monoclonal antibody therapies because they were no longer effective against the dominant strains of the COVID-19 virus.
Antiviral medications work inside the cells to inhibit viral replication. At the same time, the monoclonal antibodies targeted the virus’ spike protein or other surface proteins by binding to the virus particles to block them from entering the body’s cells. Therefore, patients should receive treatment after a positive COVID-19 test as soon as possible. However, doctors can only prescribe antiviral medications within five days of symptom onset.
Paxlovid and Long COVID
Paxlovid is an antiviral medication used to treat COVID-19 in certain patients. It is a combination of two drugs, nirmatrelvir, and ritonavir, that work together to attack the virus in the body.
Nirmatrelvir is a drug that belongs to a class of antiviral medications called protease inhibitors. It works by blocking the action of an enzyme called the SARS-CoV-2 protease, essential for the virus to replicate and spread in the body. By inhibiting the protease, nirmatrelvir can help prevent the virus from multiplying and spreading to other cells in the body.
Ritonavir is another protease inhibitor often used with other antiviral medications to increase effectiveness. It works by blocking an enzyme called cytochrome P450 3A4, which breaks down and eliminates drugs from the body. By blocking this enzyme, ritonavir can increase the levels of nirmatrelvir in the body, improving its antiviral activity against SARS-CoV-2.
Together, nirmatrelvir and ritonavir work to attack the virus in different ways, blocking its ability to replicate and spread in the body. This function can help to reduce the severity of COVID-19 symptoms and improve the chances of recovery in certain patients.
Connection Between Long COVID and Autoimmune Diseases
In their journal article, COVID-19 and Autoimmune Diseases, Liu Y et al. explained that COVID-19 shares similarities with autoimmune diseases in clinical manifestations, immune responses, and pathogenic mechanisms. Strong immune reactions manifest in the pathogenesis of both disorders. Autoantibodies, a hallmark of autoimmune diseases, can also be detected in COVID-19 patients. Furthermore, some patients have developed autoimmune diseases, such as Guillain–Barré syndrome or systemic lupus erythematosus, after COVID-19 infection. Investigators speculate that Covid can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells.
Next Steps
While Western medicine struggles to understand the pathogenesis of long COVID and autoimmune diseases, it is essential to create strategies for coping with the illnesses. For example, while not a cure, acupuncture is an effective tool for helping reduce lingering symptoms and improve life quality.
Raleigh Acupuncture treats long COVID and autoimmune diseases like chronic fatigue syndrome, Lyme disease, Crohn’s disease, and more. Acupuncture is safe, with no severe adverse side effects. You can learn more about our treatments for particular cases HERE.
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I still am forever in your debt for helping me through the Lymes recovery. My body pain and fatigue were overwhelming before getting acupuncture. I still tell everyone today that I am 100% positive that my recovery was a direct result of your expert care. Truly. I have very little residual effects from the disease that I can easily live with. So again,thank you not only for your amazing skills, but for the compassion and kindness that you showed me during that time.