Slow diagnosis and treatment of long-term Covid was one of our worst mistakes throughout the pandemic. Covid affects an estimated 100 million people around the world. If we take into account the fact that diagnoses are still lacking, and that we do not yet know how Omicron and future variations may affect the disease, we can expect that figure to skyrocket.
Numerous symptoms are reported by patients with long-term Covid, the most common of which are weariness, brain fog, muscle weakness, shortness of breath, low oxygen levels in the blood, sleep problems, and even depression. In certain cases, people are in such bad shape that they are unable to do anything, not even walk a few feet. There may also be an increased risk of stroke and heart attack. There is a great deal of concern that even a mild and sometimes asymptomatic Covid-19 infection may cause long-term impairment.
It has long been known that acute Covid-19 is not just a lung condition, but that it has a substantial impact on the vascular (blood flow), and coagulation (blood clotting) systems.
A recent study in my lab found that both acute and long-term Covid-19 patients had considerable microclot formation in their blood. Clots can occur in people with good physiology (for instance, when you cut yourself). Fibrinolysis, a mechanism through which the body efficiently dissolves clots, is the key to this success.
Persistent microclots are resistant to the body’s natural fibrinolytic mechanisms in the blood of individuals with extended Covid. Several inflammatory chemicals, such as clotting proteins such as plasminogen, fibrinogen, and Von Willebrand factor (VWF), as well as the antiplasmin Alpha-2, were detected in significant concentrations in the persistent microclots (a molecule that prevents the breakdown of microclots).
As a result of chronic microclots and hyperactivated platelets (both of which play a role in clotting), cells are not getting enough oxygen to support physiological processes (known as cellular hypoxia). The reported debilitating symptoms may be linked to widespread hypoxia.
How come lengthy Covid sufferers can not visit their local clinic or doctor to learn about therapy alternatives? Diagnosing these patients is difficult at the moment due to the lack of widely available general pathology tests
Doctors tell patients with life-threatening illnesses that their pathology test findings are in the “normal” or “healthy range.” As a result, many individuals are informed that they should try meditation or exercise in order to alleviate their symptoms. Because the inflammatory chemicals are locked inside the fibrinolytic-resistant microclots, routine lab techniques fail to detect them (visible under a fluorescence or bright-field microscope, as our research has shown). Inflammatory compounds, such as autoantibodies, go unnoticed when the molecular content of the plasma’s soluble portion is assessed.
Treatments including antiplatelet and anticoagulant regimens have showed promising outcomes in long Covid patients, according to preliminary studies, provided that any bleeding risks associated by taking these medications are well monitored by professionals. Help apheresis, which filters away microclots and inflammatory chemicals in a dialysis-style procedure but uses heparin to induce extracorporal lipoprotein/fibrinogen precipitation, may also be beneficial for patients. Doctors Beate Jaeger and Asad Khan spoke to the BBC about this issue recently; you can see their conversation here).
Research and clinical trials are urgently needed to better understand and validate the link between irregular blood coagulation and hypoxia, as well as vascular dysfunction in patients with chronic Covid. Even if you do not have long-term Covid, you could benefit from this research because the symptoms observed in long-term Covid patients share many parallels with those seen in chronic and viral-related disorders, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A lack of a biomarker for extended Covid does not suggest that biomarkers do not exist. We only have to dig a little deeper.