Long COVID, vaccines and antibody tests

Here is some good news for older adults who are worried about long COVID. A new study has found that most people infected with the SARS-CoV2 virus recover within 12 months, regardless of the severity. The study showed that 75% recovered at the 12-month mark after becoming ill with the virus, and 25% of patients still had at least one of the three most common symptoms (coughing, fatigue and breathlessness). Researchers found that patients with persistent symptoms also had antibodies associated with autoimmune illnesses, as well as raised levels of cytokines, which cause inflammation.

The findings are based on a survey of 106 adults recovering from COVID-19 infections at three, six and 12 months after contracting the disease. All the patients surveyed were healthy and had no pre-existing autoimmune conditions or any other underlying diseases pre-pandemic.

“Generally, one should not worry if they are feeling unwell right after their infection, as the chances of recovering within 12 months are very high, and just because you have typical long COVID symptoms at three months does not mean they will stay forever,” said senior author Manali Mukherjee, an assistant professor of the Department of Medicine at McMasters University in Canada. “However, the study highlights that at 12 months, if you still feel unwell and the symptoms are persisting or worsening, you should definitely seek medical attention.”

Mukherjee said patients with persistent long COVID symptoms should see a rheumatologist because they specialize in autoimmune disorders and can better assess development of rheumatological complications and the need for an early intervention. She said that most patients with long COVID currently are assessed by lung experts and infectious disease specialists, who do not specialize in autoimmunity.

Mukherjee said that of the patients who recovered, a reduction in autoantibodies and cytokines was matched by their symptoms improving. Those who had elevated antibody and cytokine levels after one year were those whose symptoms persisted.

“Sometimes, while the body is fighting the virus, the immune system gets so amped up that, in addition to making antibodies that kill the virus, it can produce those that attack the host,” said Mukherjee.

Vaccinations may dramatically reduce the risk of long COVID

Being vaccinated with at least two doses of Pfizer vaccines dramatically reduces most of the long-term symptoms individuals reported months after contracting COVID-19. Researchers in Israel found that eight of the ten most-commonly reported symptoms were reported between 50% and 80% less often among individuals who received at least two doses of COVID-19 vaccine compared with those who received no doses.

Nearly 3,500 adults across Israel participated in the study and it was carried out between July and November 2021. These individuals completed a survey with a variety of questions about previous COVID-19 infection, vaccination status, and any symptoms they were experiencing.

More than half of the participants (2,447) reported no previous SARS-CoV-2 infection, while 951 were previously infected. Of those infected, 637 (67%) received at least two vaccine doses. Of the 2,447 individuals reporting no previous infection 21 (0.9%) received one dose, 1,195 (48.8%) received two doses, 744 (30.4%) received three doses, and the rest were unvaccinated (19.9%).

After adjusting for factors such as age and time elapsed from infection to responding to the survey, the researchers found that vaccination with two or more doses of the Pfizer vaccine was associated with a reduced risk of reporting the most common post-COVID symptoms. Among those in the current study group, the most common symptoms reported were fatigue, headache, weakness of limbs, and persistent muscle pain.

The study contributes to scarce information to date about the impact of vaccination on long COVID.

“We don’t fully understand what happens in the months and years following COVID-19 in terms of physical and mental health and wellbeing,” said study lead author Michael Edelstein, of Bar-Ilan’s Azrieli Faculty in Israel. “Because long COVID seems to affect so many people, it was important to us to check whether vaccines could help alleviate the symptoms. It is becoming increasingly clear that vaccines protect not just against disease, but as the results of this study suggest, against long-term, sometimes life-changing, effects of COVID-19.”

Do I need a booster and do I need it now?

A team of scientists from the Singapore-MIT Alliance for Research and Technology (SMART), MIT’s research enterprise in Singapore, have developed a quick test kit that can tell if a person has immunity against COVID-19 and its variants.

This rapid point-of-care test measures antibodies made by an individual. It requires a drop of blood and takes just 10 minutes for results, compared to the 24 to 72 hours required for conventional laboratory testing. The test kit detects the levels of neutralizing antibodies against SARS-COV-2 and its variants such as Delta and Omicron.

Using a paper-based assay that is coated with chemicals that bind to antibodies in the blood sample, the test kit is low-cost, fast, and has up to 93% accuracy. It paves the way for personalized vaccination strategies, where people are only given vaccinations and booster shots when necessary, depending on their antibody levels and immune response. Having an accurate and rapid test can enable governments and healthcare organizations to effectively manage limited vaccine resources, and address vaccine hesitancy, particularly concerning multiple booster doses.

Vaccination has been an integral component of public health strategies to tackle the COVID-19 pandemic, and 12.6 billion doses across 184 countries have been administered as of September 2022. Vaccines reduced the COVID-19 death toll by 63% within the first year of their rollout, preventing an estimated 19.8 million deaths worldwide, according to a report by the World Health Organization (WHO).

“Our study proves that our new test kit can be a powerful tool, allowing healthcare organizations to screen people and determine their vaccination needs, especially against the current and upcoming variants. This will help allay some people’s fears that they will be ‘over-vaccinated with a booster’, since the results will inform them accurately if they are well-protected against COVID-19 or not,” said study investigator Peter Preiser an Associate Vice President for Biomedical and Life Sciences at NTU Singapore.

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