November 22, 2023

Researchers Provide a New Hypothesis for Long Covid

New and Noteworthy from The New York Times, original article by Pam Belluck

Based on their discovery that serotonin levels were lower in individuals with the complex illness, a team of scientists is putting out a new hypothesis to account for some cases of long-term Covid.

Researchers from the University of Pennsylvania contend that serotonin reduction is brought on by viral leftovers that remain in the gut in their study, which was published on Monday in the journal Cell. They claim that memory issues and several neurological and cognitive effects of long-term Covid may be specifically explained by depleted serotonin.

This study is one of several recent investigations that show specific biological alterations in the bodies of those who have long-term COVID. These findings are significant since long-term COVID can take many different forms and frequently goes undetected by conventional diagnostic methods like X-rays.

The study may pave way for potential therapies, such as serotonin-boosting drugs. The biological pathway that the authors' research presents may connect several of the leading hypotheses on what causes long-term Covid, including persisting virus traces, inflammation, increased blood clotting, and autonomic nervous system dysfunction.

“All these different hypotheses might be connected through the serotonin pathway,” said Christoph Thaiss, a lead author of the study and an assistant professor of microbiology at the Perelman School of Medicine at the University of Pennsylvania.

“Second of all, even if not everybody experiences difficulties in the serotonin pathway, at least a subset might respond to therapies that activate this pathway,” he said.

“This is an excellent study that identifies lower levels of circulating serotonin as a mechanism for long Covid,” said Akiko Iwasaki, an immunologist at Yale University.

The blood of 58 individuals who had been experiencing long Covid for 3 to 22 months after their infection was examined by researchers. These findings were contrasted with blood tests done on 60 patients who were in the early, acute stage of coronavirus infection and on 30 patients who had no post-Covid symptoms.

The Perelman School of Medicine's Maayan Levy, the study's senior author and an assistant professor of microbiology, noted that levels of serotonin and other metabolites changed immediately following a coronavirus infection, just as they do following other viral infections.

Serotonin, however, was the only major chemical that did not return to pre-infection levels in those with long Covid.

For long Covid, researchers are searching for biomarkers, or biological alterations that may be detected to aid in diagnosis. According to Dr. Thaiss, the latest research points to three possible causes: virus leftovers in the feces, low serotonin, and elevated interferon levels.

The majority of experts agree that there won't be a single biomarker for the condition, but rather a number of signs that may differ depending on the type of symptoms and other variables.

There is tremendous need for effective ways to treat long Covid, and clinical trials of several treatments are underway. Dr. Levy and Dr. Thaiss said they would be starting a clinical trial to test fluoxetine, a selective serotonin reuptake inhibitor often marketed as Prozac, and possibly also tryptophan.

“If we supplement serotonin or prevent the degradation of serotonin, maybe we can restore some of the vagal signals and improve memory and cognition and so on,” Dr. Levy said.

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New York Times Article:

https://www.nytimes.com/2023/10/16/health/long-covid-serotonin.html

Link to Study:

https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6

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