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Technology Can a COVID Vaccine Help Long-Haul Sufferers?

10:55  29 march  2021
10:55  29 march  2021 Source:   usnews.com

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Amanda Finley had a rapid heart rate.

NEW YORK, UNITED STATES - 2021/02/13: Nurse administers covid vaccine into the arm of the patient at community-based pop-up covid vaccination site in Chinatown at Confucius Plaza Community Center. Pop-up site was managed by NorthWell Health System personnel and activated on order by Governor Andrew Cuomo. (Photo by Lev Radin/Pacific Press/LightRocket via Getty Images) © (Lev Radin/Pacific Press/LightRocket via Getty Images) NEW YORK, UNITED STATES - 2021/02/13: Nurse administers covid vaccine into the arm of the patient at community-based pop-up covid vaccination site in Chinatown at Confucius Plaza Community Center. Pop-up site was managed by NorthWell Health System personnel and activated on order by Governor Andrew Cuomo. (Photo by Lev Radin/Pacific Press/LightRocket via Getty Images)

It was a symptom the 42-year-old Kansas City, Missouri, resident says she had for months after testing positive for COVID-19 in October. After her diagnosis, Finley says she watched as her oxygen levels dropped to dangerously low levels, but she decided to forgo the emergency room since she didn't have insurance.

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The result of doing so, she says, was a heart problem. Long after her infection, Finley was regularly experiencing a heart rate of 120 to 130 beats per minute, a condition known as tachycardia. She tried prescribed medication to reduce it, but says it left her sleepy and short of breath.

But then something changed: Finley received her first dose of the Moderna COVID-19 vaccine in late February.

"I won't lie, the first week after the Moderna vaccine, that knocked me off my tail," she says. Her heart rate again increased and she spent the week sleeping off her fatigue. But a week after her shot, she says she woke up and realized her tachycardia was gone. She believes the vaccine is what did it; others have their doubts.

Yet Finley's not the only "long-hauler" – a term that's come to describe a person sickened by COVID-19 who has lingering symptoms of illness weeks or months later – who says getting a vaccine seemed to reduce or change those symptoms. It's a phenomenon some researchers and providers are taking note of, although they say it's too soon to tell whether the COVID-19 vaccines currently in use could be helping or even curing long COVID.

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Long-haul COVID-19 or long COVID is still a little-known area in ongoing coronavirus research. The National Institutes of Health last month launched an initiative to study its causes and identify treatment options. In the agency announcement, NIH Director Dr. Francis Collins said long COVID occurs when individuals sickened by COVID-19 don't recover fully over the course of a few weeks. The symptoms they may experience are wide-ranging.

"(T)hese symptoms, which can include fatigue, shortness of breath, 'brain fog', sleep disorders, fevers, gastrointestinal symptoms, anxiety, and depression, can persist for months and can range from mild to incapacitating," Collins said. "In some cases, new symptoms arise well after the time of infection or evolve over time."

With close to 30 million cases of COVID-19 in the U.S. and a multitude of people in the long-haul category, a number of recovery clinics have cropped up across the country. Meanwhile, some sufferers have turned to Facebook groups for solace.

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Finley runs one of those groups, which is some 12,000 members strong. She started it last June after initially experiencing COVID-19 symptoms in March. At the time, she said it was hard to find a provider with the capability to test her. A second exposure in October led to her eventual positive diagnosis.

Yet after first feeling sick in March and suspecting COVID-19, Finley says she never got better, and developed rashes and gastrointestinal issues. Thinking there might be others out there like her, she created the Facebook group as an outlet for people to vent frustrations, share symptoms and potential treatments, and encourage one another to remain positive.

Lately, some group members have posted about the same phenomenon Finley experienced: After just one COVID-19 vaccine dose, members said they feel better – even normal.

Seeing these stories in the Facebook group prompted Finley to design a Google Forms survey on vaccination. It's still ongoing, but she shared interim results with U.S. News. Of 68 responses, 32% reported an improvement in long-haul symptoms after a COVID-19 vaccine. About 53% reported no change, and roughly 15% reported feeling worse.

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While Finley says she doesn't want to draw conclusions yet, she thinks this is an area worth additional study.

"That's going to be an aspect that we really need to explore more," she says.

Dr. Michael Saag, a professor of infectious diseases at the University of Alabama at Birmingham, agrees. Saag is a COVID-19 survivor himself and now works with a long COVID clinic where he says there have been a few reports of patients who've said they've felt better after one vaccine dose.

"I can't explain it. But I think that is a real phenomenon," he says.

Saag offers one potential explanation, although he cautions it should be taken with a grain of salt: He thinks the immune system response to the original COVID-19 infection perhaps wasn't initially well-formed or well-developed. The introduction of a vaccine, he says, might "focus the immune system response in a different way, such that it can find peace and resolution." But he adds that this isn't yet known.

Others inside and outside of the medical field have shared similar recovery anecdotes. And Akiko Iwasaki, an immunologist at Yale University, recently wrote a Twitter thread with her hypotheses on why a vaccine might help long COVID sufferers.

Last year, Iwasaki told The Atlantic of three possibilities why someone might suffer from long COVID, including that long-haulers may still harbor the virus in a reservoir organ. She tells U.S. News those reservoirs could include brain tissue or other tissue where the virus is still replicating.

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Another possibility is that viral fragments (like a "viral ghost") may be triggering a heavy immune response, or that the immune system may be trapped in an overactive state, having been provoked by the virus.

In late February, Iwasaki wrote on Twitter that if the first possibility is true, then vaccine-induced antibody and T-cell responses may be able to "eliminate the reservoir." As for the second possibility, she wrote, "vaccine-induced immunity may be able to eliminate the viral ghost if they are associated with the spike protein" – a protein on the surface of the novel coronavirus. She says that could be done through phagocytosis, which is when white blood cells eat the viral material.

If the third possibility is true, Iwasaki explains, the vaccine may be diverting autoimmune cells.

On Twitter, she said she suspects that people with long COVID are experiencing varying degrees of all three possibilities and said a trial would be useful to pin down the cause of the apparent recovery. A fourth possibility involving "transient inflammation" tied to the vaccine, she said, would mean the recovery wouldn't last long.

Iwasaki tells U.S. News that the type of vaccine may matter, too: The Pfizer and Moderna vaccines are mRNA vaccines, for example, while the Johnson & Johnson vaccine is an adenovirus vaccine. The two types use different methods to stimulate an immune response in the body.

"Vaccines may not be the only way to help people with long COVID," she says. "Say 60% of the people aren't feeling better, so how do we help those people? So I think we need to understand the whole complexity of this long COVID" to find the appropriate treatment, Iwasaki adds.

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There's also the flip side some sufferers are wondering about: Could a vaccine trigger worse symptoms somehow?

Finley says that's one of the fears some members of her Facebook group have expressed, although she says most members understand that the vaccines will not give them COVID-19 a second time. It was part of what drove Finley, as a prominent member of the group, to get vaccinated herself.

"If they're looking to me for an answer, I just felt like I need to go get one," she says.

Dr. Farha Ikramuddin, a physiatrist at the University of Minnesota Medical School who works at a long COVID clinic, says some of her patients did actually report feeling worse after their second vaccine dose.

"The second vaccine resulted in almost like a reappearance of the symptoms that they had initially seen when they were diagnosed," she says. She has yet to see a patient who says their symptoms have improved post-vaccination.

"That doesn't mean that it's not happening," she adds. In fact, she says questions as to whether vaccines do improve long-haul symptoms are important at this stage in the pandemic, when so many people are suffering from long COVID. It's her hope that researchers work with the NIH to study this possibility.

In the meantime, both Saag and Ikramuddin say vaccination is important in terms of protection from COVID-19, as well as potentially bringing peace of mind or a sense of relief to those with long COVID.

"I think it's very important for us to have a vaccine ... and for those that this vaccine brings a resolution of their long COVID symptoms, I think that's great," Ikramuddin says.

And for those long-haulers who haven't yet gotten relief, "there are many, many like you," Ikramuddin says.

"I want our patients to know that their symptoms are validated – that it's OK, there are others who are feeling like you," she says. "And there are also others who are getting better."

Copyright 2021 U.S. News & World Report

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usr: 9
This is interesting!