WEBVTT - Scientists Narrow Down What Could Be Causing Long COVID 0:00:00.040 --> 0:00:03.760 It's Wednesday, February two. Our Oscar Ramiras from the Daily 0:00:03.760 --> 0:00:06.840 Dive podcast in Los Angeles, and this is reopening America. 0:00:07.960 --> 0:00:10.479 One of the longest running mysteries of the pandemic has 0:00:10.520 --> 0:00:13.800 been long COVID and what causes it. Studies have found 0:00:13.800 --> 0:00:17.319 that ten people that have recovered from the coronavirus get 0:00:17.360 --> 0:00:19.759 long COVID, which can appear up to three months after 0:00:19.840 --> 0:00:23.000 recovery and last for six months or more in some cases. 0:00:23.840 --> 0:00:26.480 Researchers are zeroing in on the causes, and the two 0:00:26.560 --> 0:00:29.120 leading theories are that the virus turns the immune system 0:00:29.200 --> 0:00:32.839 against the body, and despite recovering, the virus could be 0:00:32.920 --> 0:00:35.320 lingering in the body, not in the blood, but in 0:00:35.360 --> 0:00:40.239 the body's tissues. Yasmin Tayag, contributor to vox, joins us 0:00:40.240 --> 0:00:43.320 for what could be behind long covid. Thanks for joining us, Yasmin, 0:00:43.960 --> 0:00:47.760 thank you for having me. Let's talk about long covid. 0:00:47.880 --> 0:00:50.680 This is one of the most mysterious parts of the 0:00:50.680 --> 0:00:55.040 coronavirus pandemic that scientists and people have had to deal with. So, 0:00:55.320 --> 0:00:58.880 you know, long COVID. Basically, some of these symptoms keep 0:00:58.960 --> 0:01:03.000 persisting with well long after they've recovered from actually having 0:01:03.080 --> 0:01:07.600 COVID nineteen sometimes months longer than that six months, I've 0:01:07.640 --> 0:01:09.760 heard a year in some cases, people are dealing with 0:01:09.800 --> 0:01:14.000 symptoms after their initial infection, and uh, it's been very 0:01:14.080 --> 0:01:18.279 perplexing for scientists. They're starting to zero in on certain 0:01:18.319 --> 0:01:20.880 things that could be causing it. In two big theories 0:01:20.920 --> 0:01:25.360 surround the immune system obviously is going haywires still and 0:01:25.520 --> 0:01:28.760 lingering virus could also be causing problems and people and 0:01:29.280 --> 0:01:32.600 making these problems persist. So yasmin, what are scientists looking 0:01:32.600 --> 0:01:34.679 at and what are they starting to realize what's going 0:01:34.680 --> 0:01:38.480 on with this? Yeah, Well, one of the big challenges 0:01:38.480 --> 0:01:41.840 with long COVID research is that there are so many 0:01:41.880 --> 0:01:45.880 symptoms to account for, and scientists have had to figure 0:01:45.880 --> 0:01:49.880 out what is the root biological cause behind all of them. 0:01:49.920 --> 0:01:53.960 And one of the things that's been helpful is understanding 0:01:54.040 --> 0:01:57.360 that there is no one long COVID. There's probably many 0:01:57.400 --> 0:02:00.560 different subtypes of this condition that we're calling on COVID, 0:02:01.000 --> 0:02:03.200 and so with that in mind, they're teasing out the 0:02:03.280 --> 0:02:06.760 different drivers. So, as you mentioned, one of the big 0:02:06.760 --> 0:02:10.320 ones is the immune system, and this was suspected long 0:02:10.360 --> 0:02:14.840 ago um at the beginning of long COVID research. They 0:02:14.919 --> 0:02:21.440 think that because of the initial infection, the immune system 0:02:21.480 --> 0:02:26.440 and some people is just going haywire. Either it's reacting 0:02:26.639 --> 0:02:31.760 to strongly or more likely it's reacting against the self. 0:02:32.040 --> 0:02:35.519 So the body's own immune system starts attacking its own self, 0:02:36.160 --> 0:02:39.760 and that is what's behind some of the symptoms we're seeing, 0:02:39.800 --> 0:02:43.880 such as brain fog or blood clots that are being 0:02:43.880 --> 0:02:49.760 seen throughout the blood. UM. So that's one potential UH driver, 0:02:50.400 --> 0:02:53.520 and the other one, as you mentioned, the other big 0:02:54.400 --> 0:03:00.320 suspect is the possible persistence of virus and the system. 0:03:00.639 --> 0:03:05.000 So this is simply that the virus doesn't entirely get 0:03:05.000 --> 0:03:09.520 eliminated after your initial infect infection and it's just hanging 0:03:09.520 --> 0:03:12.440 out in the body. And one of the difficult things 0:03:12.560 --> 0:03:18.320 UH about studying this is that scientists are finding that 0:03:18.480 --> 0:03:20.840 the virus when it does linger, it's not really in 0:03:20.880 --> 0:03:23.880 the blood. It tends to hang out inside the tissues, 0:03:24.400 --> 0:03:26.440 and so you're not going to catch this with a 0:03:26.520 --> 0:03:33.680 simple blood test. UH. They're now developing diagnostics to find 0:03:33.720 --> 0:03:37.920 these markers that you know, would otherwise go unnoticed. UM. 0:03:38.000 --> 0:03:41.920 But lingering virus is they're not really sure what it's doing. 0:03:42.000 --> 0:03:44.320 It might not be doing anything, but it all might 0:03:44.400 --> 0:03:50.520 also be injuring tissues directly or leaking virus proteins into 0:03:50.600 --> 0:03:54.280 the blood stream which go on to activate the immune system, 0:03:54.440 --> 0:03:57.560 or they might be triggering the information in the brain 0:03:58.320 --> 0:04:02.800 by traveling up the vegas r of So scientists are 0:04:02.800 --> 0:04:06.160 trying to tease out all these different different drivers, and 0:04:06.680 --> 0:04:10.080 what complicates the matter is they're probably all interconnected. Yeah, 0:04:10.080 --> 0:04:11.560 that's what I was just gonna say. I mean, they're 0:04:11.600 --> 0:04:14.400 kind of related. Right. If the virus is lingering and 0:04:14.520 --> 0:04:17.520 the immune system is constantly picking up signs of it 0:04:17.600 --> 0:04:20.720 and you know, throwing anybodies at it, throwing stuff attitude, 0:04:21.000 --> 0:04:23.840 at least address what it's sensing, you know, it's gonna 0:04:23.920 --> 0:04:26.760 it's gonna keep the immune system in that constant state 0:04:26.760 --> 0:04:30.360 of flux um. Tiny blood clots are also in this 0:04:30.560 --> 0:04:34.000 you know, that kind of fuels that immune system reaction to. 0:04:34.160 --> 0:04:39.520 That's another one that they think could make the things persist. Yeah. 0:04:39.640 --> 0:04:42.800 The blood clots are super interesting. So they're seen in 0:04:43.000 --> 0:04:46.960 patients with both acute COVID and in patients with long 0:04:47.000 --> 0:04:52.360 COVID and UM. What scientists in South Africa are finding 0:04:52.520 --> 0:04:56.600 is that inside these clots, like these clots are really 0:04:56.640 --> 0:04:59.600 resistant to breaking down, and normally the body is able 0:04:59.640 --> 0:05:03.440 to do that. But the scientists ask why aren't these 0:05:03.440 --> 0:05:07.760 clots getting digested, and it's because inside them, hidden inside 0:05:08.040 --> 0:05:11.320 are these inflammatory molecules that are sort of preventing this 0:05:11.720 --> 0:05:16.039 digestion and they may also be triggering the immune system 0:05:16.279 --> 0:05:21.280 to react. So, you know, by blowing up these blood 0:05:21.279 --> 0:05:24.000 clots to see what's inside, scientists are getting a better 0:05:24.040 --> 0:05:27.039 idea of what what is causing them to stick around. 0:05:27.600 --> 0:05:29.480 And so these are the kind of the two leading 0:05:29.520 --> 0:05:32.720 theories right it's the immune system and the lingering virus. 0:05:32.720 --> 0:05:36.360 But they've kind of also identified, I guess, for other 0:05:36.440 --> 0:05:39.880 criteria that that people might have that could make them 0:05:40.160 --> 0:05:42.520 uh suffer from long COVID. And it's kind of some 0:05:42.560 --> 0:05:44.200 of the stuff that we've heard about before, some of 0:05:44.200 --> 0:05:47.760 the comorbidities and all that. But basically, if if you 0:05:47.839 --> 0:05:51.440 had high levels of the virus in your blood when 0:05:51.440 --> 0:05:53.800 you were infected, that can lead to long COVID. You 0:05:53.839 --> 0:05:56.520 have type two diabetes, unfortunately, that could lead to it. 0:05:56.800 --> 0:06:01.000 Epstein bar virus, which I guess of the population has 0:06:01.080 --> 0:06:04.200 it lays dormant in the body. If that gets reactivated, 0:06:04.320 --> 0:06:07.120 that can make it happen. And then these auto antibodies, 0:06:07.120 --> 0:06:09.120 which kind of talk about things that are just attacking 0:06:09.160 --> 0:06:13.080 your own cells. So these other four factors could contribute 0:06:13.080 --> 0:06:17.560 to that as well. Yeah, the recent research and if 0:06:17.560 --> 0:06:19.760 this is really early research, so it's not really a 0:06:19.760 --> 0:06:23.360 diagnostic yet, but they think these factors might put certain 0:06:23.360 --> 0:06:26.880 people at higher risk from long COVID and they will, 0:06:27.320 --> 0:06:29.440 you know, possibly be a thing to look out for 0:06:29.640 --> 0:06:34.039 as scientists try to predict who's most at risk when 0:06:34.080 --> 0:06:37.720 they're in the early stages of an infection. The good 0:06:37.760 --> 0:06:40.520 thing about this, though, is that while they're doing this research, 0:06:40.600 --> 0:06:42.840 while they're looking to see what the root causes are, 0:06:43.080 --> 0:06:45.560 a lot of the scientists and researchers are focusing a 0:06:45.600 --> 0:06:48.840 lot on the treatment of the symptoms, and you know, 0:06:48.880 --> 0:06:51.720 they feel at least pretty good that they'll have something 0:06:52.160 --> 0:06:54.279 that will kind of address some of it, at least 0:06:54.320 --> 0:06:59.600 to make the symptoms not as as worse. Yeah, you know, 0:06:59.600 --> 0:07:03.440 there's a one scientist here in New York, David Petrino, 0:07:03.600 --> 0:07:08.520 who his background is in rehab therapy, and he's finding 0:07:08.560 --> 0:07:12.160 that some rehab techniques can help people with a lot 0:07:12.200 --> 0:07:14.640 of the symptoms of lung covide a. Lot of the 0:07:14.640 --> 0:07:18.560 common ones are like breathing issues or you know, because 0:07:20.280 --> 0:07:23.280 the body isn't you know, at it working at its best, 0:07:23.400 --> 0:07:28.720 you know, problems with physical movement. And there's you know, 0:07:28.800 --> 0:07:31.520 a very slow and patient coaching that can help them 0:07:31.560 --> 0:07:36.280 recover their breathing, recover their movements. Um, and that's that's 0:07:36.320 --> 0:07:39.720 proving to be quite promising, but it doesn't cover all 0:07:39.760 --> 0:07:43.080 the symptoms. And so you know, as I talked about before, 0:07:43.120 --> 0:07:46.960 there are different subsets of the condition that you know 0:07:47.200 --> 0:07:49.960 will probably require different types of treatment. You know. On 0:07:50.000 --> 0:07:53.600 the other hand, there are also scientists working on you know, 0:07:54.400 --> 0:07:58.000 looking at different drugs that might be able to to 0:07:58.200 --> 0:08:01.320 deal with the symptoms or to deal with the blood clots, 0:08:01.320 --> 0:08:06.920 and these are all in development. But two to really 0:08:06.960 --> 0:08:10.840 get them, you know, get these treatments out into the 0:08:10.880 --> 0:08:14.040 world and helping patients, we all need to have clinical trials, 0:08:14.040 --> 0:08:17.360 which are expensive, and I think hunting is a problem 0:08:17.600 --> 0:08:19.640 with a lot of long COVID research. Yeah, I mean, 0:08:19.680 --> 0:08:22.000 just to kind of illustrate how difficult this is and 0:08:22.120 --> 0:08:26.040 the range of symptoms, right, So the symptoms that people 0:08:26.120 --> 0:08:28.680 report that have long COVID, there's more than two hundred 0:08:28.800 --> 0:08:31.520 across ten groups of different organ systems. So that's just 0:08:31.560 --> 0:08:34.480 a lot of variables really, but I wanted to ask 0:08:34.520 --> 0:08:37.400 about because it was interesting. Also, they noticed that in 0:08:37.440 --> 0:08:39.839 people that had long COVID, it kind of didn't matter 0:08:40.000 --> 0:08:43.960 if you were severely infected. People that had milder symptoms 0:08:44.160 --> 0:08:46.120 still could come down with it, right, It could come 0:08:46.200 --> 0:08:49.679 back at you months later. And you know, the kind 0:08:49.679 --> 0:08:51.640 of figures into the conversation that we're having with the 0:08:51.640 --> 0:08:54.720 O Macron variant, where we are seeing a lot more 0:08:54.720 --> 0:08:57.800 milder cases, but they still don't know. It's just too 0:08:57.800 --> 0:08:59.960 early to tell if even the O Macron variant cans 0:09:00.080 --> 0:09:03.640 for some of this long COVID. Yeah, they're really not 0:09:03.679 --> 0:09:07.360 sure yet. You know, I think there it is seeming 0:09:07.360 --> 0:09:10.120 more likely that if you have really severe disease that 0:09:10.200 --> 0:09:13.520 you'll be more likely to u end up with long COVID. 0:09:13.880 --> 0:09:17.800 But again, as you said, people who have been asymptomatic 0:09:18.120 --> 0:09:20.520 or had really mild cases also end up with long COVID, 0:09:20.559 --> 0:09:23.640 So they don't know. And with O Macron, you know, 0:09:24.679 --> 0:09:27.160 it's too early to tell. O Macron has only been 0:09:27.200 --> 0:09:30.199 around for two months, so nobody's really reporting quote unquote 0:09:30.240 --> 0:09:34.600 long COVID symptoms yet, which happened after three months. Um, 0:09:34.720 --> 0:09:37.880 but what all of the research I suppoke to told 0:09:37.920 --> 0:09:42.360 me is that regardless of whether O macron causes you know, 0:09:43.080 --> 0:09:45.840 a lower rate of long COVID, and the fact that 0:09:45.880 --> 0:09:50.840 there's so many people with O macron, you know, means 0:09:50.880 --> 0:09:54.120 that even a small proportion of those people will still 0:09:54.160 --> 0:09:58.160 be a big number. It's kind of that unfortunate lottery, right, 0:09:58.240 --> 0:10:00.480 there's just so many numbers that are happening, you know, 0:10:00.520 --> 0:10:04.079 it could unfortunately befall you. So just interesting. Look, as 0:10:04.080 --> 0:10:05.680 I mentioned, this has kind of been one of the 0:10:05.760 --> 0:10:09.199 biggest mysteries since the start of the pandemic, these ongoing 0:10:09.280 --> 0:10:12.320 lingering symptoms. They're starting to nail it down, but still 0:10:12.320 --> 0:10:14.640 a long way to go before we figured out exactly 0:10:14.640 --> 0:10:18.880 what's happening. Yasmin Tayag, contributor to Vox, Thank you very 0:10:18.960 --> 0:10:24.480 much for joining us. Thank you. I'm Oxpard Ramirez and 0:10:24.480 --> 0:10:27.240 this has been reopening America. You don't forget the effort 0:10:27.240 --> 0:10:28.960 today's big news stories. You can check me out on 0:10:28.960 --> 0:10:32.080 the Daily Dive podcast every Monday through Friday. So follow 0:10:32.160 --> 0:10:34.800 us on I Heart Radio or wherever you get your podcast.