OC43-induced Antibodies may Contribute to Long COVID Symptoms

Long COVID may occur because of past exposure to a pre-pandemic coronavirus that causes the common cold.

About 45 percent of patients with rheumatic diseases, which include rheumatoid arthritis and other chronic autoimmune disorders causing inflammation, experienced persistent symptoms associated with long COVID, 28 days after acute infection with SARS-CoV-2. This was tied to previous antibody responses to OC43 (type of corona virus), stimulating long COVID, reported researchers from across Mass General Brigham.

A person's viral history, particularly previous infections and the development of antibodies against a pre-pandemic coronavirus, may set the stage for developing long COVID ().

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‘The discovery of a biomarker-OC43 antibodies, that helps us better understand current and previous infections could shed light on an inappropriate immune response that leads to some cases of long COVID. #COVID-19 #priorinfection #immuneresponse’

The study points to a potential marker of long COVID, which could inform clinical trials and may help explain why some patients develop long COVID.

A patient population at increased risk for severe COVID-19 may help researchers understand why some people develop long-term, persistent symptoms (long COVID) while others do not.

Rheumatologists from Brigham and Women’s Hospital and Massachusetts General Hospital, founding members of the Mass General Brigham healthcare system, teamed up with experts in immunology and virology from the from the Brigham’s Division of Infectious Diseases and the Ragon Institute of Mass General, MIT, and Harvard to look for clues about long COVID in blood samples from patients with systemic autoimmune rheumatic disease.

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The team found that among these patients, those who developed long COVID were more likely to have expanded, pro-inflammatory antibodies specific to a coronavirus that causes the common cold. The new research is published in Science Translational Medicine.

“Our study offers evidence and explanation for why some of our patients may be experiencing the persistent and wide-ranging symptoms of long COVID,” said co-corresponding author Zachary Wallace, MD, MSc, of the Division of Rheumatology, Immunology and Allergy at Massachusetts General Hospital (MGH).

Tracing the Roots of Long COVID to OC43 Antibodies

Since the beginning of the pandemic, Wallace and his colleagues at the Brigham and MGH have paid special attention to this group of patients to find insights that could help inform their treatment as well as the care of broader patient populations experiencing long COVID.

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“At the very beginning of the pandemic, we joined forces to identify every rheumatic disease patient with COVID seen at our institutions so that we could follow their clinical course and collect survey and blood data,” said co-corresponding author Jeffrey Sparks, MD, MMSc, of the Division of Rheumatology, Inflammation, and Immunity at Brigham and Women’s Hospital.

“At first, we thought we might be doing this for a month or two, but the work continues today, and we are gaining important insights about a potential immune mechanism that may lead to long COVID, especially among patients with rheumatic disease,” he said.

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Wallace, Sparks, and colleagues compared immunological changes in patients with rheumatic disease who recovered from COVID-19. Specifically, investigators measured antibody responses against key antigens of SARS-CoV-2, comparing patients who developed long COVID to those who did not.

Research that spans more than one of these entities is more than the sum of its parts, helping to provide insights and unique perspectives from multiple settings and areas of expertise. Beyond the collaboration across MGH and BWH rheumatology, the work also represents a collaboration with researchers at the Ragon Institute, whose mission is to harness the immune system to prevent and cure human disease.

“When it comes to viruses, first exposure can shape lifelong immunity,” said co-corresponding author Galit Alter, PhD, who contributed to this work while at the Ragon Institute before joining Moderna Therapeutics in October 2022.

“We know that, in the setting of influenza Information about Influenza Virus Vaccine, previous exposure to a viral strain can influence a person’s immune response to subsequent strains. This concept — which we call ‘original antigenic sin,’ may be at play for coronaviruses too and may influence risk of long COVID, especially among individuals with rheumatic disease.”

The authors note that their study is restricted to individuals with rheumatic diseases, and further research is needed to determine if their findings will apply more widely to patients without a pre-existing autoimmune disorder. The researchers plan to further pursue biomarkers of long COVID, including the OC43 signature, which may be useful for developing diagnostics, therapeutics, and more targeted clinical trials to test interventions.

Reference:

Circadian rhythms, sleep, and performance in space - (https://www.researchgate.net/publication/7799615_Circadian_rhythms_sleep_and_performance_in_space)

Source-Eurekalert