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Arkansas Researchers Find Potential Cause of ‘Long Haul’ COVID-19 Symptoms

A research team from the University of Arkansas for Medical Sciences has identified a potential cause of long-lasting symptoms experienced by COVID-19 patients, often referred to as “long-haul carriers.”

Dr. Terry Harville consults with Dr. John Arthur in the lab – UAMS News

At the heart of the team’s findings is an antibody that appears weeks after an initial infection and attacks and disrupts a key immune system regulator, said lead researcher John Arthur, MD, Ph.D., professor and head of the Division of Nephrology at the UAMS School of Medicine, Department of Internal Medicine.

Up to 30% of COVID-19 patients experience persistent fatigue, mental confusion, and shortness of breath. The cause of the long COVID-19 has eluded scientists, but the UAMS team’s discovery sheds important new light on the molecular-level mechanisms behind it.

“Everything we have found is consistent with this antibody as the instigator of a prolonged COVID, so it is an exciting development,” said Dr. Arthur.

The antibody creates problems for the immune system by attacking angiotensin converting enzyme 2 (ACE2). The ACE2 enzyme helps regulate the body’s response to the virus by metabolizing a peptide that activates the immune system.

The attacking antibody interferes with the work of ACE2, making the antibody the prime suspect in long-standing disease.

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The multidisciplinary research team quickly met this spring to test the hypothesis that developed through discussions between Arthur and Terry Harville, MD, Ph.D. from UAMS, professor in the Department of Pathology and medical director of the Histocompatibility and Immunogenetics Laboratories.

Researchers tested plasma or serum for ACE2 antibodies in 67 patients in Arkansas and Oklahoma with known SARS-CoV-2 (the virus that causes COVID-19) and 13 with no history of infection. In 81% of blood samples from patients with a history of COVID-19, the samples had the antibody that attacked ACE2. In participants with no history of COVID-19, no antibodies were created to attack the ACE2 enzyme.

“If we show that the whole hypothesis is correct, that this ACE2 interference actually causes prolonged COVID, then a lot of potential treatments open up.” said Arthur. “There are drugs that should work to treat them.”

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The next step would be to try medications that could alleviate the symptoms that people have.

Little Rock Scientists published his findings this month in the magazine, The ONE Public Library of Sciences (PLUS ONE).

“This is real team science,” Arthur said. “We brought together a large group of researchers who had never worked together to produce these exciting results.”

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