Published: July 11, 2022 By Tristan Manalac BioSpace Scientists from Brigham and Women’s Hospital and Massachusetts General Hospital have discovered that the presence of the SARS-CoV-2 spike protein in plasma could be a hallmark of long-lasting COVID. These results show that the virus can remain in the body of patients suffering from prolonged symptoms. The data, published in June on the medRxiv preprint server, revealed that of the 37 participating patients with persistent symptoms, 65% had detectable levels of viral antigens in their plasma samples. The most common of these was the spike protein, which was detected in 60% of all long COVID models. Meanwhile, the spike protein was absent in the plasma of patients who did not suffer from prolonged symptoms of COVID-19. A total of 63 patients who had recovered from COVID-19 participated in the study. To look for long-term biomarkers associated with long-term COVID-19, blood samples were collected at least twice during the year after each participant’s first positive swab test. The findings have not yet been peer-reviewed. Long-term COVID, technically called post-acute sequelae of COVID-19, refers to symptoms that persist, recur, or occur months after the patient has cleared the initial infection. These symptoms vary widely, ranging from prolonged fatigue or coughing to diarrhea, rashes, and disturbances in a woman’s menstrual cycle. In some cases, long-term COVID can even manifest as depression and anxiety or cognitive problems such as brain fog. While anyone infected with the coronavirus can become ill for a long time from the coronavirus, those with severe illness, as well as unvaccinated patients, may be at much higher risk. Therefore, the United States Centers for Disease Control and Prevention points out that vaccination is an effective way to prevent post-acute symptoms. To work alongside the coronavirus vaccines, several companies are developing drugs to target different long-term symptoms of COVID-19. Clinical-stage biotech company Axcella Health has an ongoing Phase IIa study to evaluate candidate AXA1125 for long-term COVID. In preclinical studies, Axcella’s candidate showed promise in reducing markers of insulin resistance, inflammation and fibrosis. Preliminary data from clinical studies are expected later this year. Joining Axcella is Boston-based PureTech, which used LYT-100-COV (depirfenidone), an anti-inflammatory and anti-fibrotic agent, to treat persistent respiratory symptoms following COVID-19. However, the company announced last month that its candidate had not met its primary Phase II endpoint and could not demonstrate a significant benefit over placebo. LYT-100 is no longer in development for long COVID and has been dedicated exclusively to idiopathic pulmonary fibrosis. In addition, a recent trial found that thromboprophylaxis, primarily using Johnson & Johnson’s Xarelto (rivaroxaban), can significantly reduce the incidence of fatal venous thromboembolism, cardiovascular death, and other cardiac complications after recovery from COVID-19. The drug was also largely safe for this indication, causing no bleeding episodes and causing allergic reactions in only 1% of recipients. Takeda’s Trintellix (vortioxetine), a well-known antidepressant, is also being tested as a treatment for cognitive problems after COVID-19. The randomized, double-blind, placebo-controlled Phase II trial is planned to enroll approximately 200 participants and quantitatively assess cognitive function via the Digital Symbol Substation Test. The study is expected to be completed within the year. Also in Phase II evaluations is Genentech’s Esbriet (pirfenidone), which is being tested against pulmonary fibrosis after COVID-19. Enrolling nearly 150 patients, the trial will pit the trial drug against a placebo and compare the induced changes in forced vital capacity and pulmonary fibrosis. The study was expected to have been completed last month, although no figures are available. Source: BioSpace
