Thread by @microbeminded2

For more context: The team found #SARS-CoV-2 proteins indicative of viral persistence in 25% of people up to 14 months after #COVID. They controlled for vaccination + reinfection. There were very few false positives in the pre-pandemic samples, confirming accuracy of the methods

https://twitter.com/microbeminded2/status/1777482756534243827

2/ The viral proteins were found in participant blood. Where did they come from? As described in our paper below, it’s possible that at least some of the proteins “leak” into blood from persistent reservoirs of SARS-CoV-2 in tissue (gut, lungs etc): pubmed.ncbi.nlm.nih.gov/37667052/

3/ This means the new Lancet findings could even be underestimating SARS-CoV-2 reservoirs in people after COVID, since protein from reservoirs deep in the #brain or #nerves might not have made it into blood to be measured by the ultra-sensitive test used in the study

4/ Viral proteins that do leak into blood could also become trapped inside #immune cells or microclot deposits, meaning they would also be missed by the ultra-sensitive test

5/ Also, it’s possible that ultra-ultra sensitive methods - that can detect even tinier amounts of viral #proteins than the test used in the study - may need to be developed to find proteins in all post-COVID blood

6/ Overall persistence of SARS-CoV-2 in tissue (with protein potentially leaking into blood) is supported by other research. For example, the same UCSF team behind the Lancet study also found SARS-CoV-2 RNA in gut tissue up to 600 days after infection: medrxiv.org/content/10.110…

7/ This French team presented a poster showing spike in #LongCovid blood. They also found SARS-CoV-2 double stranded RNA indicative of viral replication in the platelets of LongCovid patients: croiconference.org/abstract/persi…

8/ Going back to the new Lancet findings, it’s true they found viral protein in blood from some people w/o symptoms. But what could such persistence mean for long-term #health? Perhaps it ups the chance such people cld develop chronic #disease/cardiac events in the future?

9/ B/c the most debilitating chronic diseases of our time are being tied to persistent viral infection. For example this Harvard team found that - in a neuron model - #Alzheimer’s amyloid plaque can form in response to viruses: pubmed.ncbi.nlm.nih.gov/30001512/

10/ And indeed rates of Alzheimer’s (and cardiovascular disease, diabetes) are all on the rise after COVID. For example this study found that older adults had a significantly increased risk for a new Alzheimer’s diagnosis within 360 d after COVID: pubmed.ncbi.nlm.nih.gov/35912749/

11/ Thus while SARS-CoV-2 persistence may not account for every problem after COVID (other microbiome, autoimmune issues etc can also be at play) #persistence should be further studied and funded with incredibly urgency. It is a clear, solid lead in the post-#COVID illness field

12/ At @polybio we studying SARS-CoV-2 persistence. We have formed a global Consortium of scientists working to document potential viral reservoirs in #LongCovid and related chronic conditions, with data channeled into clinical trials: polybio.org/longcovid

@polybio 13/ But many more public/private stakeholders should join the space! Recently @NIHDirector you posted abt NIH investment in therapies for #HIV reservoirs. Can you also prioritize the development of #SARS-CoV-2 reservoir diagnostics & therapeutics?

@polybio @NIHDirector 14/ @ARPA_H: The Lancet study shows that key #technology innovators such as Harvard’s David Walt are in the #LongCovid/persistence space. Can you dedicate a specific program officer to help such teams rapidly develop their tools and platforms?

@polybio @NIHDirector @ARPA_H 15/ Overall SARS-CoV-2 RNA has been found in the lymph node tissue of #children hundreds of days after infection. That is concerning for the health of our next generation. We must take more action now on a global level to study SARS-CoV-2 persistence: nature.com/articles/s4159…