More and more evidence shows how the virus lurks in your brain, lungs, intestines, eyes, and lymph nodes, which may be the cause of long Covid-19 symptoms.
We already know that the Covid-19 virus can cause serious damage to the body, causing a series of unsettling and persistent symptoms, including tachycardia, difficulty breathing, persistent cough, chronic fatigue, muscle and joint pain, neurocognitive impairment, and other heart problems, or “brain fog”, even erectile dysfunction (ED). These symptoms can persist for weeks, months, and in some cases even years after the virus test is negative.
Doctors call this “persistence of the virus.” The theory is that some people with a weaker immune system can never completely get rid of the infection. Just like the varicella-zoster virus (VZV), which lies dormant after infecting chickenpox in childhood and reappears in the form of shingles in adulthood, the Covid-19 virus may persist in the viral reservoirs in various “compartments” of your body.
The intestines last longer
Researchers closely examined the intestines of Covid-19 survivors. To explore the evidence of long-term infection with the Covid-19 virus in the gastrointestinal tract, 120 patients with mild to moderate symptoms were followed up.
Fecal, nasal, and blood samples were collected throughout the study. Viral fragments were found in feces at 28 days, 4 months, and even 10 months after the negative test in the acute phase. The persistence of the coronavirus in the intestine is longer than in the upper respiratory tract.
Blood sample results show an increase in inflammatory markers, such as an increase in white blood cell and T cell counts. This indicates that these participants are still fighting an active infection.
The intestine is just one area where the virus can hide. The virus exists in more than 30 different cell types and is present in all body tissues, inside and outside the respiratory tract, and in all major organs, including the brain, lungs, heart, lymph nodes, gastrointestinal tract, and eyes. A case showed that the Covid-19 virus persisted in the brain and other parts of the patient’s body 230 days after the first appearance of symptoms.
The virus can penetrate the lungs and take root in other areas. The viral load in these areas may be low, but it can still be identified, and this crossover may occur through the bloodstream.
Dr. Palmer, an associate professor of medicine at the University of Aurora, Colorado, who studies how the immune system responds to infectious diseases, explains another theory: certain parts of the body, such as the testicles, eyes, and brain, are considered to have immune privilege; these are areas where immune cells cannot enter well. Therefore, they are unable to fight the virus, which may lurk there.
At Harvard Medical School, David Walter’s research detected coronavirus proteins, mainly spike proteins, in the blood of some patients with long-term infection with the Covid-19 virus within a year. More patients infected with Covid-19 were found to have viral proteins in their blood in only about 20% of cases.
Negative test but lingering symptoms
Maybe you will ask the question, “How could you test negative if the Covid-19 virus is still lingering in various parts of the body?”
The way of testing the Covid-19 virus with a nasal swab only detects the virus in the upper respiratory tract, mostly in the nasal cavity, explains Dr. Palmer. So, it won’t detect the virus in your intestines, lungs, or anywhere else.
He added that more importantly, viruses such as the flu and respiratory syncytial virus (RSV) do not spread to other organs. The Covid-19 virus uses the ACE2 receptor to infect cells, which is expressed throughout the body, so Covid-19 infections are not limited to the lungs. Influenza and respiratory syncytial viruses use receptors that are more limited to the lungs and upper respiratory tract, which is why these viruses do not spread to other parts of the body like the Covid-19 virus.
The persistence of the virus
The persistence of the virus is nothing new. It is well known that common viruses, including herpes (VZV), HIV, hepatitis C, and Epstein-Barr (EBV), linger in the body, and in the case of EBV, even cause chronic diseases such as multiple sclerosis.
Coronaviruses are not the first virus to persist in the body for a long time after a negative test result. We have seen people clear the Ebola virus and find it in the eye fluid of their eyes.
In the case of the varicella-zoster virus, chickenpox may lurk and later manifest as shingles in later life, when our aging immune system is no longer as strong as before.
Potential treatments lie in finding out how to change the chronic activation of the immune system and the associated inflammation possibly caused by the hidden viral reservoir in the body.
Maybe long-term use of antiviral drugs will work, asserts Dr. Palmer: or it could be an anti-inflammatory drug, or a combination of the two. Many people are suffering from the pain of long Covid-19, and this is a race to try to find the answers.
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