Clinicians who treat long COVID are acutely aware of the unsettled nature of the field. “You do sort of feel like you’re out in the wilderness,” says Dr. Rasika Karnik, medical director of UChicago Medicine’s post-COVID clinic.
But researchers are making progress in the field, and they presented their recent findings at one of the first major gatherings dedicated to sharing emerging evidence about the possible root cause of long COVID and implications for treatment.
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There’s now strong evidence that protein and genetic material from SARS-CoV-2 persist in the blood and tissue of some long COVID patients well after their initial illness. Scientists believe these “viral reservoirs” could be driving many of the problems in long COVID patients, although it isn’t yet clear exactly how this is happening — and whether the virus itself is replicating.
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But the story gets more messy from there because these viral reservoirs may not be the primary culprit.
While they are more likely to find viral persistence in the most symptomatic long COVID patients, not everyone with long COVID has it, Peluso notes, “And then really importantly, we’re also seeing this in some people who feel totally fine — and we don’t know what that means.”
