Posted on Infectious Diseases

New study highlights scale and impact of long COVID

Researchers from the Universities of Arizona, Oxford and Leeds analyzed dozens of previous studies on long-term COVID-19 to examine the number and range of people affected, the underlying mechanisms of the disease, the many symptoms that patients develop, and current and future treatments.

Long COVID, also known as Post-COVID-19 condition, is generally defined as symptoms persisting for three months or more after acute COVID-19. The condition can affect and damage many organ systems, leading to severe and long-term impaired function and a broad range of symptoms, including fatigue, cognitive impairment – often referred to as ‘brain fog’ –  breathlessness and pain.

Long COVID can affect almost anyone, including all age groups and children. It is more prevalent in females and those of lower socioeconomic status, and the reasons for such differences are under study. The researchers found that while some people gradually get better from long COVID, in others the condition can persist for years. Many people who developed long COVID before the advent of vaccines are still unwell.

“Long COVID is a devastating disease with a profound human toll and socioeconomic impact,” said Janko Nikolich, MD, PhD, “By studying it in detail, we hope to both understand the mechanisms and to find targets for therapy against this, but potentially also other infection-associated complex chronic conditions such as myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia.”

If a person has been fully vaccinated and is up to date with their boosters, their risk of long COVID is much lower. However, 3%-5% of people worldwide still develop long COVID after an acute COVID-19 infection. According to the Centers for Disease Control and Prevention, long COVID affects an estimated 4%-10% of the U.S. adult population and 1 in 10 adults who had COVID develop long COVID.

The review study also found that a wide range of biological mechanisms are involved, including persistence of the original virus in the body, disruption of the normal immune response, and microscopic blood clotting, even in some people with only mild initial infections.

There are no proven treatments for long COVID yet, and current management of the condition focuses on ways to relieve symptoms or provide rehabilitation. Researchers say there is a dire need to develop and test biomarkers such as blood tests to diagnose and monitor long COVID and to find therapies that address root causes of the disease.

People can lower their risk of developing long COVID by avoiding infection – wearing a close-fitting mask in crowded indoor spaces, for example – taking antivirals promptly if they do catch COVID-19, avoiding strenuous exercise during such infections, and ensuring they are up to date with COVID vaccines and boosters.

“Long COVID is a dismal condition but there are grounds for cautious optimism,” said Trisha Greenhalgh, lead author of the study and professor at Oxford’s Nuffield Department of Primary Care Health Sciences. “Various mechanism-based treatments are being tested in research trials. If proven effective, these would allow us to target particular subgroups of people with precision therapies. Treatments aside, it is becoming increasingly clear that long COVID places an enormous social and economic burden on individuals, families and society. In particular, we need to find better ways to treat and support the ‘long-haulers’ – people who have been unwell for two years or more and whose lives have often been turned upside down.”

Posted on Diabetes, Multiple Sclerosis

Can we ‘recharge’ our cells? A break through for MS folks and diabetics?

MoS₂ nanoparticles

A microscopic look into a cell with MoS₂ nanoparticles Credit Dr Akhilesh Gaharwar/Texas A&M Engineering

We might take a vacation or relax at the spa when we need to recharge. But what if we could recharge at the cellular level, fighting against ageing and disease with the microscopic building blocks of the human body?

The ability to recharge cells diminishes as humans age or face diseases. Mitochondria, often called the cell’s powerhouse, are central to energy production. When mitochondrial function declines, it leads to fatigue, tissue degeneration, and accelerated ageing. Activities that once required minimal recovery now take far longer, highlighting these organelles’ role in maintaining vitality and overall health.

While current treatments for ailments related to ageing and diseases like type 2 diabetes, Alzheimer’s, and Parkinson’s focus on managing symptoms, Texas A&M researchers have taken a new approach to fighting the battle at the source: recharging mitochondrial power through nanotechnology.

Nanoflowers

Led by Dr. Kanwar Abhay Singh, a biomedical engineering postdoctoral associate in the Gaharwar Laboratory at Texas A&M, the team has developed molybdenum disulfide (MoS₂) nanoflowers. Named because of their flower-like structure, these nanoparticles contain atomic vacancies that can stimulate mitochondrial regeneration, helping cells generate more energy.

“These findings offer a future where recharging our cells becomes possible, extending healthy lifespans, and improving outcomes for patients with age-related diseases,” said Dr. Akhilesh Gaharwar, Tim and Amy Leach Professor and Presidential Impact Fellow in the Department of Biomedical Engineering at Texas A&M.

According to Gaharwar, the nanoflowers could offer new treatments for diseases like muscle dystrophy, diabetes, and neurodegenerative disorders by increasing ATP production, mitochondrial DNA, and cellular respiration. They discovered that the atomic vacancies in the nanoflowers stimulate the molecular pathways involved in mitochondrial cell replication.

Research collaborators include Texas A&M faculty and students. From the Department of Biophysics and Biochemistry, Dr. Vishal Gohil provided insights into the mechanisms that could drive the improvement of mitochondrial function.

“This discovery is unique,” Dr. Gohil said. “We are not just improving mitochondrial function; we are rethinking cellular energy entirely. The potential for regenerative medicine is incredibly exciting.”

Other Department of Biomedical Engineering contributors include Dr. Hatice Ceylan Koydemir, assistant professor, and Dr. Irtisha Singh, an affiliate assistant professor in the Department of Molecular and Cellular Medicine. Singh contributed computational analysis that revealed key pathways and molecular interactions responsible for the energy boost.

A Profound Discovery

“By leveraging advanced computational tools, we can decode the hidden patterns in cellular responses to these nanomaterials, unlocking new possibilities for precision medicine,” Singh said. “It’s like giving cells the right instructions at the molecular level to help them restore their own powerhouses — mitochondria.”

The next steps for the research team include identifying a method for delivering the nanoflowers to human tissue, with the goal of eventual clinical application.

“In science, it’s often the smallest details that lead to the most profound discoveries,” Gaharwar said. “By focusing on the unseen — like atomic vacancies in nanomaterials — we are uncovering new ways to solve big problems. Sometimes, the real breakthroughs come from digging deeper and looking beyond the obvious.”

Posted on autoimmune conditions, Diabetes, Lupus

Women with premature ovarian insufficiency are at greater risk of autoimmune diseases

Women with premature ovarian insufficiency are at greater risk of severe autoimmune diseases

Dr Susanna Savukoski – Credit

Severe autoimmune conditions such as Type I diabetes, Addison’s disease, lupus and inflammatory bowel disease are between two to three times more common in women who have been diagnosed with premature ovarian insufficiency (POI) compared to the general population.

The research, published today (Thursday) in Human Reproduction, one of the world’s leading reproductive medicine journals, is the largest to investigate the link between autoimmune conditions and POI, has followed nearly 20,000 women for longer than any other study and is the only one to match women with POI with women of similar ages in the general population for comparison.

The researchers say their findings significantly strengthen the hypothesis that autoimmune processes play a “pivotal role” in the onset of POI.

POI occurs when ovaries no longer work properly and have stopped producing eggs in women younger than 40 years. Periods become irregular and then stop, and some women experience menopause symptoms.

Dr Susanna Savukoski, a gynaecology and obstetrics doctor at Oulu University Hospital and University of Oulu, Finland, led the study. She said: “Estimates of the prevalence of premature ovarian insufficiency of autoimmune origin have ranged from 4% to 50%. Our study has found that autoimmune diseases were two-to-three-fold more common in women diagnosed with POI at the time they were diagnosed, and the incidence of these diseases was two-to-three-fold higher during the first years after being diagnosed with POI, compared to a control group of similarly aged women from the general population. The incidence was higher than in the control group even more than a decade after being diagnosed with POI.”

Dr Savukoski and her colleagues analysed health data from Finland’s comprehensive registries. From the medicine reimbursement registry maintained by the Social Insurance Institution of Finland, they identified 3972 women who had been granted the right to full reimbursement for hormone replacement therapy (HRT) because of POI diagnosis under the age of 40 years between the years 1988 and 2017. Each woman with POI was matched with four women of similar ages, forming a control group of 15708 women. Both groups of women analysed data on severe autoimmune conditions – diseases diagnosed and treated in specialist health centres – between 1970 and 2017.

They found that among women who were diagnosed with POI, 223 women (5.6%) had been diagnosed with at least one autoimmune disorder before the date when reimbursement for HRT because of POI was granted, and 503 women (12.7%) were diagnosed with at least one autoimmune disorder after the date of HRT during the follow-up period.

Women were 2.6 times more likely to have an autoimmune disorder before a POI diagnosis when compared to the control group. Among women with POI, the risk of autoimmune conditions ranged from nearly double for over-active thyroid glands to almost 26 times for polyglandular autoimmune diseases – rare diseases of the hormone (or endocrine) system.

Women without existing autoimmune diseases at the time they were diagnosed with POI were nearly three times as likely to be diagnosed with an autoimmune disease in the following three years, with the risk decreasing but still significantly higher than in the control group during the follow-up period of at least 12 years. 

Dr Savukoski said: “These findings reflect the fact that the association between POI and severe autoimmune diseases is strong and that the women with POI have long-term risk for autoimmune conditions. As with POI, severe autoimmune diseases typically manifest with significant symptoms and can have very unfavourable effects on general health, functional ability and quality of life. Luckily, there are good medication options available for many of these conditions.

“It’s important to stress that most women with POI do not develop severe autoimmune conditions, and most women with severe autoimmune diseases do not develop POI. However, medical professionals should be aware of the increased risk, and patients should also be informed about it.

“It should be noted that the risk is not the same for all autoimmune conditions: the association between POI and some autoimmune conditions, such as polyglandular autoimmune syndrome, Addison’s disease and vasculitis, was very strong – a ten to 26-fold risk of having these diseases among women with POI preceding their POI diagnosis compared to the controls – while the risk of having rheumatoid arthritis or hyperthyroidism was about two-fold.

“As POI threatens fertility at a young age, this indicates that women with an increased risk of the condition should be encouraged to try to conceive when they are young. However, some autoimmune diseases can significantly increase the risk of pregnancy complications, especially if therapeutic control is not good enough, and this should be considered in discussions with patients. Unfortunately, so far, there are no treatments available to prevent the development of POI or autoimmune diseases.”

The biological mechanisms underlying the association between POI and autoimmune diseases are not fully understood, especially as the mechanisms may differ depending on the disease.

“Future research should focus on finding detailed mechanisms of how POI develops in different autoimmune conditions. That would enhance the development of preventive treatments against POI of autoimmune origin and other autoimmune conditions as well,” said Dr Savukoski. “We are investigating whether long-term use of HRT can prevent other conditions developing among women with POI.”

Posted on Diet

Vegans’ intake of protein and essential amino acids is adequate but ultra-processed foods are needed

The study concluded that textured soy protein and plant-based protein supplements were the main ultra-processed products determining adequate protein intake for Brazilian vegans. The research involved 774 men and women.
Textured soy protein and plant-based protein supplements were the main ultra-processed products that determined adequate protein intake for vegans.

Their findings show that, on average, the participants consumed the recommended amount of proteins and essential amino acids and that their diet consisted mainly of unprocessed and minimally processed foods. However, participants who consumed proportionally lower levels of industrialized products such as protein supplements and textured soy protein were more likely to exhibit inadequate protein intake, suggesting a significant reliance on nutrients from ultra-processed proteins for this population.

Coined by researchers at the same university’s School of Public Health (FSP-USP), the term “ultra-processed products” refers to industrially formulated edible substances synthesized from fractionated ingredients and blended with chemical additives (colours, aromas, emulsifiers, thickeners etc.) to enhance their palatability.

“Our results contradict the stigma that a vegan diet can’t provide the amount of protein and essential amino acids a person needs and show that a vegan diet can be nutritionally adequate. Moreover, the vegans in the study consumed ultra-processed products less than the general population,” said Hamilton Roschel, head of the Applied Physiology and Nutrition Research Group at FM-USP’s Center for Lifestyle Medicine.

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“Animal food products are known to be generally more dense in protein and essential amino acids. For example, meat, milk and eggs contain more protein per gram than rice or beans. It was therefore important to investigate whether this requirement was met by diets consisting solely of plant protein,” Roschel said.

This was the main reason for investigating whether a vegan diet affords adequate protein and acceptable levels of essential amino acids.

The study also found a significant correlation between adequate protein intake and consumption of ultra-processed products. “Although this group consumed a small amount of ultra-processed products, some participants appeared to rely on them to meet their protein needs. This is partly because unprocessed foods are generally less dense in protein, which paved the way for the so-called meat substitute industry, whose market share is growing,” Roschel said.

Meat substitutes consist of plant protein processed to mimic different types of meat, such as vegan hamburgers, sausages, and nuggets. Cheese substitutes, such as soy, pea, rice, or potato protein, are also available. Both are considered ultra-processed products.

It is worth noting that consumption of ultra-processed products is associated with a heightened risk of weight gain, diabetes, hypertension and other cardiovascular diseases, depression, some types of cancer, and premature death. Not all the effects of plant-based ultra-processed products are known, but recent evidence suggests they, too, maybe unhealthy.

The researchers concluded that textured soy protein (TSP) and plant-based protein supplements were the main ultra-processed products that determined adequate protein intake for Brazilian vegans.

“Although they tend to be classified as ultra-processed products, TSP and protein supplements aren’t necessarily unhealthy, which can’t be said of ultra-processed products that contain high levels of fat, sugar, sodium, preservatives and artificial additives, for example,” Roschel said.

As a broad category, Ultra-processed products are considered unhealthy in many studies, but there is robust evidence that soy-derived foods do not harm human health. “TSP is an important source of protein and essential amino acids for vegans, even though it’s classified as ultra-processed. Ultra-processed products vary considerably in formulation, and despite the consensus that they should generally be avoided, it isn’t reasonable to ignore the clear differences between them,” he said.

As the researchers note, the same can be said about plant-based protein supplements, “an evidence-based strategy to support muscle health also associated with protein adequacy” in different contexts, such as when unprocessed and minimally processed foods do not supply sufficient protein or when a clinical condition requires a different kind of nutritional management. “In these contexts, plant-based protein plays an important role and should not be overlooked,” Roschel said.

“Our findings don’t show that ultra-processed products are good, and the findings should not be used to encourage their consumption. However, it would be wrong to close one’s eyes to their significant differences and the importance of their role in specific contexts.