Unveiled: The Long-Term Effects of COVID-19

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I was sitting in macroeconomics, exchanging glances with my classmates as we watched the clock tick by to the end of the school day  After attending macroeconomics, my last class of the day, I am ready to leave school and talk to my fellow classmates in the hallways.  Suddenly, our assistant principal storms into the crowd of high-schoolers – we are forced to clear out the hallway, and, shockingly, that was the end of high school as we knew it.  Much like everyone else, I did not understand what COVID-19 really was and patiently waited for the end of this pandemic.     

According to the CDC, there have been “78 million COVID-19 cases, and more than 926,000 deaths reported in the United States since the start of the pandemic” [2].  To put this into perspective, the SARS-CoV-1 pandemic had about 8,096 cases. [4]. The H1N1 Influenza pandemic had between 700 million and 1.4 billion cases, with about 284,000 deaths – a death to case ratio much smaller, but still devastating, than the ratio for our current pandemic [4]  As a result of this pandemic, there has also been a drastic increase in the number of hospital visits for issues related to mental health and behavior among adolescents, with the number of pediatric emergency department visits increasing between 2019 and 2022 – a time period that appropriately coincides with the onset of this socially isolating pandemic [4].  

Fortunately, the number of new COVID-19 cases has been plateauing, with the projected 7-day average of new cases decreasing by almost 43% [4]. Of course, one must pose a few questions: what are the long-term effects of the virus?   What role does the vaccine play in mitigating the long-term effects of COVID?  Is there any way to combat this virus’ long-term effects effectively, or have all of our scientific efforts been in vain? 

Long-term effects of COVID-19 have often been referred to as “Long COVID,” and it has afflicted almost half of the individuals who have been diagnosed with COVID-19 – specifically, these individuals have faced lingering COVID-19 symptoms for nearly six months after their initial diagnosis according to a study performed by the Penn State College of Medicine.  Some of the common symptoms of Long COVID, as identified by Dr. Vernon Chinchilli and his research associates, noted issues in mobility, cardiovascular health, mental health, mobility, and a variety of other newly developed abnormalities not previously present or prevalent in those individuals prior to COVID-19 diagnosis [3]. 

Unfortunately, the biological basis behind long-term COVID-19 is not so clear, though there have certainly been ideas behind this phenomenon.  Dr. William Murphy, a UC-Davis based immunologist, proposed an autoimmune mechanism that has the possibility of explaining Long COVID, which centered around the cascading pathway initiated by a spike protein [5]. This is a protein that contains peplomers (or “spikes”), which it uses to gain entry into a host cell.  More detailed explanations have been put forth by Dr. Aaron Ring and Dr. Akiko Iwasaki, both of whom are immunologists based in the Yale School of Medicine. In their paper, Dr. Ring and Dr. Iwasaki propose a model based on autoantibodies, antibodies that mistakenly target and react with a person’s own tissues or organs, that have been found to possibly linger in the immune systems of patients diagnosed with acute COVID-19 which damage nearby tissue and other essential structures [1].  

 Will the recent development of effective COVID-19 vaccination treatments somewhat curb the long-term effects of COVID-19, or are long-term effects truly random and out of our scientific and human control? To answer this, we must briefly discuss the science behind the vaccine and understand the backbone that governs how it actually works.  First, the COVID-19 vaccine works by inducing and elevating the amount of T cells and antibodies present in our immune system that can correctly identify and attack SARS-CoV-2 viral particles, preventing it from spreading and replicating – leading to “hidden reservoirs in the body,” stated Dr. Akiko Iwasaki [6].  In essence, the act of being vaccinated allows an individual to mount a more targeted attack on the COVID-19 virus in such a way that the virus is not able to spread across the immune system, thereby decreasing the longevity of symptoms and reducing the likelihood that one contracts it at all.  Therefore, the vaccine allows us more leeway and normalcy with regards to living life the “normal” way.   

Despite the T cells and antibodies activated by the COVID-19 vaccine, research has not been able to definitively prove that the vaccine prevents any long-term viral effects.  According to research preprinted in August 2021 by a group of researchers based in Northwestern University, “a subset of T cells is persistently activated as would happen with an ongoing SARS-CoV-2 infection” [5].  This is not to say that the vaccine has been ineffective – as shown by numerous articles, including one in which Dr. Wilder-Smith states that “symptomatic cases in household contacts of vaccinated cases was about 50% lower than that among household contacts of unvaccinated cases” [8]. 

It is practically a fact that COVID-19 will continue to envelop every part of our lives, from going to the grocery store on a Sunday morning to heading to the movies with our friends.  One would hope that vaccination is the only key required to unlock the heavily guarded mystery that is the solving of COVID-19.  Unfortunately, COVID-19 is a multi-faceted virus trapped behind a plethora of doors and an amalgamation of treatments and tools that must come together to mitigate the giant that is SARS-CoV-2.  Only through a holistic and novel solution can we truly get back to a sense of normalcy.  By working together our chances of reaching normally drastically increases.  As the late poet Mattie Stepanek states, “Unity is strength… when there is teamwork and collaboration, wonderful things can be achieved” [7]. 

Edited by: Nick Rogers
Illustrated by: Jenny Yoo

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