Precision Medicine for more Oxygen (P4O2) - COVID-19 extension
Understanding differences between patients with Long COVID
In the P4O2 COVID project, we investigated mechanisms that caused Long COVID and looked at whether we could discover subgroups within the group of patients with Long COVID.
We examined 95 people, 3-6 months after infection with SARS-CoV-2 and ~9 months later. The patients were included from the outpatient clinics from five hospitals in the Netherlands and ~90% of them was hospitalized at the acute infection. Clinical data were collected, questionnaires were administered, biological samples were collected, lung function tests and CT scans were performed and measurements were taken of the (home) environment (exposome). Research was also conducted in the laboratory. Some of the participants took part in a combined lifestyle intervention, in which a nutritional supplement could also be used.
The project led to the discovery of subgroups of Long COVID, which differ in terms of type of complaints and/or biological mechanisms. For example, lung complains were more frequent in one group that was clustered on the basis of their gut microbiome compared to the other group, indicating that the microbiome might be involved in the complaints. The frequency of specific complaints reduced in most of the participants, but this was not true for all participants and not for all symptoms. Clinical and environmental risk factors were found that reduce the chance of recovery. Multiple new treatment targets were found (microbiome, innate and adaptive immune system, hemoglobin, SMURF-1, IL-1b, IFNy, epithelial barrier function). The lifestyle intervention seems to increase the chance of recovery. Physicians can use this knowledge to determine treatment and governments can adjust environmental policies to address recovery from Long COVID.
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