A role for NK and T-cells dysfunctions in Long-COVID fatigue [COVID-19]

  • Research type

    Research Study

  • Full title

    A role for NK and T-cells dysfunctions in the development of Long-COVID fatigue

  • IRAS ID

    297784

  • Contact name

    Frederique Ponchel

  • Contact email

    mmefp@leeds.ac.uk

  • Sponsor organisation

    The University of Leeds/head of Research integrity and Governance

  • Clinicaltrials.gov Identifier

    not applicable, not applicable

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Prolonged symptom of fatigue over 12 weeks post infection, labelled as Long-COVID are appearing at an alarming rate in COVID patients from the community. It is already suggested that 10% of patients report fatigue persisting for >12 weeks after recovering from the infection (with >300,000 cases already reported in last November 2020).

    From the past experience with other virus-related prolonged (or chronic) fatigue, the main findings were that treatment including exercising have limited efficacy. Management of CF therefore focus on a “Pacing” strategy, allowing to perform activities on limited energy resources, paracetamol, napping, and "DO NOT" exercise as the main advice. Success and resolution on the long term depends on early recognition and treatment over the first 3 years post infection. Outcome is unpredictable, some people recuperating well and other suffering for years/life.

    The cellular and molecular basis of chronic fatigue are unclear but dysfunctions of the immune system have been associated with chronic fatigue for over 2 decades. One hypothesis notably relates a dysfunctional immune response to the virus which continues while the virus is gone, with possible altered processes in the brain related to maintaining inflammatory responses, potentially resulting in cognitive impairment, although this remains to be demonstrated. Immune dysfunctions include abnormalities in blood white cells (with NK and T-cell responses) and inflammation (with cytokine release).

    Mapping the immune abnormalities specific to Long-COVID is the first task to elucidate the role of NK and T-cells in this conditions. How these dysfunctions change with time and with respect to the severity of the fatigue also needs to be established.

    Overall, we aim at identifying immune abnormalities and to determine if they can return to normal with an effective management of the fatigue. This may open new therapeutic opportunities to improve patient’s response to rehabilitation by simultaneously targeting immune functions that are deficient.

  • REC name

    East Midlands - Leicester South Research Ethics Committee

  • REC reference

    21/EM/0112

  • Date of REC Opinion

    29 Apr 2021

  • REC opinion

    Further Information Favourable Opinion