With around 5% of COVID-19 patients estimated to develop long COVID, it remains a global health issue.
To help doctors and the community, experts have launched a new podcast series for health professionals to showcase new research findings, treatment options, and practical tips for GPs to introduce into their consultations.
Combining emerging research findings with practical, hands-on tips and advice, the series was designed to deliver accessible education and information, with its creators keen to ensure the disease stays on the radar for health funders and policymakers.
The podcast will be hosted by Dr David Lim, a GP and medical educator, GP and public health physician Flinders University Associate Professor John Litt, infectious disease researcher and CEO of the Burnet Institute Professor Brendan Crabb and Professor Steven Faux, a rehabilitation and pain physician.
The series will also include long COVID definitions, incidence and symptoms, describe clusters of presentations and useful investigations for GPs to utilise, and evidence and tips around approaches to rehabilitation, including paced return to exercise, and liaising with workplaces.
The team of GPs, rehabilitation and infectious disease physicians with expertise in long COVID were involved in the development of an evidence-based long COVID risk calculator, CoRiCal. This resource, developed by a consortium of Australian universities, can be used to calculate an individualised estimate of the risk of developing long COVID.
Associate Professor Litt says the calculator aims to enhance shared decision-making and inform the decisions patients make in consultation with their GPs.
Meanwhile, a research collaboration between SAHMRI, the University of Queensland, Flinders University and other institutes in Australia has shed new light on the ongoing health damage caused by long COVID, in a significant step towards improving future disease management.
Following the release of the Australian Government's COVID-19 Response Inquiry Report, the study, recently published in Nature Microbiology, has found inflammatory markers in the blood of long COVID patients 18-24 months after infection which could explain why many experience ongoing cardiovascular issues.
Officially dubbed post-acute sequelae of COVID-19 (PASC), the condition is defined by a range of symptoms, including cardiovascular symptoms in some patients such as chest pain and heart palpitations, that can persist for months or even years after recovery from the acute phase of COVID-19.
Professor of Systems Immunology at SAHMRI and Flinders University, Professor David Lynn, says the research team combined blood samples collected from patients with long COVID in South Australia and Queensland for the study, comparing long COVID patients with and without cardiovascular symptoms to healthy control samples.
"We performed an advanced method called transcriptomics on blood samples from individuals at 44 and 68 weeks post-infection, to measure which of the 20,000+ human genes were turned on and off," says Professor Lynn.
Collaborators at the University of Queensland, led by Dr Kirsty Short, subsequently showed that there were elevated trace levels of cytokines, proteins which help control inflammation in the body, in the blood samples from these individuals.
"Lab studies showed these trace-level cytokines had a direct effect on the functionality of cardiac muscle cells sometimes referred to as 'pacemaker cells,' " says Dr Short, who also helped to develop CoRiCal.
"These particular types of cells are fundamental building blocks for our heart, so damaging them could lead to the cardiovascular symptoms observed in these patients."
Dr Feargal Ryan, a postdoctoral fellow in Professor Lynn's laboratory at SAHMRI and Flinders University who led the analysis of the transcriptomics data, says the study showed a clear distinction between those with and without PASC.
"We found those with PASC consistently had increased expression of genes involved in inflammation," says Dr Ryan.
"These individuals present with different inflammatory responses depending on their symptoms. For example, those with cognitive issues may exhibit a different biological profile compared to those with heart-related concerns."
The discovery of this variation in immune response reinforces the need for a personalised treatment approach.
"Long COVID isn't one single condition but rather a range of conditions, each with its own unique mechanisms. Identifying these differences will help us manage and hopefully mitigate the impact for tens of millions of people," adds Professor Lynn.
The findings are especially timely, with the COVID-19 Response Inquiry Report highlighting the need for continued research into the long-term health effects of the virus.
Further research will aim to diagnose the causes of this prolonged inflammation and how it might be treated.
"We still have a lot to learn about what keeps the immune system in this heightened state. Understanding this will be vital in developing effective treatments and support for those living with long COVID," says Professor Lynn
The study was made possible by the combined efforts of a large team, including the patients who donated samples, clinical teams at hospitals across the country that collected the samples, the South Australian Genomics Centre, as well as support from the Flinders Foundation to conduct transcriptomics.
