Interview about new post-Covid study in Marburg
“Symptoms significantly improved or completely disappeared”
New study on post-Covid
(Translated via Google.)
A research team from Marburg has found a new approach to treating post-Covid symptoms: cholesterol and blood pressure medications are showing astonishing success. However, study initiator Bernhard Schieffer does not want to give the all-clear about the corona virus in an interview.
Researchers in Marburg have taken a step forward in alleviating the long-term effects of corona: In a new study , they identified a protein that is altered in post-Covid patients. They then treated these people with a combination of cholesterol-lowering drugs and drugs for high blood pressure.
The result: In up to 90 percent of those affected, symptoms such as fatigue, dizziness, sleep disorders or heart palpitations were alleviated or even disappeared completely. Bernhard Schieffer, head of the post-Covid outpatient clinic at Marburg University Hospital and co-author of the study, explains in an interview why this is good news, but not yet a cure for long and post-Covid.
hessenschau.de: Professor Schieffer, where do we stand in the fifth year since the outbreak of the Corona pandemic from the perspective of long-term or post-Covid research?
Bernhard Schieffer: From the perspective of long and post-Covid research, we are faced with two problems. One problem is that each corona wave continues to generate between eight and 15 percent new long or post-Covid cases, which will remain the case according to the WHO and RKI. The numbers vary greatly depending on which gender or age group you look at. This is a very current problem because people no longer accept that corona even exists anymore.
The second problem is that certain patients are at risk of developing chronic ME/CFS disease, meaning that these patients will remain permanently ill or restricted. This refers to patients who were infected during the hot phase of the corona pandemic until around the end of 2022 or who were plunged into post-vaccine symptoms as a result of the vaccine. And we do not yet know the biochemical causes of this chronicity.
Long and post-Covid, ME/CFS
Long Covid refers to longer-term health impairments after a corona infection that extend beyond the acute phase of the illness of about four weeks. In the literature, post-Covid is referred to after twelve weeks in adults, and after just eight weeks in children and adolescents.
ME/CFS can occur after a viral infection such as mononucleosis, the real flu and COVID-19. One of the main symptoms is that patients are no longer able to cope. This so-called post-exertional malaise (PEM) can be triggered by physical or mental exertion, and even by overstimulation - for example by light or noise.
hessenschau.de: Are solutions to the problems in sight?
Schieffer: There are different approaches. There is the strategy of the Federal Minister of Health, who, among other things, wants to release an off-label drug atlas for treatment in the next few weeks ( off-label drugs are used for diseases for which they are not actually approved, editor’s note ). In addition, the Federal Ministry of Education and Research and the Federal Ministry of Health have launched various initiatives.
But, as is often the case with scientific projects, they simply need time. The projects have to be initiated, have to get started, have to be assessed. A lot has been done worldwide, not just in Germany, but the wheels of justice simply grind slowly.
hessenschau.de: Where does your current research project start?
Schieffer: Our project aims to find new biomarkers that are suitable for monitoring post-Covid patients ( biomarkers are characteristics that can be measured in blood or tissue samples. They can indicate diseases, editor’s note ). We have identified the so-called HDL, the high density lipoprotein. It is also called the “good cholesterol”.
It is one of the few molecules that can migrate in and out of any organ system, taking cell waste products with it. That is its biological task. It ultimately migrates back to the liver, where these waste products are metabolized.
The hypothesis of our interdisciplinary team was that changes in cholesterol metabolism and long-term dysregulation of blood pressure could be at least partly responsible for post-Covid or post-vaccine symptoms.
hessenschau.de: And your hypothesis turned out to be true?
Schieffer: Yes, the background is that HDL works like a vacuum cleaner bag. For us, it is a look into the crystal ball of post-Covid. In it, we find many insightful molecules that also point to new biochemical processes that are impaired or partially destroyed by Corona.
Compared to healthy controls, the patients’ HDL cholesterol showed significant changes. We then gave the patients a cholesterol-lowering drug and a medication for high blood pressure.
Four to six months later, we followed up with the patients and almost all of them - between 85 and 90 percent - had significantly improved their symptoms or had completely disappeared.
hessenschau.de: What symptoms did the study participants have? There is a whole range of symptoms that can be attributed to post-Covid or post-vaccine.
Schieffer: The question of symptoms is a very critical one. We selected the patients very carefully. We assigned the symptoms of our many patients to certain clusters using an AI-based mathematical algorithm. Based on this, we selected the patients and assigned them to this therapy.
The group we examined here had developed an infection-related lipid metabolism disorder; this is the largest group of patients.
hessenschau.de: But it is not yet a causal post-Covid treatment.
Schieffer: It is a rapidly available therapeutic approach that can be chosen to eliminate the worst symptoms. We are not talking about working on the cause. We do not yet know how to get the coronavirus out of the body. It is similar to the Epstein-Barr virus or the HIV virus. The adequate development of drugs for such a disease takes a very long time.
hessenschau.de: How far has research into the causes progressed?
Schieffer: Today, we assume that Covid-19 is a disease that begins in the lungs and then develops into a generalized vascular inflammatory disease - with corresponding thrombus formation, disruption of the blood-brain barrier, disruption of cerebral blood flow and corresponding nerve inflammation.
This is also where the very varied post-Covid symptoms come from, from visual disturbances to the development of neurodegenerative diseases such as MS or Parkinson’s to inflammation-like cardiac muscle symptoms, heart failure, electrolyte disturbances in the heart muscle, and so on.
hessenschau.de: Is Covid-19 also the reason why the duration of sick leave has become increasingly longer in autumn and winter?
Schieffer: Absolutely. What we know from flu infections, which are over after five to seven days with or without a doctor, is not something we know from Corona. It has also been reported in the media that the new strain requires a very delayed and very lengthy healing process so that the patients can get back on their feet.
hessenschau.de: Given this background, what resources do we need besides research funding?
Schieffer: In Hesse, we are in the process of establishing a center for post-infectious diseases such as post-Covid. The first discussions have been held and there are initial acknowledgements that we need something like this. We also need it for future pandemics caused by as yet unknown pathogens.
We need to bring together a wide range of disciplines, all of which work together to ensure that patients are cared for as quickly as possible. This requires a lot of persuasion at the federal level, but I have never encountered closed doors or a lack of understanding.
It also has to get into people’s heads: Yes, the pandemic is over. No, the disease is not off the table. We will have to deal with further strains and further mutations of this disease over the next few years, perhaps decades. All of us, because you can become infected at any time.
hessenschau.de: That sounds worrying.
Schieffer: It’s definitely not about scaremongering. We understand more every day, but research also shows us how long-term we have to think, three or four ways around, and how transdisciplinary we have to be. The biochemistry of this disease is a complete challenge to us.
Marburg cardiologist Bernhard Schieffer heads the post-Covid outpatient clinic at the University Hospital of Giessen and Marburg (UKGM) based in Marburg, which also cares for people with post-vaccine syndrome. Image © Lara Trizzino
Bernhard Schieffer
Professor Bernhard Schieffer is head of cardiology at the Faculty of Medicine at Philipps University Marburg. He set up the post-Covid outpatient clinic at Marburg University Hospital. In addition to his working group, other Marburg scientists participated in the study.