Pain Mechanisms in long-Covid

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The COVID-19 pandemic has affected hundreds of millions of people and while many individuals recover fully about 1 in 10 suffer from long term symptoms known as long-COVID. We know already that some patients still experience symptoms after more than one year. Muscle and joint pain and fatigue are common symptoms of long-COVID along with breathing problems and loss of smell. Some patients also suffer from abnormal sensations (pins and needles and burning pain) which could be due to damage to some sensory nerves. The mechanisms underlying pain and abnormal sensations in long-COVID are unknown and there are no effective therapies. Also there is currently no laboratory method to diagnose long-COVID. Our research combines patient and lab-based studies to understand why long-COVID patients suffer from pain To do this, we will characterise the qualities, intensities and location of pain in long-COVID patients, test whether there is damage to pain-sensing nerves, and measure the impact of pain and fatigue on daily life. The pain and fatigue seen in long-COVID resembles the symptoms found in patients with fibromyalgia, and we have very recently shown that the body's normal defence mechanism, the immune system, is responsible for pain in fibromyalgia patients. Immune cells produce antibodies which normally help us to fight infections. Our results showed that fibromyalgia patients produce antibodies that attack their own bodies and stimulate pain sensing nerves. We will therefore test to see whether antibodies are also responsible for pain and fatigue in long-COVID. To do this we will purify antibodies from people with long-COVID, inject them into mice and measure if the mice develop symptoms of pain and fatigue. We will also examine if long-COVID antibodies obtained from people who have sensory nerve damage, targets the similar sensory nerves in the mice. We will find out at a molecular level what part of the nerves are being targeted and begin to understand how the antibodies have their effects. Our work will improve management of long-COVID and potentially provide a laboratory method for diagnosing this condition.