According to the Centers for Disease Control and Prevention (CDC), following the onset of the COVID pandemic, as many as one in 10 infected people are developing Long COVID, in which symptoms persist for weeks, months, or years post-infection. And while Long COVID can affect anyone—from infants to the elderly—there is a significant prevalence among women between the ages of 30 and 50.
The National Institutes of Health (NIH) funded $1.15 billion for Long COVID research, but many feel this amount is insufficient. NIH support for investigations of ME/CFS is also seen as modest, even though between 836,000 and 2.5 million adults in the United States are estimated to suffer from ME/CFS, according to an Institute of Medicine Report, with annual health care costs and lost productivity to be between $17 billion and $24 billion.
"Long COVID has put a spotlight on existing diseases such as ME/CFS and chronic Lyme disease, which have been traditionally and historically ignored until very recently,” says Iwasaki. “The pandemic has led to further research into them. The new public awareness of these diseases is partly because Long COVID is occurring simultaneously in 75 million people globally. Long COVID has taught the world that these diseases are real, and we need to study them. People are spreading disinformation about Long COVID, and it detracts from research. ME/CFS and Long COVID are related. Up to 50 percent of people will get ME/CFS after having Long COVID.”
Iwasaki’s research work discovered that in some patients with Long COVID, increased levels of antibodies to viruses such as the one that causes Epstein-Barr are seen, indicating a reactivation of latent herpesviruses. She also was able to demonstrate that the level of cortisol in patients with Long COVID is lower than in other groups, and that there are changes in T cell and B cell activation.
On June 5, Iwasaki received the 2023 Else Kröner Fresenius Prize for Medical Research in Frankfurt, Germany. This prestigious honor recognizes Iwasaki’s “groundbreaking contributions in the areas of diseases of worldwide significance,” and will support her current and future investigations of Long COVID and other chronic and debilitating post-acute infection syndromes (PAIS) such as ME/CFS and Lyme disease. One of her research goals is to identify biomarkers that can differentiate the various forms of PAIS. Bringing therapies that would help people with ME/CFS and other PAIS would be a crowning achievement.
Additionally, Iwasaki has teamed up with Harlan Krumholz, MD, Harold H. Hines, Jr. Professor of Medicine (Cardiology) and professor in the Institute for Social and Policy Studies, of investigative medicine, and of public health (health policy), on a clinical trial by providing the oral antiviral Paxlovid to Long COVID patients. They both hope to discover clinical insights on potential markers for diagnostic testing and targets for future interventions. As director of the Yale Center for Infection & Immunity, Iwasaki hopes to galvanize a large team of collaborators to tackle PAIS, including ME/CFS and chronic Lyme disease.
Iwasaki attributes her continued research efforts in part to donor generosity. “I’m deeply grateful to Emily Fairbairn and Carol Sirot for their support,” says Iwasaki. “Thank you for believing in my team and our research in finding the answers.”