COVID-19 RECOVERY: What Recovery? SARS-CoV-2 Viral Antigens Found In Non-Pulmonary Tissues Of Recovered Patients!
: The current NAT PCR Nasal swab test can be described as one of the most inaccurate diagnostic protocols to assess whether a person has recovered from COVID-19 and even to a certain degree to assess even if a person has been infected.
If we were to look at the start of the pandemic that started in Wuhan China, Chinese researchers along with the WHO first assumed that the COVID-19 was simply a respiratory disease and that the main points of entry were the nasal airways and that only the respiratory tract were affected hence the original NAT-PCR nasal swab tests. The test it had limitations in terms of accuracy and also in terms of generating high incidences of both false positives and false negatives. (We do not even want to go into details of the issues of the pitfalls of the amplification cycles being used). Shockingly the rest of the world is stupidly enough still conforming to that same diagnostic protocol till now to detect infections and ascertain if individuals have recovered!
As time progressed, various published studies have shown that the SARS-CoV-2 coronavirus is capable of infecting humans through numerous other ways including the eyes, ears, mouth etc and also penetrate into various tissues and organs of the body. Despite the advances in understanding the pathogenesis of the SARS-CoV-2 virus, no one bothered to develop better and more accurate diagnostic platforms or develop more detailed protocols to test if a person has truly recovered from COVID-19 and that there are no traces of the virus in the body. Many are simply adapting or further developing from the same protocol.
Till now, no health authority or even organization is willing to directly confront this issue and what we have now are so called ‘recovered ‘COVID-19 patients who were tested negative based on nasal swabs tests and as long as they did not display certain symptoms, they are being deemed as recovered.
It seems as if there is a concerted effort to simply mislead the general public so as to not cause fear and also over tax the public healthcare systems.
However the growing incidences of complications arising from long term health issues from those who were deemed as recovered can no longer be ignored or covered up.
There is more and more documented evidence of the SARS-CoV-2 coronavirus virus being found in the various organs and tissues of so called ‘recovered’ patients with the virus causing unimaginable damage.
In a recent study in Singapore, a team of researchers led by Dr Joe Yeong, and Prof Tony Kiat Hon Lim, have reported the presence of residual SARS-CoV-2 ribonucleic acid (RNA) ie the virus' genetic material in stool samples and gastrointestinal tissues from recovered COVID-19 patients.
The enteric involvement of SARS-CoV-2 has already been long known. However, the detection of the viral antigens within gastrointestinal and hepatic organs 'during the convalescent phase' has, until now, not yet been reported.
The direct infection of the gastrointestinal organs and its consequential fecal-oral transmission route is a serious concern for COVID-19 pathology.
The research team from Singapore in this context investigated the presence of SARS-CoV-2 virus particles in
intestinal and liver tissues and the SARS-CoV-2-specific immunity.
The study findings were published on a preprint server but are currently being peer-reviewed. https://www.medrxiv.org/content/10.1101/2020.10.28.20219014v1
The research cohort consists of 2 COVID-19 patients ie both middle-aged men, diagnosed with COVID-19, from which they have recovered.
It was reported that Patient 1 underwent laparoscopic right hemicolectomy (for a large circumferential malignant mass in the colon).
The patient 2 had a significant medical history of chronic hepatitis B virus-related liver cirrhosis and segment VII hepatocellular carcinoma (HCC). He underwent curative resection of HCC.
It was reported that the colon, ileum, appendix, and lymph nodes tissues were removed during surgery from patient 1, while liver tissues were removed from patient 2.
Utilizing immunohistochemistry, the study team detected SARS-CoV-2 nucleocapsid from intestinal and liver tissues in both the patients. The SARS-CoV-2 nucleocapsid and angiotensin-converting enzyme 2 (ACE2) receptor were in close proximity. They also found SAR-CoV-2 spike protein (or S-protein). However, the viral RNA – detected by reverse transcription-polymerase chain reaction (RT-PCR) testing – was not present in liver tissues, possibly because of the long recovery period.
Despite many post-mortem studies showing SARS-CoV-2 in various organs, the findings from patients with mild COVID-19 are distinct from these post-mortem studies; patients who succumbed to COVID-19 had a more severe disease course and thus might not be representative of the general population.
In the case of these two patients, both men suffered from mild infection and recovered a few months before this study.
The study team performed ex vivo
peptide stimulation assays involving a cocktail of the viral nucleocapsid, spike, and membrane proteins to examine SARS-CoV-2-specific immunity in the tissues from recovered patients. Results show that SARS-CoV-2-specific CD38+Granzyme B+CD4+ T cells were elicited, suggesting that SARS-CoV-2-specific memory T-cells may be maintained in both tissue and blood - approximately three months into recovery; this finding is the first report.
Interestingly, the SARS-CoV-2 viral particles have been detected in patients' respiratory tracts recovered from COVID-19 - raising concern for potential SARS-CoV-2 virus reservoirs. In the human host after so called recovery
The study team warned, "Together, it seems that SARS-CoV-2 might be cleared in the digestive tract later than in the respiratory tract. Therefore, a negative nasopharyngeal swab result might not necessarily indicate complete viral clearance from the body."
Significantly this study is the first report of detecting the SARS-CoV-2 antigens in non-pulmonary tissues in clinically recovered COVID-19 patients.
Although conducted in a non-postmortem setting, it presents an important preliminary investigation that throws light on the caution required around COVID-19 recovered patients and disease management plans. Further investigations are required to test if the viral antigens are infectious ie its competence and stability in the environment and the abundance in shedding.
The study team said, "We propose caution when handling tissues from patients who have a recent history of COVID-19, particularly during aerosol-generating procedures such as ultrasonic dissection surgery."
Importantly, the prevalence and prognosis of the SARS-CoV-2 viral antigens involvement in daily life are mostly unknown. This first evidence of the presence of RNA particles in recovered COVID-19 patients might have implications in public health policy regarding the transmission of COVID-19 infection besides the respiratory route.
Although there has been numerous reports showing that recovered patients even exhibiting viremia after recovery, this documented case has various implications and its time the medical community and researchers start addressing the issues point on.
Thailand Medical News has also covered articles in the past that indicates that the SARS-CoV-2 coronavirus is able to prime the human host immune system to accommodate long term reservoirs in the body. https://www.thailandmedical.news/news/coronavirus-warning-study-reveals-that-after-infection-phase,-the-sars-cov-2-manipulates-human-host-immune-system-to-facilitate-its-long-term-stay
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