Olympic gold medalist Alex Kopacz may be used to being short of breath when pushing a bobsled, but last year after being hospitalized with COVID-19, he experienced a very different type of shortness of breath.
He was put on oxygen for two months and experienced a number of other health issues in the months following his COVID-19 infection, including blood clots in his lungs and throughout his body.
“It was hard to breathe and it was only a matter of time to see if my body would heal,” Kopacz said.
It took him nearly four months to get back on his feet and breathe normally again. But without even an official diagnosis of so-called long COVID, the 31-year-old had no answers about what was happening to him.
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That’s how he got involved in a new Canadian research trial involving patients with post-COVID syndrome – a study that has identified a potential culprit that is causing some people to continue to experience respiratory problems in the months after contracting COVID-19.
A team of researchers based in five centers across Ontario focused on a microscopic abnormality in the way oxygen moves from the lungs and into the blood vessels of long COVID patients in their trial.
This anomaly could explain why these patients feel short of breath and unable to perform strenuous activities, says lead researcher Grace Parraga, who holds a Tier 1 Canada Research Chair in Pulmonary Imaging at the Schulich School of Medicine & Dentistry in Western University.
“These feelings of breathlessness are very consistent with our finding that we’re not moving oxygen around as efficiently as we should,” she said.
Many long-time COVID sufferers have asked doctors what’s wrong with them as routine clinical tests and chest exams come back with normal readings.
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“It’s very exciting for us to find something wrong – whether it’s in the patient’s lungs and not in their head,” Parraga said.
The study, which was funded by the Ontario COVID-19 Rapid Research Fund, involved 34 patients – 12 who had been hospitalized with COVID-19 and 22 others who had not been hospitalized.
The patients were assessed around nine months after their infection began and still had a number of debilitating symptoms.
Using an MRI technique developed by Western University that is five times more sensitive and has five times the spatial resolution of a CT scan, the researchers were able to see how tiny branches of air tubes in the lungs carried the oxygen in the red blood cells of their patients.
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Red blood cells are responsible for transporting oxygen from the lungs to the rest of the body. Any disruption in the flow of this oxygen to the red blood cells will trigger the brain to say, “breathe more” — leading to a feeling of shortness of breath, Parraga explained.
All 34 patients who took part in the study had problems with the level of oxygen absorbed by their red blood cells.
And they all had the same outcome, regardless of the severity of their symptoms or whether they had been hospitalized with COVID-19 — another key finding, Parraga said.
“All these patients had this anomaly. They all had very severe symptoms so their exercise scores were low, they were short of breath when they exercised and when we measured the oxygen levels in their blood at their fingertips after exercise, it was also low.
And those external measurements matched the abnormality the researchers found in their MRI measurement of the lungs, she said.
“The conclusion is that now we know what’s wrong.”
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The reason why this anomaly occurs is not yet known. But identifying this as a possible trigger for these patients’ symptoms is an important step in trying to find out more, Parraga said.
“I think now that we know what’s going on, we can move on to why. And I think the important part is why some people and why not others? How do you predict who goes and who doesn’t? So it’s going to take us a bit longer to get there.
Dr. Michael Nicholson, a pulmonologist with the post-acute COVID-19 program at St. Joseph’s Hospital in London, Ont., co-author of the study, says the results give patients an identifiable reason why they are still experiencing symptoms. months after contracting COVID-19.
So far, normal tests done on these patients haven’t picked up on what’s happening to them, so they often feel like they’re imagining their illness, he said.
“There is nothing absolutely obvious. And so these people are now getting a response that there is in fact something wrong with this very particular site along the way,” Nicholson said.
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“For those other people, that we can now say, ‘I understand your symptoms, I think we have a better appreciation of what’s going on. We don’t necessarily know that completely. ‘… It’s a plus point for them.
The research team acknowledges that the sample size of this study, which was peer-reviewed, is small and therefore the results should be considered “exploratory and hypothesis-generating”.
But that hasn’t dampened their enthusiasm for making progress in understanding long COVID and taking a step closer to understanding how to treat it.
“I think it’s a beautiful scientific Pandora’s box, so to speak, that opens up and says, ‘OK, now we need to focus on why this is happening,'” Nicholson said.
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