The Long-Term Effects of COVID-19: Ivaska Presents at APHA Conference

As the world continues to move beyond the COVID-19 pandemic, lingering questions remain about the disease’s long-term effects. One Ursinus College professor and alumna have made strides in answering one of these questions.

In October, Associate Professor of Health Sciences and Director of the TRACE Lab Nicole Ivaska, along with Ursinus College alumna Laura Rothschild ’23, presented at the American Public Health Association (APHA) Conference in Minneapolis, Minn. Their presentation titled Gonadal Hormone Responsivity: Distinguishing Immune Response Following Natural Sars-Cov-2 Viral Infection on a College Campus explored the transition from an acute COVID-19 infection to what they call long-COVID, a term used to describe the disease’s prolonged impact on a portion of those affected.

“Laura did her honors research with me, and she was eager to explore COVID-related research,” Ivaska said. “I immediately jumped on that because I thought it would be a great collaboration for the two of us.”

Ivaska and Rothschild focused on long-COVID, examining the population-specific factors influencing to the long-term prevalence of the disease. The college population at Ursinus served as an ideal testing ground, allowing them to compare the experiences of younger college students with those of older patients who had been infected at some point. Their decision to work with a younger demographic also raised questions about the role of hormones in immune response.

“Laura was particularly interested in hormones and wondered if they played a role in the SARS-CoV-2 infection.,” Ivaska said. “She thought younger and healthier students might have certain hormone levels that would affect the immune system differently than older adult who may have multiple co-morbid conditions.”

The study focused on sex hormones—estradiol, testosterone, as well as cortisol, a stress hormone. In the TRACE Lab, the duo ran blood and saliva tests to collect data. They found that estradiol, present in both males and females, was associated with the production of Sars-Cov-2 antibodies. Estradiol, which is a form of the estrogen hormone, modulates B-cell function. B-cells secrete antibodies, which help recognize and fight viral infections. Increased cortisol levels from prolonged stress can lower estrogen levels.

“That depletion on the immune system, combined with the extra stress students experience during their college years, were leading to symptoms consistent with long-COVID, even in healthy young adults,” Ivaska said.

Ivaska believes the study’s findings suggest a clue to interpreting long-COVID as a series of events that include hormone function and possible reactivation of dormant Epstein–Barr virus (EBV).

“It’s like where someone gets chicken pox and that virus can reactivate to cause shingles later in life,” Ivaska said. “EBV can cause mononucleosis but may also reactivate following hormone changes or infection.”

This is the next phase of Ivaska’s research. She plans to investigate how hormone levels, in combination with other factors, may act as a “switch” that can reactivate dormant EBV following COVID-19. Over the fall semester, Ivaska and her students began recruiting participants for the new phase of testing.

“We have students who are going into healthcare who are eager to gain clinical experience, but they are also deeply committed to research and want to be a part of this next phase,” Ivaska said.

Rothschild, who graduated from Ursinus, has since enrolled at Penn Nursing School, where she is working toward her board certification.

“I’m thankful for Laura and all the students in the TRACE Lab,” Ivaska said. “They’re committed, great workers, and I really appreciate them.”