What Causes LongCovid? What Causes Hair Loss in Covid-19? The answer to these two questions is the same: infection of Immune Privileged Cells (IPCs).

The Coronavirus usually infects the lungs, causing breathing difficulty, pneumonia, and worse (ARDS). But Longhaulers, persons who have had Covid-19 for a long time, often begin with mild to moderate cases of Covid-19, not severe cases. They also typically receive little or no medical care. So the virus, instead of being cleared by medication plus the patient’s own immune system, spreads throughout the body, looking for a place to call “home”. As the immune system ramps up its fight against the virus, it is cleared from most places in the body. But IPCs are mostly shielded from the immune system. And if the virus becomes established in those cells, it can persist long after other Covid-19 patients are healed. Most mild cases of Covid-19 heal themselves, via the person’s own immune system — but not if the virus gets into IPCs.

That is the theory. It is not certain; there are no studies yet. After I published my first explanation of this theory or hypothesis, I later found the idea had been previously published by someone else. This theory as to the cause of LongCovid was first explained by Dr. William Petri in an article dated July 31, 2020.

Dr. Petri Explains His Theory

William Petri, M.D., Ph.D. teaches at the University of Virginia Medical School. His article is called: Does Coronavirus Linger in the Body?.

The reason for the title is that many physicians think that Longhaulers are no longer infected with SARS-CoV-2 (the Coronavirus). They have various explanations for the symptoms of LongCovid.

Some think that the body was injured by the virus, and this continuing damage and slow healing causes LongCovid. If that were true, then the Covid-19 patients who had the most severe cases would be the Longhaulers. On the contrary, most Longhaulers have had mild to moderate cases.

Others think that the virus is gone, but the immune system is dysregulated, causing these symptoms. But Longhaulers sometimes test positive for the virus, and they have some symptoms that do not seem to be related to immune system dysregulation. And, the immune system could still be dysregulated, if the virus is present.

So the main premise of the hypothesis is that the SARS-CoV-2 virus remains active in LongCovid patients. And that is the theory of Dr. Petri. Here’s his explanation on the subject:

Dr. Petri: “I am a physician-scientist of infectious diseases at the University of Virginia, where I care for patients with infections and conduct research on COVID-19.”

“A chronic or persistent infection continues for months or even years, during which time virus is being continually produced, albeit in many cases at low levels. Frequently these infections occur in a so-called immune privileged site.”

“There are a few places in the body that are less accessible to the immune system and where it is difficult to eradicate all viral infections. These include the central nervous system, the testes and the eye. It is thought that the evolutionary advantage to having an immune privileged region is that it protects a site like the brain, for example, from being damaged by the inflammation that results when the immune system battles an infection.

“An immune privileged site not only is difficult for the immune system to enter, it also limits proteins that increase inflammation. The reason is that while inflammation helps kill a pathogen, it can also damage an organ such as the eye, brain or testes. The result is an uneasy truce where inflammation is limited but infection continues to fester.”

“The mounting evidence suggests that SARS-CoV-2 can infect immune privileged sites and, from there, result in chronic persistent – but not latent – infections.” [Source]

Dr. Petri originated this theory as to the cause of LongCovid. I’m working to explain the theory, in as much detail as possible, and to see if this understanding of the cause sheds light on possible treatments. I believe that this theory explains everything about LongCovid.

What Does The Theory Explain?

Why do some persons become Longhaulers and other persons do not? Many Longhaulers have underlying weaknesses in their immune system, or they never received treatment for Covid-19, or they have chronic medical conditions. This explains why some Covid-19 patients show signs of the virus in IPCs (e.g. hair loss), yet they don’t go on to become Longhaulers. The difference is found in the health of each person.

Why do someLonghaulers have hair loss? The anagen hair follicles contain the cells that cause hair growth. They are IPCs — Immune Privileged Cells. The virus infects these cells, disrupting hair growth and causing hair loss.

Why do Longhaulers have so many symptoms from the Central Nervous System (CNS)? These symptoms include difficulty focusing or concentrating (“brain fog”), memory loss, seizures, dizziness, and problems with balance, various forms of insomnia, and others [see the Patient-Led Covid-19 Symptoms Survey]. The CNS is an Immune Privileged Site, and it is THE main site where the Covid-19 virus becomes established to cause LongCovid. That is why so many Longhaulers have CNS symptoms.

Why do some Longhaulers lose their sense of taste and smell? The virus can infect the support cells around the neurons (cranial nerves) responsible for smell and taste, which might not be a question of immune privilege. However, it is possible for the virus to infect neurons. It does not seem to be able to replicate well (or at all?) in neurons, certainly not as well as in lungs. That needs more research.

What about eye related symptoms? The eye is at the end of the optic nerve, which is also a cranial nerve. If the virus is in the CNS, it can infect the eyes. The muscles that control eye movement are themselves controlled by cranial nerves (III, IV, VI), while facial sensation is controlled by cranial nerve V.

Some Longhaulers report symptoms of “facial paralysis, hearing loss, vision loss”; what can explain this? The nerves that control the facial muscles (VII) and facial sensation (V) are cranial nerves, so are the nerves for hearing and vision. The virus infects the CNS, which is an Immune Privileged Site, and which includes these cranial nerves.

What explains symptoms of fatigue, brain fog/concentration challenges, chills/sweats, trouble sleeping, etc.? These may be symptoms of infection of the CNS.

Many Longhaulers report that they still have symptoms similar to “regular” Covid-19, such as breathing difficulty, and problems with lungs, chest pain, cough, etc. These are not Immune Privileged Sites.

The explanation is that the virus hides from the immune system in the Immune Privileged Sites. But periodically, the virus multiplies and then spreads beyond those protected sites into the rest of the body. The lungs are particularly vulnerable to the virus, and so the lungs become re-infected. Then the immune system, which now possesses antibodies and T-cells adapted to the virus, fights the virus and clears it from most of the body — but it remains in the Immune Privileged Sites. Then, a little while later, the virus multiplies again in the protected Sites, and spreads again, causing this cycle of recurring symptoms often reported by Longhaulers.

Some of the symptoms of LongCovid seem to relate to the autonomous nervous system, which is not Immune Privileged. But it is closely connected to the CNS, so the virus can spread from the latter to the former. The virus also spreads periodically from the Immune Privileged Sites to the rest of the body, and does cause some of the same symptoms as regular Covid, such as excess inflammation and harm to the lungs, intestines, etc.

As Dr. Petri mentioned, the testes are also an Immune Privileged Site. Some studies have noted infection of the testes with the Coronavirus. Other Immune Privileged Sites include the placenta and the fetus, both of which can be infected by the virus. See my previous article on IPCs and Longhaulers for the references and a more detailed explanation of these Sites.

* Does coronavirus linger in the body?
* The Longhaulers Hidden Virus Hypothesis
* Longhaulers happens when the virus hides in Immune Privileged Cells
* What Causes Longhaulers Syndrome? (LongCovid)
* Interview with a Former Longhauler
* Dr. Mobeen Syed’s Longhauler Treatment Note that the tweet misspells Deltacortril by dropping one of the ‘R’s. Deltacortril is prednisolone.

Many commentators have noted similarities between LongCovid and ME/CFS. Perhaps they have similar causes. ME/CFS may be caused by a virus (not the Coronavirus) hiding in Immune Privileged Sites. This would suggest that the only effective treatments would be those that cross the BBB and inhibit the virus.

Ivermectin has been tried for LongCovid and, interestingly, it provides only temporary relief. This could be explained by the fact that Ivermectin does not cross the BBB. So the drug clears the virus from most of the body, but not the CNS. Some relief results (though not from CNS symptoms), but then the virus multiplies and spreads beyond the CNS again.

It explains everything.

Ronald L. Conte Jr.
Note: The author of this article is not a doctor, nurse, or healthcare provider, and this article does not offer medical advice.