Celestia Diagnostics Searches for a Definitive Test

By Laura Freeman

Like so many 23-year-olds with a newly minted degree, Mendel Fishman felt immortal.

“I was a runner in good health and just starting a career in finance. What I hadn’t taken into account was that it was 2020—the year COVID-19 changed everything,” he said.

Fishman survived the acute phase of infection by the virus that killed millions of people around the world, but he was left with the lingering health challenges of long COVID that made his body feel like it was no longer his.

“The fatigue, the joint and muscle pain were bad enough, but the respiratory problems went on and on,” he said. “There was nothing I could do that made it any better. In the past, when I was getting over a cold or the flu, I could build back my respiratory capacity and clear my lungs by just going for a run and gradually getting back to normal. This time it didn’t work.”

When Fishman went back to his doctor, he learned that his lingering symptoms were consistent with an emerging syndrome that was showing up in COVID patients. It had a name, but no test that could definitively diagnose it.

“They called it Long COVID,” he said. “The CDC’s best guess as of March 2024 was that about seven percent of U.S. adults, around 17 million people, suffer from it. That’s not just a personal and public health problem. With so many people unable to function at the same level and do what they did before, that’s an economic crisis.”

According to CDC figures, about one in five people age 18 to 64 who are infected with COVID-19 will eventually develop long COVID. For people over 64, the risk increases to one in four.

In addition to exhaustion similar to chronic fatigue, long COVID may include neurological symptoms such as brain fog, loss of sense of taste or smell, dizziness on standing, pins and needles sensations, depression and anxiety. Muscle and joint pain are often a problem, and there may be continuing respiratory, heart, immune and digestive system issues as well as other problems that may differ from patient to patient.

“Long COVID completely changed my perspective on life. Instead of just a career in business, I became passionate about using the administrative skills I had learned in school to do something to contribute to the effort to overcome long COVID,” Fishman said.

After looking into the many needs associated with the disease, Fishman decided he could be most useful by starting at the beginning and pulling resources together to launch a research organization that focuses on developing a diagnostic test that can definitively tell doctors whether a specific patient has long COVID.

“It isn’t just that patients need to know that they have the condition so their doctors can develop a treatment plan,” he said. “Researchers also need to better understand the mechanisms behind the disease in order to work on new ways to fight it. For a clinical trial to provide useful information, researchers need to know for certain which subjects actually have long COVID. To know whether a new drug is working, they have to be able to measure a patient’s condition before the drug for a baseline to compare it to after treatment.”

With this goal in mind, Fishman founded Celestia Diagnostics, a biotech incubator company located in Southern Research Institute’s Station 41.

“I recruited Hanan Chweih Vendrame, PhD to head up research,” he said. “We’ve just added a data analyst and we anticipate adding more people as the work progresses.”

Celestia Diagnostics is looking at multiple biomarkers and comparing their potential to serve as the basis of tests that could answer the question of whether long COVID is responsible for a patient’s suffering.

“It isn’t enough to look for antibodies,” Fishman said. “A patient may have antibodies because they had COVID or were vaccinated. They also may have had both and their immune system simply failed to produce antibodies that we can detect.”

Fortunately, Celestia is identifying other potential biomarkers and indicators they are studying to determine their feasibility for developing for testing.

“The most recent biomarker we are looking at now involves fibrin amyloids that are associated with microclot formation,” Fishman said. “They seem to be common, but we still have to determine the mechanisms involved and how reliable they are as an indicator. We are likely to look at a lot of possibilities as we narrow down the most effective ones.”

According to NIH reports, fibrin amyloid microclots are frequently found in long COVID patients and could be involved in triggering an immune system response that could explain some of the symptoms that are often reported with long COVID.

“Once we determine the right target, the next step will be developing it into a diagnostic test that can be used in trials,” Fishman said. “When clinically proven and on the market, there will still be plenty of work ahead. So many infections, especially viruses like COVID, leave a lot of problems in their wake, including health issues that may go on for years.”

The immune system, the genetics and epigenetics involved in health issues seem to be frequent targets of viral infections and may be the trigger for other health problems. Tracking what germs are doing and providing clues on how to overcome their effects is likely to create plenty of work to keep Celestia Diagnostics and Mendel Fishman active throughout a long career ahead.