❦ It's no wonder that depression and PTSD rates✢ are up in people living with Long COVID.
✢ Long COVID: major findings, mechanisms and recommendations ➤
There are no approved therapies for the physical or cognitive disabilities that now plague 65 million people around the world, a conservative estimate given the degree of undocumented cases.
It is now clear from US and UK investigations of approximately 2,000 previously hospitalized Covid patients that six months later more than half have problems managing finances and paying bills as well as completing everyday activities like preparing meals, bathing, getting dressed, or walking across a room.
But what exactly is going on inside the brains of these people from a biological and pathological perspective?
Autopsy studies show that the virus can persist✢ in some people for many months even though they have no symptoms and test negative for the virus.
✢ Persistent SARS-CoV-2 infection in patients seemingly recoveredfrom COVID-19 ➤
Brains donated by people who died of Covid-19 also show widespread problems in the cells lining the blood vessels and exaggerated clotting, supporting the idea of Covid-19 as a blood flow disorder✢ that brings on brain disease.
✢ Neurovascular injury with complement activation and inflammation in COVID-19 ➤
Perhaps the most harrowing thing I have done in 30 years as a physician-scientist has been to ask family members I'd never met, often in the middle of the night via telephone during the height of the Covid surges, if I and my colleagues could study their loved one's brain.
In a study we conducted of 20 of these priceless brain donations✢, we found brain swelling due to decreased blood flow and heightened activity in microglial cells, the so-called 'white matter' in brains that support the neurons that transmit thoughts and help store information. We saw this even in young previously healthy individuals.
A study from the National Institutes of Health of 44 complete autopsies✢ mapped and quantified the distribution of SARS-CoV-2 and showed it was widely distributed throughout the body, including in the hypothalamus and cerebellum in the brain and neurons in the spinal cord.
✢ SARS-CoV-2 infection and persistence in the human body and brain at autopsy ➤
Especially relevant to Long Covid, viral fragments were detected in some of the brains of people who died many months after symptom onset.
In Their Own Words
Barbara Nivens, who retired from retail management at age 59, has been diagnosed by her neurologist as having rapid onset dementia due to Covid-19.
An incredibly thorough medical work-up found no plausible causes for this dementia other than its onset following her Covid infection, which she contracted before the vaccine was available.
Matt Fitzgerald, age 26, is a mechanical engineer who worked for Tesla and now designs surgical devices – when he can. Since recovering from his initial bout with Covid-19, he's developed a condition characteristic of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) known as post-exertional malaise, which is why even slight exertion leaves him and millions like him inexplicably incapacitated.
❦ Barbara Nivens:
— “I walk down the hall and see dozens of pictures of family trips and feel like a ghost because I don't remember any of them. Now I'm trying to figure out who Barbara 2.0 is going to be.”
(Her husband, tearing up as he listened to her, said softly, “I just want my wife back.”)
❦ Matt Fitzgerald:
— “I feel like I'm underwater.
When you talk to me, I can hear you, but my brain does not understand the words. I can't comprehend what you're saying. I have no intellectual capacity or energy to digest data.
At work my brain is just begging for rest. I struggle with finding words and completing tasks in a timely manner. It's the worst.
I'll be in a meeting and know exactly what I want to say before I say it. I'll start saying it and I'll get to a word, and I just cannot think of the word.
I'll just be like, ‘Give me a moment,’ and I'll go through my brain cycling through words. This week it was 'consistent'. I couldn't think of the word 'consistent'. I kept thinking it was 'coincident' or 'concentric' or 'constant'.”
Such problems in executive function, memory, and processing speed are what many people complain about in the Long COVID support groups.
Science validates their injuries.
A picture is emerging from animal models showing how on-going inflammation of glial cells disrupts the electrical conduction highways in the brain's white matter that link to and support the neurons in gray matter.
It's as if the bridges (white matter) linking different territories of the brain have been blown up and the land itself (nerves in the cerebral cortex and hippocampus) becomes scorched, leaving people with Long COVID plagued by thinking and memory deficits.
❂
📖 (16 Feb 2023 ~ Stat) The haunting brain science of Long COVID ➤
© 2023 E. Wesley Ely / Stat.
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