Brain fog is one of the most common persistent court cases in long COVID patients. It affects up to 46% of patients who also face other cognitive disorders such as memory loss and difficulty concentrating.
Now, researchers believe they know why. A new study has found that these symptoms may be the result of a viral-borne brain injury that may cause cognitive and mental health issues that persist for years.
Researchers found that 351 hospitalized patients with severe COVID-19 showed symptoms of long-term brain damage one year after contracting the SARS-CoV-2 virus. The effects occurred on a range of cognitive tests, self-reported symptoms, brain scans, and biomarkers.
In the initial study, participants took a cognitive test with age-appropriate scores for those who had not suffered a severe COVID-19 crisis. A blood pattern was then taken to look for specific biomarkers, which showed that elevated levels of certain biomarkers were consistent. with brain injury. Using brain scans, the researchers also found that certain regions of the brain related to attention had reduced volume.
According to the researchers, the patients who participated in the study were “less accurate and slower” in their cognition and had at least one intellectual fitness condition, such as depression, anxiety or post-traumatic stress disorder.
The brain deficits seen in COVID-19 patients were due to 20 years of brain aging and provided evidence of what doctors feared: that this virus could damage the brain and lead to persistent intellectual fitness problems.
“We discovered general deficits in cognition,” said the study’s lead author, Benedict Michael, PhD, director of the Laboratory of Infection Neuroscience at the University of Liverpool, England. “The cognitive and memory aspects that patients complained about were related to neuroanatomical changes in the brain. “
Cognitive deficits were not unusual in all patients, but the researchers said they did not yet know whether brain damage led to permanent cognitive impairment. But studies provide patients who have been through some doctors with evidence that their situations are not a figment of their imagination. said Karla L. Thompson, PhD, senior neuropsychologist at the COVID Recovery Clinic at the University of North Carolina School of Medicine.
“Even though this pandemic has been going on for several years, many providers don’t have those residual symptoms in their patients,” Thompson said. “This is why the use of biomarkers is important, as they provide an objective indication that the brain has been compromised in some way.
Some long COVID patients have said that misleading their doctors into thinking they have a physical illness has been a persistent challenge during the pandemic, especially when it comes to the often confusing set of symptoms related to brain fog. One study found that up to 79% of respondents reported negative interactions with their healthcare providers when seeking remedy for their long-term COVID symptoms.
Researchers don’t know exactly what causes this brain damage, but they do know some clues. Previous studies have warned that these types of injuries are likely to be the result of a lack of oxygen to the brain, especially in hospitalized patients, like those in this study, who are put on ventilators.
In the past, brain scans have shown atrophy of the brain’s gray matter in COVID-19 patients, most likely caused by inflammation due to a superior immune reaction rather than the virus itself. This inflammatory reaction appears to affect the central nervous system. In the new study, researchers discovered some neuroprotective effects similar to steroid use during hospitalization to decrease brain inflammation.
The findings recommend that doctors deserve to trump their skepticism and the option that their patients have suffered a brain injury and deserve to be treated appropriately, said James C. Jackson, PsyD, a neuropsychiatrist at Vanderbilt University School of Medicine. that if he walks like a duck and talks like a duck, he’s a duck,” Jackson said.
He contends that treatments used for patients who have brain injuries have also been shown to be effective in treating long COVID–related brain fog symptoms. These may include speech, cognitive, and occupational therapy as well as meeting with a neuropsychiatrist for the treatment of related mental health concerns.
Treating COVID prolonged brain fog as a brain injury may help patients return to some semblance of normalcy, the researchers said. “What we’re seeing in terms of biomarkers of brain damage and differences in brain scans correlates with the real-world disorders that those patients face on a regular basis,” Jackson said. These come with disruptions at work and in life with multitasking, memorizing details, meeting deadlines, synthesizing gigantic amounts of data and maintaining focus on the task at hand, he said.
There are also fears that, even with treatment, brain aging caused by the virus could have long-term repercussions and that this long-lasting injury could cause the early onset of dementia and Alzheimer’s disease in those who were already vulnerable to it. A study from the National Institute of Neurological Disorders and Stroke (NINDS) found that in other people infected with COVID-19 who already had dementia, the virus “rapidly accelerated structural and functional deterioration of the brain. “
“We already know the role that neuroinflammation plays in the brains of Alzheimer’s patients,” Thompson said. “If long COVID is linked to prolonged brain inflammation, this largely explains the mechanism underlying brain aging [reported through the study]. “
In some ways, this study raises almost as many questions as it answers. While this provides concrete evidence of the damage the virus causes to the brains of patients who have contracted severe COVID-19, researchers do not know the effect on the brain. those who have had less severe cases of the virus.
For Ziyad Al-Aly, MD, study and progression lead at St. John’s Veterans Affairs Health System, the Veterans Affairs Health System of St. LouisLouis, the fear is that some long COVID patients are simply suffering from cognitive deficits that are more sophisticated but still have an effect on their daily lives. . and they don’t get the assistance they need.
What’s more, said Al-Aly, it’s unclear whether the impacts of the brain damage are permanent or how to stop them from worsening. Researchers and clinicians need a better understanding of the mechanism that allows this virus to enter the brain and do structural damage. If it’s inflammation, will anti-inflammatory or antiviral medications work at preventing it? Will steroids help to offset the damage? “It’s critical we find some answers,” he said.
“SARS-CoV-2 will go anywhere. It will continue to infect the population, so if it really is a virus that damages the brain in the long term or permanently, we want to find out what can be done to prevent it. Al-Aly said.
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