Matt Fitzgerald used to bike 3500 feet up and down the Santa Ana Mountains on three-hour rides just for fun. Now, nine months after being infected with SARS-CoV-2, the virus that causes covid-19, he can’t walk. On flat surfaces for 20 minutes without days of exhaustion.
“My long life of covid is still terrifying,” he told me. Last weekend, I cleaned my car, dried it, put it back in the garage. Then I became seriously ill, I may only get up a little to get food. I can’t read or call my mother. I am a shell. of myself. But my physical disorders are not as serious as my brain disorders. It’s hard to describe. He can talk about brain fog, but that doesn’t do him justice.
Another of my patients, Barbara Nivens, forced into early retirement as a result of a long Covid. Four months after recovering from a mild case of Covid-19, “My memory started to fade,” he told me. “I had cognitive difficulties as a manager, and then HR. came after me. “
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It’s no wonder that rates of depression and PTSD are rising among other people living with covid for a long time. There are no approved treatments for the physical or cognitive disabilities that ultimately affect 65 million other people worldwide, a conservative estimate given the number of undocumented cases. It is now transparent from US polls. and the UK of around 2,000 hospitalised Covid patients in the past who, six months later, mostly have trouble managing their finances and paying expenses, as well as performing daily activities such as preparing meals, bathing, dressing. or walking in a room.
But what exactly is going on in the brains of those other people from a biological and pathological point of view?
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Autopsy studies show that the virus can persist in other people for several months, even if they have no symptoms and test negative for the virus. Brains donated by other people who died of covid-19 also show widespread disorders in the cells lining blood vessels. and exaggerated clotting, supporting the idea that COVID-19 is a blood flow disorder that causes brain disease.
Perhaps the most heartbreaking thing I’ve done in 30 years as a doctor-researcher has been to ask a circle of family members I’ve never met, in the middle of the night over the phone at the height of the Covid outbreak, if I and my colleagues can simply examine the brains of their loved ones. In a study we conducted on 20 of those valuable brain gifts, we found inflammation of the brain due to decreased blood flow and increased activity in microglial cells, the brain’s so-called white matter that supports neurons. that convey information from the mind and the assistance shop. We have noticed this even in the past in healthy young individuals.
A National Institutes of Health study of 44 complete autopsies mapped and quantified the distribution of SARS-CoV-2 and showed that it was widely distributed in the body, adding hypothalamus and cerebellum in the brain and neurons in the spinal cord. Particularly applicable for For a long time, viral fragments of Covid were detected in some of the brains of other people who died several months after the onset of symptoms.
Evidence that the virus may persist in other people has encouraged the design of several prolonged trials of covid treatment with Paxlovid. The authors of the NIH post-mortem study concluded: “Here we offer the most comprehensive research to date on the cellular tropism, quantification, and patience of SARS-CoV-2 in the human body, adding the brain. “
tropism? This is when cells are unknowingly directed through a stimulus, such as a virus, to turn and walk in a potentially pathological new direction. Could it be that returning to a healthy state, the brains of other people with long-term Covid have been redirected to some form of premature aging or senescence?
Nivens, who retired from retail control at age 59, was diagnosed by her neurologist with rapid-onset dementia due to Covid-19. An incredibly thorough medical check-up found no credible cause of this dementia other than its onset after her Covid-19 infection, which she contracted before the vaccine became available.
Fitzgerald, 26, is a mechanical engineer who worked for Tesla and now designs surgical devices, when he can. Since recovering from his initial war against covid-19, he has developed a characteristic condition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) known as post-exertional malaise, which is why even minimal exertion leaves him and millions like him inexplicably incapable.
Here’s how they describe their lives today:
“I walk down the aisle and see dozens of travel photos from the family circle and I feel like a ghost because I don’t have any of them. Now I’m looking for who Barbara 2. 0 will be. (Her husband, in tears) as she listened to her, said quietly, “I just need my wife back. “)
To help rebuild his memory, Nivens does brain exercises and adds the Color Bee game. “It will tell you, for the bee to enter ‘Click on all green leaves. ‘And then I will locate myself by clicking orange and yellow green, then I kill my bee, and you only get 3 bees.
“We were doing puzzles, so I would put one in the studio and just to locate a piece, it would take me forty-five minutes to an hour. Because I thought I would know what I was looking for, and then all of a sudden, I forgot about it. It makes me think I’m crazy.
“I feel like I’m underwater. When you communicate to me, I hear you, but my brain doesn’t perceive words. I perceive what you say. I don’t have the intellectual capacity or power to digest data.
“At work, my brain only asks for rest. I struggle to locate complete words and responsibilities at the right time. That’s the worst. I will be in an assembly and I will know exactly what I have to say before I say it. I start saying it and I come to a word, and I just can’t think of the word. I’m just going to say “Give me a moment” and I’m going to make my brain work through words. This week, it’s consistent. He couldn’t think of the coherent word. I kept thinking it was coincident or concentric or constant.
“I used to build prototypes several days a week and now, if I do it in the lab, I’m pretty exhausted for a week. It’s terrifying. I mean, I had to dig very deep. How much longer will I feel that way?I’m scared.
Such problems with executive function, memory, and processing speed are what many other people complain about in the long-running Covid equipment that my colleagues and I have developed and supply weekly to Long Covid survivors across the country as part of the serious illness, the brain. dysfunction, and the Survival Center at Vanderbilt University Medical Center and VA Medical Center Nashville.
Science validates your injuries. One symbol emerges from animal models showing how ongoing inflammation of glial cells disrupts electrical conduction highways in the brain’s white matter that bind to gray matter neurons. It’s as if the bridges (white matter) linking other brain territories have burst and the earth itself (nerves in the cerebral cortex and hippocampus) is burning, leaving other people with covid tormented for a long time by deficits in thinking and memory.
An MRI study from George Washington University on other people who had mild symptoms of covid-19 a few months ago found much less gray matter in their brains than they had. This disturbing finding complements a giant controlled study conducted as part of the UK Biobank that appears, compared to other people who had never tested positive for SARS-CoV-2, an actual loss of brain tissue in the olfactory cortex and limbic formula (thinking about smell, feelings, and altered memory formation) was observed in other long-standing Covid people.
This follows positron emission tomography studies of other people with long-term covid who appear to have altered cellular metabolism in the frontal lobe six months after an acute attack of covid. , memory, cognitive abilities, chronic pain and sleep disorders, which impair quality of life.
Long Covid is now considered a disability through the U. S. Department of Health and Human Services. But the truth is that most people have a hard time qualifying for financial resources. They feel abandoned and are also unemployed.
While waiting for the effects of ongoing and future clinical trials, Nivens, Fitzgerald and others like them are focusing on cognitive rehabilitation brain exercises, such as crossword puzzles, banana grams, and sudoku. , long-term ME/CFS patients will need to be informed about the daily art of following their own pace.
As the public fitness disaster of the long Covid unfolds, everyone can play a role. We can validate the suffering of others who are overly stigmatized and unbelieved, even through fitness professionals. We can help friends and lovers find their voice as experts in their own illness. And, most importantly, we want to start talking more about the long Covid because this is an emergency for those who live with it, for the heads of households who now feel that they are letting down those who count. in them, for the workforce and beyond.
On a private level, each and every American can take steps to reduce the likelihood of contracting covid, or prolonged covid. A study of another 440,000 people with a single covid infection, 40,000 with infections and five million controls who had never had covid. more deaths and prolonged Covid after Covid infections. If treated by your doctor, get the new bivalent vaccine and wear a mask in indoor public spaces such as theaters and airplanes.
E. Wesley Ely is an acute care physician, professor of medicine and critical care at Vanderbilt University Medical Center, associate director of aging studies at the Tennessee Valley Geriatric Affairs Geriatric Clinical, Educational, and Research Center, and of Every Deep-Drawn Breath. (Scribner, one hundred percent of whose net income goes into a fund created to help Long Covid survivors and their families. )He obtained written permission from Matt Fitzgerald and Barbara Nivens to share their names and stories.
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