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Long Covid: The Post-COVID Brain Seems To Recover Never

long COVID: "The virus is Not Always As Benign As Some People Think It Is."

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Long Covid: The findings of the new report reveal the horrific long-term repercussions of COVID-19.

If you had COVID-19, your brain may still be affected by it. In the first year following the infection, those who have contracted the virus are more likely to experience Long Covid as a range of neurological conditions.

Experts from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system have carefully examined federal health data to identify such complications as strokes, cognitive and memory issues, depression, anxiety, and migraine headaches.

In addition, the post-COVID brain is linked to movement disorders, including tremors, involuntary muscle contractions, epileptic seizures, altered hearing and vision, balance and coordination issues, and other symptoms resembling those of Parkinson’s disease.

The findings were published in Nature Medicine today.

The results provide “a comprehensive assessment of the long-term neurologic consequences of COVID-19,” according to senior author Ziyad Al-Aly. 

“Past studies have examined a narrower set of neurological outcomes, mostly in hospitalized patients,” says the author, adding, “we evaluated 44 brain and other neurologic disorders among both nonhospitalized and hospitalized patients, including those admitted to the intensive care unit.” 

And the results of the study show “the devastating long-term effects of COVID-19. These are part and parcel of long COVID. The virus is not always as benign as some people think it is.”

Al-Aly estimated that COVID-19 was responsible for more than 40 million new cases of neurological diseases worldwide.

There are few known risk factors for long-term neurological issues aside from having a COVID infection

According to Al-Aly, they’re “seeing brain problems in previously healthy individuals and those who have had mild infections.”

“It doesn’t matter if you are young or old, female or male, or what your race is. It doesn’t matter if you smoked or not, or if you had other unhealthy habits or conditions.”

Few persons in the study received COVID-19 vaccinations since the vaccines were not widely available throughout the study period, which lasted from March 2020 to early January 2021. Additionally, the data predates delta, omicron, and other COVID variants.

A prior study published in Nature Medicine under the direction of Al-Aly discovered that vaccinations slightly lower the chance of long-term brain issues by 20%. While vaccinations are undoubtedly vital, it’s also critical to note that they do not completely protect against certain chronic neurologic illnesses, according to Al-Aly.

The researchers examined over 14 million de-identified medical information in a database maintained by the United States Department of Veterans Affairs, the country’s largest integrated health-care system. Patients included all ages, races and sexes.

They compiled a controlled data set consisting of 154,000 individuals who survived the first 30 days after being infected with COVID-19 between March 1, 2020, and January 15, 2021. Statistical modelling was used to compare neurological outcomes in the COVID-19 data set with two other groups of people who did not have the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same time period, and a control group of more than 5.8 million people from March 2018 to December 31, 2019, a long time before the virus infected and killed millions of people around the world.

Over the course of a year, the researchers assessed cognitive function. People with COVID-19 were 7% more likely to have neurological problems than those who had not been infected with the virus. On the basis of extrapolating this percentage based on the number of COVID-19 cases in the U.S., that equals approximately 6.6 million individuals who have experienced brain damage due to the virus.

One of the most prevalent brain-related, long-COVID symptoms is memory issues, sometimes known as brain fog. People who received the virus had a 77% higher probability of experiencing memory issues compared to those in the control groups. 

“These problems resolve in some people but persist in many others,” Al-Aly adds. “At this point, the proportion of people who get better versus those with long-lasting problems is unknown.”

Surprisingly, the researchers discovered a higher risk of Alzheimer’s disease among those infected with the virus. In comparison to the control groups, there were two extra cases of Alzheimer’s per 1,000 COVID-19 patients. It’s rare that someone who has had COVID-19 will suddenly develop Alzheimer’s disease, according to Al-Aly. Alzheimer’s disease takes time to develop. But what we believe is happening is that COVID may push those who already have a tendency to Alzheimer’s over the edge, putting them on a speedier path to the disease. It is rare but alarming.

People with the virus were also 50% more likely than the control groups to experience an ischemic stroke, which occurs when a blood clot or other obstruction prevents an artery from supplying the brain with blood and oxygen. Ischemic strokes are the most common type of stroke and can cause difficulties speaking, cognitive confusion, vision problems, loss of feeling on one side of the body, lifelong brain damage, paralysis, and death.

“There have been several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of the blood vessels and then trigger a stroke or seizure,” Al-Aly adds. “It helps explain how someone with no risk factors could suddenly have a stroke.”

In general, COVID-19 carriers reported 80% higher rates of epilepsy or seizures, 43% higher rates of mental health conditions like anxiety or depression, 35% higher rates of mild to severe headaches, and 42% higher rates of movement disorders compared to non-carriers. The latter includes tremors, jerky movements, and other symptoms resembling Parkinson’s disease.

Patients with COVID-19 also had a 30% higher risk of developing eye issues such as blurred vision, dry eyes, and retinal inflammation, as well as a 22% higher risk of developing hearing issues like tinnitus, or ringing in the ears.

“Our study adds to this growing body of evidence by providing a comprehensive account of the neurologic consequences of COVID-19 one year after infection,” the senior author adds.

According to Al-Aly, the long-term consequences of COVID on the brain and other systems highlight the necessity for governments and health systems to create policies, public health initiatives, and prevention programmes in order to control the pandemic and make preparations for a post-COVID society. 

“Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated — but, so far, absent — global, national and regional response strategies,” he concludes.

Source: 10.1038/s41591-022-02001-z

Image Credit: Getty

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