January 5, 2023
4 minute read
Source/Disclosure
helio interview
Disclosure:
Frontera reports NIH funding. Al-Aly and Koroshetz do not report related financial disclosures.
As the world continues to grapple with the effects of the COVID-19 pandemic, people around the world are dealing with symptoms of SARS-CoV-2 infection for months and sometimes years after initial infection.
Acute sequelae of COVID-19, more commonly referred to as long-term COVID, are defined by the CDC as a wide range of new, recurrent or ongoing health problems that people experience after being infected with SARS-CoV-2. Causes COVID-19.
Although there is currently no definitive reason why COVID persists in people infected with SARS-CoV-2, researchers across the United States have been studying its effects for over a year. On September 16, 2021, the NIH announced that he would allocate nearly $470 million to her long-term COVID research.
Jennifer A. Frontera
“Honestly, there are multiple reasons why people have long-term symptoms, and it depends on how severe the initial COVID-19 course was.” Jennifer A. Frontera, MD, A neurocritical care specialist at New York University Langone Health told Helio: “People who were hospitalized or had low oxygen levels could have had very different medical conditions than those who did not require hospitalization.”
Headache, the most common symptom of fatigue
In October 2022, Brain, Behavior, ImmunityIn addition, 80% of patients in the study self-reported at least one neurological symptom.
The SARS-CoV-2 virus has been circulating for almost two calendar years, but experts are still studying how and why symptoms persist, as well as the different areas of the body the virus affects. . COVID-19 is a respiratory infection, but for a long time COVID has had a pronounced impact on the central nervous system, especially the brain.
“clearly, [long COVID] It’s not just respiratory disease. ” Ziyad Al-Aly, MDdirector of the Center for Clinical Epidemiology and director of research and education services for the Veterans Affairs St. Louis Health Care System, told Helio. .”
all organs affected
August 2021, electronic clinical medicine, researchers published data from an international study involving thousands of patients in 56 countries infected with COVID-19. The authors reported over 200 symptoms in all organ systems related to her COVID over time. Al-Aly reported similar results in a study he co-authored in October.
People with COVID-19 are at a much higher risk of several long-term symptoms, not just headaches and brain fog, Al-Aly said. He and his researchers found an increased risk of all types of stroke. cognitive and memory conditions such as Alzheimer’s disease; episodic disorders; sensory disturbances; hearing and vision problems; loss of smell and taste;
Al-Aly said he and his colleagues undertook the study thinking the data would confirm their suspicion that brain fog and fatigue were the main long-term effects of COVID on the brain. “But what we found is actually much deeper than that,” he said. “People infected with SARS-CoV-2 actually have different neurological abnormalities. It actually spans different areas of the nervous system. That was quite a discovery.”
Al-Aly, who has been at the forefront of long-running COVID research since the beginning of the pandemic in the United States, explained why COVID-19 affects different organ systems in the body, ultimately causing long-lasting symptoms. said that there are many hypotheses.
Vascular and Inflammatory Hypotheses
“The vascular hypothesis suggests that SARS-CoV-2 can interact with the endothelial layer of blood vessels, which are practically everywhere,” said Al-Aly. “[The virus can] It stimulates the endothelial layer, making it easier for the endothelium to form blood clots and microclots. ”
This was one of several hypotheses spoken by Al-Aly, but it is currently unknown if any of them are true. Walter Koroschetz, M.D., The director of the National Institute of Neurological Disorders and Stroke told Healio that rather than affecting the brain, COVID-19 may be affecting the body’s immune system.
“If you have the flu, you’ll have symptoms, but that’s due to the fact that it’s not the virus you’re infecting. [body].
Koroshetz compared the long-term effects of COVID to those in patients with rheumatoid arthritis, a chronic inflammatory condition. He said most people with rheumatoid arthritis report similar fatigue symptoms.
“It’s part of an autoimmune disease where the immune system is overactive,” Koroschetz said. “Similar fatigue symptoms and problems occur with regard to processing speed. These conditions are thought to be due to inflammatory mediators affecting brain function.”
also have mental problems
An additional concern about long-term COVID is mental rather than physical. Depression and anxiety are reported to be on the rise among individuals with persistent symptoms, as symptoms persist for months at a time, and he even a year or more, Frontera says.
“Depression is probably bidirectional,” she said. “We know that people who have suffered brain injuries, such as stroke, Parkinson’s disease or seizures, are at increased risk of depression. Depression is caused by a neurochemical or neurotransmitter imbalance in the brain. We know that it can be caused by primary brain injury.
Frontera, who recently co-authored a study on stressors and their impact on recovery from COVID-19, said common problems in life can add to the long-term burden of COVID and the process of recovery from infection. said there is
“Financial insecurity, food insecurity, social isolation, battling new disabilities, and the death of loved ones can all affect many neurological symptoms and ability to recover after hospitalization,” she said. said.
Frontera noted that it’s important for clinicians to look at all aspects of a patient’s life, as several individual factors can influence the severity of certain symptoms.
“If there are environmental or socioeconomic structures that social workers, or anyone else who can provide patient resources, can address, that’s important to keep in mind,” she said. and treating some of the problems, such as food insecurity and financial insecurity, would go a long way to improving some of the conditions we see.”
References:
Chen AK and others brain behavior immunity health. 2022; doi:10.1016/j.bbih.2022.100491.
Davis HE, et al. E Clinical Medicine. 2021; doi:10.1016/j.eclinm.2021.101019.
Xu E et al. nat med. 2022; doi:10.1038/s41591-022-02001-z.
