New research shows COVID-19 can cause lasting brain damage
A series of recent studies has provided compelling evidence that COVID-19 infection can lead to long-term brain injuries that persist for months after the initial illness. Researchers have found biomarkers of brain damage in blood samples and imaging scans of patients who had COVID-19, even those who had mild initial infections.
The findings come from three key studies published in the past week in major scientific journals. A study published in Nature Communications looked at blood samples from patients who had recovered from COVID-19 infections. They found elevated levels of markers linked to brain injury, inflammation, and the breakdown of neurons. These markers remained detectable for over 7 months after the initial illness.
Another study published in the journal Brain examined brain MRIs from over 500 patients who had recovered from COVID-19. They found tissue damage and shrinkage in multiple areas of the brain that are linked to cognition, memory, and mental health. Patients who required intensive care had more severe imaging abnormalities.
A third study published in Cureus suggests nutritional interventions that may help in the recovery process for patients experiencing neurological symptoms after COVID-19.
COVID brain effects similar to other critical illnesses
The recent research indicates that while COVID-19 can lead to measurable brain injury, the effects are similar to what is seen after other severe illnesses like pneumonia, sepsis, or cardiac arrest.
A study published in the Times of India compared brain MRIs from over 800 patients who had recovered from COVID-19, sepsis, cardiac arrest, or other critical illnesses. While COVID-19 patients showed imaging evidence of brain tissue damage, there was no statistical difference compared to the other groups. This indicates the brain effects of COVID-19 are likely due to the severe inflammation and oxygen deprivation during the acute infection rather than a unique pathology of the virus itself attacking the brain directly.
However, the scale of the COVID-19 pandemic means vastly greater numbers of patients are experiencing these brain injuries compared to a typical flu season or rates of cardiac arrest, suggesting an impending wave of neurological issues.
|% with signs of brain injury on MRI
Table shows similar rates of detectable brain abnormalities on MRI between COVID-19, sepsis, and cardiac arrest patients in recovery phase.
Lasting Impact on Memory and Cognition
The recent studies add to a growing body of literature indicating that COVID-19 infection can lead to lasting cognitive deficits and “brain fog” for a significant number of patients.
As the Times of India reports:
“Memory and thinking problems affect roughly a quarter of Covid survivors up to six months after infection, per a recent study published in ‘Nature Medicine’…The study also found that patients hospitalised with severe Covid had a 77% higher risk of developing memory issues.”
Areas of the brain linked to executive functioning appear especially impacted. A study cited by Cureus found that “CNS effects of COVID-19 can specifically damage the prefrontal cortex, an area critical for executive functioning.” Deficits in focus, decision making, reasoning and working memory linked to prefrontal cortex damage could have major implications for people resuming work and family responsibilities.
Mental Health Effects and Neuroinflammation
In addition to cognitive impacts, COVID-19 is likely leading to increased incidence of anxiety, depression and other mental health disorders. This could be due both to the psychological trauma of the illness as well as direct effects of inflammation and oxygen deprivation on the brain’s limbic system which regulates emotion.
An article in India.com states:
“According to a study published in The Lancet Psychiatry, in the three months following testing positive for Covid-19, diagnosis of anxiety disorders increased to 17 per cent, mood disorders to 14 per cent, substance misuse disorders to 7 per cent and insomnia to 5 per cent.”
Neuroinflammation is believed to play a key role in many of the lasting neurological effects being observed. A piece in Veronews explores links between serotonin imbalance and neuroinflammation as a possible mechanism:
“Neuroinflammation can also reduce serotonin production and reuptake, contributing to depressive disorders…anti-inflammatory medications and supplements may be helpful additions to standard SSRI antidepressants for patients with inflammation-associated depression.”
So while we now have clear evidence that COVID-19 substantially impacts long-term brain health, further research is urgently needed to determine the best treatments and interventions.
Long Road to Recovery
For those suffering lasting neurological symptoms after COVID-19, the path to full recovery remains long and uncertain.
An article in MedPage Today quotes Dr. Avindra Nath, intramural clinical director at the National Institute of Neurological Disorders and Stroke:
“It’s unlikely that these patients will have full recovery with no sequelae, especially those that had more severe disease”
However, specialists emphasize that gradual improvement over time is still very possible. Environmental factors also likely play a key role, indicating lifestyle changes could aid recovery.
Dr. Serena Spudich, Yale University, recommends “good sleep hygiene, reducing stress, meditation, yoga, and avoiding environments where there’s exposure to chemicals” along with other basic health principles of nutrition and exercise.
We may also see the development of pharmaceutical interventions, like anti-inflammatories, or even cutting-edge treatments such as hyperbaric oxygen therapy to help repair damaged neurological tissue.
Ongoing Monitoring Needed
The recent research indicates patients with even mild COVID-19 illness should have brain health monitoring even months after recovering from the initial infection. Routine bloodwork or neurological exams are unlikely to detect evidence of ongoing inflammation or damage.
An article from Inside Precision Medicine highlights this gap, stating:
“The findings indicate that more sophisticated approaches are needed to accurately detect the impact COVID-19 has on the central nervous system…”
Advanced MRI imaging and analysis of biomarkers in cerebrospinal fluid could reveal subtler changes not otherwise evident. This would allow earlier interventions in the hopes of halting further deterioration.
Catching and addressing these issues early on also carries economic implications when it comes to estimating healthcare costs, productivity losses from neurological Long COVID, and need for workplace or disability accommodations. A piece in the Statesman notes:
“Long-term monitoring of the outcomes of patients infected with SARS-CoV-2 is likely going to be essential for health systems around the world.”
In summary, while daunting, the growing research on post-COVID brain health underscores the need for patience and compassion. Our healthcare system must continue adapting to offer neurological monitoring and coordinated mental health support along with emerging pharmacological options tailored to treat COVID’s long shadow.
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