Home Medizin Neue Erkenntnisse deuten darauf hin, dass Long-COVID eine Hirnverletzung sein könnte

Neue Erkenntnisse deuten darauf hin, dass Long-COVID eine Hirnverletzung sein könnte

von NFI Redaktion

Brain Fog is one of the most common and persistent complaints among patients with Long-COVID, affecting up to 46% of patients who also struggle with other cognitive issues such as memory loss and concentration difficulties.

Researchers now believe they know why. A new study has found that these symptoms may be the result of a virus-induced brain injury that can cause long-lasting cognitive and mental health problems.

Researchers found signs of long-term brain damage in 351 patients who were hospitalized with severe COVID-19 one year after being infected with the SARS-CoV-2 virus. The results were based on a series of cognitive tests, self-reported symptoms, brain scans, and biomarkers.

Brain deficits equivalent to a 20-year brain aging

In the preprint study, participants underwent a cognitive test, and their results corresponded to the age-related expectations for those who had not suffered a severe bout of COVID-19. Blood samples were then taken to look for specific biomarkers, which were found to be associated with brain injury. Brain scans also revealed volume loss in certain regions of the brain associated with attention.

Participants in the study were found to be „less accurate and slower“ in their perception and were reported to have at least one mental health condition such as depression, anxiety, or post-traumatic stress disorder.

The brain deficits observed in COVID-19 patients were equivalent to a 20-year brain aging, providing evidence for doctors‘ fears that this virus can damage the brain and lead to persistent mental health problems.

„We discovered global deficits in cognition,“ said lead study author Benedict Michael, PhD, Director of the Infection Neuroscience Lab at the University of Liverpool in Liverpool, England. „The cognitive and memory problems reported by the patients were associated with neuroanatomical changes in the brain.“

Proof that the symptoms are not a figment of the patient’s imagination

Cognitive deficits were common in all patients, but the researchers said they did not yet know whether the brain damage leads to a permanent cognitive decline. However, the research provides patients, who have been overlooked by some doctors, with evidence that their conditions are not imaginary, said Dr. Karla L. Thompson, head neuropsychologist at the COVID Recovery Clinic at the University of North Carolina School of Medicine.

„While the pandemic has been ongoing for several years, there are still many providers who do not believe their patients have these residual symptoms,“ Thompson said. „That’s why the use of biomarkers is important, providing an objective indication that the brain has been damaged in some way.“

Some Long-COVID patients have said that throughout the pandemic, it has been an ongoing struggle to convince their doctors that they have a physical illness, especially in relation to the sometimes vague collection of symptoms associated with Brain Fog. A study found that up to 79% of study participants reported negative interactions with their health care providers when seeking treatment for their Long-COVID symptoms.

How do COVID-related brain injuries occur?

Researchers are unsure what causes these brain injuries but have found some clues. Previous studies suggest that such injuries may result from a lack of oxygen in the brain, particularly in patients who, like those in this study, were hospitalized and intubated.

Brain scans have previously shown gray matter atrophy in COVID-19 patients, likely caused more by inflammation due to an amplified immune response than by the virus itself. This inflammatory response seems to affect the central nervous system. In the new study, researchers found some neuroprotective effects of using steroids during hospitalization to reduce brain inflammation.

The results suggest that doctors should overcome their skepticism and consider the possibility that their patients have suffered a brain injury and should be treated appropriately, said James C. Jackson, PsyD, neuropsychiatrist at Vanderbilt University School of Medicine. „The old saying goes: If it walks like a duck and quacks like a duck, it’s a duck,“ Jackson said. He claims that treatments for patients with brain injuries have also proven effective in treating Long-COVID-related Brain Fog symptoms. This may include speech, cognitive, and occupational therapy and meeting with a neuropsychiatrist to address associated mental health issues.

A new way forward

Treating Long-COVID Brain Fog as a brain injury can help patients return to a semblance of normalcy, researchers said. „What we are seeing in terms of biomarkers for brain injury and differences in brain scans correlates with real problems these patients deal with on a daily basis,“ Jackson said. This includes issues with multitasking, remembering details, meeting deadlines, summarizing large amounts of information, and maintaining focus on the task at hand, he said.

There is also concern that the virus-induced aging of the brain may have long-term effects and that this lasting damage could lead to the early onset of dementia and Alzheimer’s in those who were already susceptible. A study by the National Institute of Neurological Disorders and Stroke (NINDS) found that the virus „rapidly accelerated structural and functional deterioration of the brain“ in individuals with COVID-19 who already had dementia.

„We already know the role of neuroinflammation in the brains of patients with Alzheimer’s disease,“ Thompson said. „If Long-COVID is involved in persistent brain inflammation, this contributes significantly to explaining the underlying mechanism of brain aging reported in the study.“

There is more to learn

In some ways, this study raises almost as many questions as it answers. While it provides concrete evidence of the damage the virus inflicts on the brains of patients severely affected by COVID-19, researchers know nothing about the effects on those who had less severe cases of the virus.

Ziyad Al-Aly, MD, head of research and development at the Veterans Affairs St. Louis Health Care System, is concerned that some Long-COVID patients may be suffering from more subtle cognitive deficits that still impact their daily lives and are not getting the help they need.

Furthermore, Al-Aly said it is unclear whether the effects of brain damage are permanent or how to prevent progression. Researchers and clinicians need a better understanding of the mechanism that allows this virus to invade the brain and cause structural damage. If it is inflammation, can anti-inflammatory or antiviral medications prevent this? Do steroids help counteract the damage? „It’s important for us to find answers,“ he said.

„SARS-CoV-2 is not going anywhere. It will continue to infect the population. So, if it is indeed a virus that damages the brain long-term or permanently, we need to find out what can be done to stop it,“ Al-Aly said.

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