Here’s what we know about COVID-19’s impact on the brain

Understanding Long COVID: Symptoms, Brain Impact, and Ongoing Research

1. Impact on the Brain

Neurological Complications: Early in the pandemic, experts anticipated neurological complications with COVID-19, drawing parallels with other viruses that have had long-term cognitive impacts on individuals.
Autopsy Findings: Autopsies have revealed significant brain damage in severe COVID-19 cases, including blood vessel damage and inflammatory cells in and around the brain. The virus itself was rarely found in the brain, suggesting other mechanisms causing the observed damages.

2. Hypotheses on Long COVID's Effect on the Brain

Researchers propose three main hypotheses to explain the neurological symptoms observed in long COVID patients:

Direct Infection: The virus might directly infect cells in the nervous system or other supportive structures in the brain, causing a range of symptoms.
Autoimmune Responses: The body's immune system might mistakenly attack parts of the brain, triggering a variety of symptoms that could persist due to the long-lasting activation of autoimmune cells.
Distal Inflammation: Inflammations happening in distant parts of the body, such as the lungs, might stimulate cells within the brain, causing long-term changes and triggering neurological issues.

3. Symptoms of Long COVID

Long COVID refers to a range of symptoms that continue for weeks or months after the acute phase of a COVID-19 infection has resolved. Some of the symptoms include:

Brain Fog: Individuals might find it hard to concentrate, remember things, or carry out cognitive tasks that were previously easy for them.
Neurological Issues: Apart from brain fog, individuals can experience headaches, abnormal skin sensations, and in rare cases, acute psychiatric syndromes including delusions or psychosis.
Respiratory Symptoms: These include a fast heart rate and shortness of breath, indicating that the respiratory system is still under stress or recovering.
Skin Changes: Some individuals report a strange sensation on the surface of their skin, which is a neurological symptom manifesting on the skin.
Gender Disparity: Studies have found that women are at a greater risk of developing long COVID compared to men.

4. Rehabilitation Approaches

Clinics worldwide are trying different rehabilitation strategies, including:

Autonomic Rehabilitation: This approach is personalized and involves very gentle movements paired with breathwork to help rehabilitate the autonomic nervous system, which controls bodily functions that we are not consciously directing, like heartbeat and digestion.
Cognitive Symptoms and Dysautonomia: Not all cognitive symptoms are a result of dysautonomia, and the rehabilitation might not work for everyone.

5. Drug Trials for Long COVID

Researchers are exploring various treatment avenues, including drug trials. Here are some details about the potential drug trials:

Immune Modulating Drug Trial: The National Institutes of Health is planning a trial involving immune-modulating drugs. The trial is structured to have three arms:
- Placebo: One group will receive a placebo to serve as a control group.
- Intravenous Immunoglobulin (IVIG): This group will receive Intravenous Immunoglobulin (IVIG), a treatment often used in autoimmune diseases, to modulate the immune response.
- Intravenous Corticosteroids: This group will receive intravenous corticosteroids, a class of drugs used to reduce inflammation in the body.
Sledgehammer Approaches: These approaches affect the immune system in many different ways and are not targeted therapies. The goal is to understand the broad impacts these treatments might have on long COVID symptoms.
Regulatory Approval: Before the trial can commence, it awaits regulatory approval to ensure safety and compliance with the necessary regulatory frameworks.

6. Vaccination and Long COVID

Vaccination has shown to have a varied impact on long COVID symptoms, and understanding this can potentially guide future treatments:

Positive Impact: Some individuals have reported feeling much better after receiving the vaccine, which might be due to the elimination of persistent virus or viral remnants triggering chronic inflammation.
No Change or Negative Impact: Conversely, there are individuals who do not experience any change in their symptoms post-vaccination, and some even feel worse, possibly due to exacerbation of autoimmune responses.
Future Therapies: Understanding the mechanisms through which vaccination affects long COVID symptoms can potentially help in developing therapies that can emulate the beneficial effects observed in some individuals post-vaccination.

7. The Road Ahead

Learning from Long COVID Research: The ongoing research into long COVID not only aims to find solutions for the current crisis but also hopes to shed light on other post-viral illnesses, potentially revolutionizing treatment approaches in the future.
Opportunity for Breakthroughs: The research presents a significant opportunity to understand and find treatments for other similarly related diseases, offering hope to millions suffering from post-viral syndromes.

This guide aims to provide a comprehensive understanding of long COVID, detailing the impact of the virus on the brain, the symptoms experienced by individuals, and the ongoing efforts in rehabilitation and drug trials to find effective solutions. It is a dynamic field with research ongoing, and it is hoped that the concerted efforts will lead to effective solutions in the near future.