LivingCOVID-19 and the brain: possible causes, consequences and treatments

COVID-19 and the brain: possible causes, consequences and treatments

Among the list of organs that can be affected by the infection caused by the SARS-CoV-2 coronavirus, the brain is one of those that first began to be investigated but has encountered more complications along the way. However, there are research groups that continue with this task.

Can the coronavirus infect the brain?

During the early months of the COVID-19 pandemic, there were a number of symptoms that recurred among patients that seemed to have a connection to the presence of the coronavirus in the brain, such as loss of smell.

Today it is believed that anosmia (loss of smell) is mainly caused by infection of different cells of the olfactory mucosa found in the roof of the nostrils, and not by a brain infection or damage to neurons or nerves. . However, there is a small chance that it will occur in a small percentage of patients.

Preliminary analyzes of the brains of people who died of COVID-19 showed clear damage to the brain tissue , but they did not find abundant remnants of the virus , only the effect caused by the infection. In addition, pneumonia was one of the most worrying symptoms, and much of the research focused on treating those symptoms.

On the other hand, autopsy studies were limited in patients suffering from very severe SARS-CoV-2 infection , leaving mild and moderate cases without data on the impact of infection on the brain.

Persistent Covid (Long Covid) dio la clave

More than two years later, we are facing a different situation regarding COVID-19. The numbers of deaths in vaccinated populations are minimal, and the vast majority of patients manage to recover without major complications .

However, now we are dealing with persistent COVID-19 , which affects 30-45% of patients who go through this coronavirus infection. This disease is diagnosed if one or more symptoms persist for more than thirty days after the onset of infection.

Among the symptoms that usually last are anosmia, fatigue and cognitive problems . Being patients who suffer from these symptoms for months, this has made it possible to study the effects of the infection in greater detail, especially when the organ is difficult to access, as is the case with the brain.

Among the symptoms related to the brain, researchers have identified different categories of symptoms . We have what is defined as “mental fog” (from the English brain fog) that makes tasks such as concentration or memory difficult.

Other patients experience a change in how their skin feels to the touch . Finally, there is the category that includes those who suffer from headaches .

Also, patients who suffer from another neurological disease and who have experienced more pronounced flare-ups or worsening of symptoms such as psychosis , accentuated by SARS-CoV-2 infection.

The task of identifying these symptoms and finding the causative agent is very complicated, because most patients are negative in the coronavirus test and other diagnostic tests such as magnetic resonance imaging do not provide any evidence either.

Three possible causes

The first possibility for which the coronavirus causes symptoms in the brain is a direct infection in this tissue , which remains for months and the immune system is unable to eliminate.

The second option is that the symptoms are caused by our own immune system cells that have reached the brain and are causing damage in different areas. It would be an autoimmune disease and that would explain why it lasts for months, since once activated, it is difficult to deactivate.

Lastly, it may be due to a side effect or consequence of inflammation taking place in another organ (either the heart or the lungs). This inflammation sends a series of signals to the brain that permanently damage them.

It is also possible that the three scenarios are true and since they are not mutually exclusive, all three could occur, although the probability is much lower.

Some rehabilitation programs to eliminate the nervous system symptoms caused by SARS-CoV-2 are based on a series of slow and delicate movements to reestablish nerve connections while paying attention to breathing and circulation.

Sometimes this rehabilitation also has an effect on other neurological symptoms, but not always. Vaccination against COVID-19 in patients suffering from persistent covid has also resulted in improvement in most symptoms, but not in all patients receiving the vaccine.

There is a percentage of patients who do not improve , and another percentage that even worsen after vaccination. This could be explained based on the three possible causes already exposed. If a person has developed an autoimmune disease or chronic inflammation , vaccination can potentiate symptoms in an already activated system.

A new study wants to evaluate the effect of injecting antibodies or corticosteroids into these patients. Although it has not yet started , it aims to find a way to alleviate the symptoms associated with the brain caused by infection that can not only help COVID-19 patients, but any other type of viral infection that leaves long-term sequelae.

References:

Nath. Status: enrolling by invitation. Last Update Posted June 10, 2022. Immunotherapy for Neurological Post-Acute Sequelae of SARS-CoV-2. ClinicalTrials.gov. NCT05350774

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