The neurobiology of Long Covid Monje/Iwasaki 2022

J

Jaybee00

Senior Member (Voting Rights)
https://www.cell.com/neuron/fulltext/S0896-6273(22)00910-2#relatedArticles


[URL]https://www.cell.com/neuron/pdf/S0896-6273(22)00910-2.pdf?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0896627322009102%3Fshowall%3Dtrue


Abstract
Persistent neurological and neuropsychiatric symptoms affect a substantial fraction of people after COVID-19 and represent a major component of the post-acute COVID syndrome, also known as long COVID. Here, we review what is understood about the pathobiology of post-acute COVID-19 impacts on the CNS and discuss possible neurobiological underpinnings of the cognitive symptoms affecting COVID-19 survivors. We propose the chief mechanisms that may contribute to this emerging neurological health crisis.
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Quoting and reformatting —

COVID-19 may affect the central nervous system in (at least) six main ways.
  • First, the immune response to SARS-CoV-2 in the respiratory system may cause neuroinflammation - increasing cytokines, chemokines and immune cell trafficking in the brain and inducing reactive states of resident microglia and other immune cells in the brain and brain borders.
  • Second, SARS-CoV-2 rarely may directly infect the nervous system.
  • Third, SARS-CoV-2 may evoke an autoimmune response against the nervous system.
  • Fourth, reactivation of latent herpesviruses like Epstein-Barr virus may trigger neuropathology.
  • Fifth, cerebrovascular and thrombotic disease may disrupt blood flow, disrupt blood-brain-barrier function, and contribute to further neuroinflammation and/or ischemia of neural cells.
  • Lastly, pulmonary and multiorgan dysfunction occurring in severe COVID can cause hypoxemia and metabolic disturbances that can negatively affect neural cells.
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Based on my early ME experience the cognitive impairment was reversible in that as the ME abated my cognitive impairment also abated. I had days or even months when my cognitive capacity returned to premorbid levels. However, thirty years on and many relapses later and an overall ongoing deterioration, I no longer experience periods when my brain seems to work normally.
 
Jaybee00 said:
Well some good-ish news here.



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Seeing how many people recovered from the worst of what brain fog can be, this has been obvious for a while now. It's good that experts are seeing the obvious but it's been obvious from patient forums for at least 1.5 years.

And that makes it especially frustrating because all of this is clearly treatable, there will not be a roadblock once the cause is figured out, stalled because they understand the issue but that it's irreversible.

All of this is treatable, in most cases it goes away on its own. Which makes all the claims of effective treatments invalid for now, the odds of recovery are basically a coin toss at 6 months. People like Garner claiming to have recovered using the powers of their mind are basically seeing themselves as geniuses for winning a coin toss.

So the only obstacle to achieving this is... the medical profession. The will to do the work. More importantly the will to stop blocking the work because of historical baggage.

We could have known all of this decades ago, if it wasn't for the BPS sabotage. It didn't require any advanced technology. Hell, those basic facts could have been obvious a full century ago, it only took paying unbiased attention and rigorous work. It was clearly too much to ask, though.
 
rvallee said:
And that makes it especially frustrating because all of this is clearly treatable, there will not be a roadblock once the cause is figured out, stalled because they understand the issue but that it's irreversible.
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I hope that's the case. That ME doesn't cause any permanent damage, but that there's some "switch" that's flipped and we just need to flip it back.
 
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