CV-19 brain damage

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Long Covid is known to include brain problems, including headache, fatigue, smell loss, sleep problems, and brain fog. People with these problems didn’t necessarily have severe Covid.

A new study autopsied nine people 24 to 73 years old (seven men and two women) who died during the first wave of the pandemic from March to July 2020. (Original “wild-type” Covid.) Five died suddenly; four were found dead at home and one in a subway. The others died within days to weeks of symptom onset. They showed microvascular abnormalities in their brain on post-mortem MRI. Their brains were compared with 10 controls.

SARS-CoV-2 infection was confirmed with testing. All participants had evidence of lung involvement at the time of autopsy, but only one required ICU admission.

The interesting thing is that no virus was found in the affected brains. All the problems were caused by immune system reactions. Remember that many of the fatal Covid-19 cases in younger people were caused by a very strong immune system reaction (“cytokine storm”).

The brain damage found in the dead people was caused by an immune system attack on the inner lining of the tiny blood vessels in the brain. This causes the blood vessels to leak into the brain around them. The leakage inflames the microglia, which are active support cells in the brain with many functions. The activated microglia begin to eat neurons.

In addition, tiny blood clots stick to the inner lining of the blood vessels, attracting more immune complexes to stick to them. Could this cause mini-strokes? I don’t know, but it can’t be good.

https://www.medpagetoday.com/neurology/longcovid/99664?xid=n…

People aren’t dying from the attack on the brain but they get messed up for a long time.

A separate study showed that some people with long Covid have persistent dysregulation of the peripheral immune system that can last 6 months or more. This could make them more vulnerable to other infections and also exacerbate other chronic conditions.

https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291…

The newest Covid variants are known to evade the immune system. Does that mean they won’t cause long Covid? I doubt it. Murphy’s Law says that the immune system will be activated enough to cause autoimmune problems but not enough to smack down Omicron BA.5.

Many people are catching different variants of Covid repeatedly. Will this make long Covid worse? I don’t know, but it can’t be good.

Be careful out there. Covid isn’t done with us yet.

Wendy

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For those who might be interested, Eric Topol is a physician-scientist who posts great summaries and updates about Covid on Twitter:

https://twitter.com/EricTopol

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Caution should be used making conclusions on studies of 17 people.
The data is insufficient to even justify larger studies and certainly should
not be published to generate worries or concerns.

Howie52
IMO - This type of article is worse than hearsay.
May not be political but not anything to judge economically.

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< Caution should be used making conclusions on studies of 17 people.
The data is insufficient to even justify larger studies and certainly should
not be published to generate worries or concerns.>

I prefer large data sets, the bigger the better. Note that I always report the size of the data set whenever I report research.

That being said, Covid-19 has thrown curveballs from the very start. Many of the important insights came from very small reports that, under normal circumstances, wouldn’t be acceptable as data sets. (That includes the report from Italy in 2020 that Vitamin D deficiency correlated strongly with severe Covid.)

The data from the article with the autopsies obviously can’t be replicated on living long Covid patients. I think it would be worth replicating on long Covid patients who died of other fatal conditions or accidents but it would be pretty difficult to collect qualifying bodies fast enough to do valid autopsies. (A research group would have to organize feeder hospitals which have a lot of other problems of higher priority.)

The second article, which showed long-term immune activation in many long Covid patients, can be done on living people.

From a practical standpoint, learning that the immune system plays a large part in long Covid could help doctors develop treatments based on immune responses. This could be an important insight. Of course, much more evidence and work is needed. But the information is not “worse than hearsay.”

Wendy

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Caution should be used making conclusions on studies of 17 people.

No question. I’ll give you a data set of one: my nephew. One of the earliest people to get Covid, happened within a month or so of the first instances in this country. Maybe not a big surprise, he was 29, highly social, spent days selling people stuff and most nights in bars in Philadelphia where some of the earliest breakouts were reported.

Flash forward a few months: he reports “being controlled” by the CIA, or perhaps by 9 (specific) people in California. Has developed a tic, laughs inappropriately at times, even when nothing has happened and nobody has said anything. He has called the police to tell them about this “mind control”, and they showed up (at the parents’ house) but as he is not violent there is nothing they can do. He has tried to hire a private detective to “investigate” his nemeses, but has run through his bank account and so can’t get further. He occasionally books an airline ticket to California until his Mother finds out, at which time she cancels it and pulls out her hair.

He refuses to believe there is anything wrong, even though he has gone from “high performer” at his job to being fired from that one and two others. Refuses counseling, is living with parents, will not even consider the possibility of medication.

His reality has changed, he is sure he is fine and wishes everyone would stop telling him there’s something wrong. “There’s nothing wrong, I’m fine”, and that’s that.

Now I acknowledge that this could be a coincidence, that Covid had nothing to do with it, but it seems strange that he was a bright, normal, well adjusted 20-something who has gone down the rabbit hole in such a short amount of time.

I worked for three years at Greystone State Hospital in NJ (as a painter, side and summer job in college) and lived among similar people. It was a different time, when such people were institutionalized more readily. Their world is different, and they think they’re fine and you’re all crazy, and no amount of logic will convince them otherwise. I claim no medical expertise in this, but I (and the rest of the family) have done a fair amount of using Google with the phrases “Covid” and “psychosis” and it is amazing how many such reports there are, and from all over the world.

He has turned from functionally capable young adult to “ward of his parents”, and as they are not financially secure, soon to be “ward of the state”, I would guess. It’s a tragedy, and I have a front row seat.

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I’m sorry to hear that your nephew has developed schizophrenia.

The National Alliance on Mental Illness (NAMI) says that recent research suggests a relationship between autoimmune disorders and the development of psychosis.

https://www.nami.org/About-Mental-Illness/Mental-Health-Cond…

The Covid-caused immune system attack on the lining of the blood vessels in the brain is an autoimmune attack. Many autoimmune disorders are idiopathic (unknown reason) but others are associated with various viruses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723519/

Unfortunately, the chronic autoimmune disease persists after the acute viral infection subsides.

Much more research would be needed to demonstrate whether Covid initiates an autoimmune attack in the brain that could trigger psychosis. But the hypothesis is reasonable and backed up by the autopsy findings of autoimmune trigger of glial neurophagy (glial cells eating neurons in the brain).

Like everything else that affects the brain, the risk wouldn’t be universal but it could severely affect those who had underlying vulnerabilities.

Wendy

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Wendy beat me to it.

Your nephew sounds like my BIL. He was doing very well in his early 20’s and then just went downhill and never came back. That was now over 20 years ago. It has been a tragedy for him and the family.

Schizophrenia typically hits males in the early 20’s.
https://www.mayoclinic.org/diseases-conditions/schizophrenia….

It might just be correlation with COVID instead of causation. However, from what I understand, schizophrenia is one of those genetic diseases where a gene needs to get “turned on” for the disease to manifest. Maybe COVID is the thing that did it, maybe not.

Lifelong medication is currently the only way to address it. Having seen my BIL over the early years of incorrect diagnoses and false hopes that he would “pull out of it” and even with periods of relative functionality, it is all futile without the drugs. I can only advise that your nephew’s family do whatever is needed to get him evaluated and (most likely) medicated.

As for my BIL, in the 15 years since he’s been medicated, he’s had his ups and downs, but he actually manages a somewhat independent life. Before the meds, it was a violent roller coaster that almost ended his life in a suicide attempt.

I hope my armchair speculation is incorrect, and I hope the best for your family. If it is schizophrenia, it is an awful condition for everyone involved.

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