Authors: Wes Ely August 25, 2022 The Washington Post<\/p>\n\n\n\n
The young man pulled something from behind both ears. \u201cI can\u2019t hear anything without my new hearing aids,\u201d said the 32-year-old husband and father. \u201cMy body is broken, Doc.\u201d Once a fireman and emergency medical technician, he\u2019d had covid more than 18 months before and was nearly deaf. He was also newly suffering from incapacitating anxiety, cognitive impairment and depression. Likewise, a 51-year-old woman told me through tears: \u201cIt\u2019s almost two years. My old self is gone. I can\u2019t even think clearly enough to keep my finances straight.\u201d These are real people immersed in the global public health catastrophe of long covid<\/a>, which the medical world is struggling to grasp and society is failing to confront.<\/p>\n\n\n\n As such stories clearly indicate, covid is biologically dangerous long after the initial viral infection. One of the leading hypotheses behind long covid is that the coronavirus is somehow able to establish a reservoir in tissues such as the gastrointestinal tract<\/a>. I believe the explanation for long covid is more sinister.<\/p>\n\n\n\n The science makes it increasingly clear<\/a> that covid-19 turns on inflammation and alters the nervous system even when the virus itself seems to be long gone. The virus starts by infecting nasal and respiratory lining cells, and the resulting inflammation sends molecules through the blood that trigger the release of cytokines in the brain. This can happen even in mild covid cases. Through these cell-to-cell conversations, cells in the nervous system called microglia and astrocytes are revved up in ways that continue for months \u2014 maybe years. It\u2019s like a rock weighing down on the accelerator of a car, spinning its engine out of control. All of this causes injury to many cells, including neurons. It is past time we recognized this fact and began incorporating it into the ways we care for those who have survived covid.<\/p>\n\n\n\n For too long, the mysteries of long covid<\/a> led many health-care professionals to dismiss it as an untreatable malady or a psychosomatic illness without a scientific basis. Some of this confusion comes down to the stuttering cadence of scientific progress. Early in the pandemic, autopsy findings from patients who died of covid<\/a> \u201cdid not show encephalitis or other specific brain changes referable to the virus\u201d as one report noted. Patients with profound neurological illnesses resulting from covid-19 had no trace of the virus in the cerebrospinal fluid<\/a> encasing their brains.<\/p>\n\n\n\n These studies left most medical professionals mistakenly convinced that the virus was not damaging the brain. Accordingly, we narrowed our focus to the lungs and heart and then scratched our heads in wonder at the coma and delirium<\/a> found in more than 80 percent of covid ICU patients. A robust study from the Netherlands<\/a> showed that at least 12.5 percent of covid patients end up with long covid three months afterward, yet because \u201cbrain fog\u201d wasn\u2019t identified until later in the pandemic, these investigators didn\u2019t include cognitive problems or mental health disorders in the data they collected. Thus, this otherwise beautifully executed study almost certainly underestimated the rate of long covid.<\/p>\n\n\n\n Since the early days of the pandemic, we\u2019ve learned a great deal about the neurological effects of SARS-CoV-2. Earlier this year, the UK Biobank neuroimaging study<\/a> showed that even mild covid can lead to an overall reduction in the size of the brain, with notable effects in the frontal cortex and limbic system. These findings help explain the profound anxiety, depression, memory loss and cognitive impairment experienced by so many long-covid patients.<\/p>\n\n\n\n A new study<\/a> published in the Lancet of more than 2.5 million people matched covid-19 patients with non-covid patients to determine the rate of recovery from mental health complaints and neurological deficits<\/a> like the depression and brain fog in my own patients. What it revealed is partly encouraging and partly devastating: The anxiety and mood disorders in long covid tend to resolve over months, while serious dementia-like problems, psychosis and seizures persist at two years.<\/p>\n","protected":false},"excerpt":{"rendered":" Authors: Wes Ely August 25, 2022 The Washington Post The young man pulled something from behind both ears. \u201cI can\u2019t hear anything without my new hearing aids,\u201d said the 32-year-old husband […]<\/p>\n","protected":false},"author":2,"featured_media":5360,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58,59,75,78,90,144,207,289,290],"tags":[],"class_list":["post-5358","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-brain","category-brain-fog","category-cerebral-venous-sinus-thrombosis","category-cerebrovascular-disease","category-clots-bleeds","category-endothelium","category-heart","category-long-haul-disease","category-long-term-effects"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/5358","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5358"}],"version-history":[{"count":0,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/5358\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/5360"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5358"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5358"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}