Covid Side Effects: Unraveling the Neurological & Psychiatric Impacts

[Evo]

TL;DR Summary

Researchers find that people who only suffered mild infections can be plagued with life-altering and sometimes debilitating cognitive deficits.

I thought it might be interesting and helpful to put all information on known side effects of Covid in one thread. Please feel free to add any information on side effects here.

How does COVID-19 affect the brain? A troubling picture emerges.

Davis is among a large portion of COVID-19 patients—possibly as high as 30 percent, according an estimate from the https://www.nimh.nih.gov/news/events/announcements/neurologic-and-psychiatric-effects-of-sars-cov-2-meeting—who suffer some type of neurological or psychiatric symptoms.

https://www.nationalgeographic.com/...20210820&rid=6BB08808740E9FEDD2938054BB46CA41

 

[jim mcnamara]

There are other mentions of Covid neurologic and cognitive sequelae in several threads here. So when one appears let's try to get it moved here.

 

[Vanadium 50]

When we do that can we change the title then? These aren't side effects - they're just plain old effects.

 

[Evo]

There are other mentions of Covid neurologic and cognitive sequelae in several threads here. So when one appears let's try to get it moved here.

I am wondering if this can be the cause of the unexplainable bouts of severe brain fog, inability to stand, confusion, inability to focus my eyes that I have been experiencing since I had the mostly asymptomatic Covid in March 2020. I've not changed meds or diet, it just hits me like a brick wall, lasts 2-3 days then just as quickly goes away. I was beginning to fear I may have a brain tumor. I do need to see my doctor and "have my head examined"

 

[jim mcnamara]

I posted a preliminary study on serum markers that were high for clotting factors - this was found in people with previous Covid infections and who had long haul sequelae.

https://www.physicsforums.com/threads/covid-long-haulers.1000763/#post-6529268

I believe recruitment on a large RCT to study this very problem is underway. See if your physician wants to contact them about enrolling you. You may or may not qualify. ...do not know.

 

[jim mcnamara]

@Vanadium 50 - Yes about title change, but probably the best term is sequelae - symptoms that appear after the primary problem - in this case defined as PCR negative tests on Covid patients for 10-14 days depending on the country. The CDC re-messaged from 14 to 10 days for self-quarantine just recently.

It is @Evo 's thread. Her call.

 

[bhobba]

I am wondering if this can be the cause of the unexplainable bouts of severe brain fog, inability to stand, confusion, inability to focus my eyes that I have been experiencing since I had the mostly asymptomatic Covid in March 2020. I've not changed meds or diet, it just hits me like a brick wall, lasts 2-3 days then just as quickly goes away. I was beginning to fear I may have a brain tumor. I do need to see my doctor and "have my head examined"

I think it is quite possible. Those are the exact symptoms I have seen reported in news media and online posts from sufferers. Of course, as you know, we can't make a medical diagnosis here. Still, certainly, it would seem worthwhile going to a clinic that treats long haulers:
https://www.scientificamerican.com/...linics-treat-mysterious-and-ongoing-symptoms/

You may end up with a specialist from the new specialty I regularly see since my bout of Bells Palsy - a neuropsychiatrist. They are more common in the US than here in Aus because psychiatrists in the US take the same exam as neurologists for board certification. In Aus, you have to do further study after being qualified as a psychiatrist or neurologist.

The insidious thing about long haulers is you can have Covid asymptomatically and still get it. Very disturbing.

Thanks
Bill

 

[Astronuc]

I am wondering if this can be the cause of the unexplainable bouts of severe brain fog, inability to stand, confusion, inability to focus my eyes that I have been experiencing since I had the mostly asymptomatic Covid in March 2020.

Ostensibly, SARS-Cov-2 will affect any biological system that includes ACE-2.

Although sharing a close evolutionary relationship with SARS-CoV, the receptor-binding domain of SARS-CoV-2 differs in several key amino acid residues, allowing for stronger binding affinity with the human ACE2 receptor, which may account for the greater pathogenicity of SARS-CoV-2. The loss of ACE2 function following binding by SARS-CoV-2 is driven by endocytosis and activation of proteolytic cleavage and processing. The ACE2 system is a critical protective pathway against heart failure with reduced and preserved ejection fraction including, myocardial infarction and hypertension, and against lung disease and diabetes mellitus.

Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188049/

From 2008 - Angiotensin‐converting enzyme 2 in the brain: properties and future directions
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667944/

Angiotensin-converting enzyme 2 (ACE2), the proposed receptor of SARS-CoV-2, is expressed in the respiratory airways at low levels (blue) compared to the intestine, kidney, heart, and pancreas. After SARS-CoV outbreak in 2003, ACE2 was identified as the receptor for entry into lung epithelial cells (Li et al., 2003).

November 20, 2020 - ACE2: Evidence of role as entry receptor for SARS-CoV-2 and implications in comorbidities
https://elifesciences.org/articles/61390

The role of ACE-2 receptor seems well established as does the presence of ACE-2 in the brain and other organs. The effects probably depend on virus load and how it spreads through the pulmonary and circulatory systems.Edit - incidentally, there is another similar thread from November on the post-Covid syndrome or long-haul effects.
https://www.physicsforums.com/threa...a-covid-infection-post-covid-syndrome.996408/

 

[Ygggdrasil]

I have a couple of things to say in this thread, and will probably compose a few posts on separate topics. But, first, we've had quite a few threads on the long term effects of COVID-19, so here's an attempt to link them here for future reference:

Some general threads on long COVID:
https://www.physicsforums.com/threads/covid-19-long-haul.1000128/
https://www.physicsforums.com/threa...a-covid-infection-post-covid-syndrome.996408/
https://www.physicsforums.com/threads/younger-covid-19-patients-long-haulers.995061/
https://www.physicsforums.com/threads/covid-long-haulers.1000763/

Some threads focusing on neurological symptoms of long COVID:
https://www.physicsforums.com/threads/covid-19-described-pathology-a-new-extent.994500/
https://www.physicsforums.com/threads/covid-19-neurological-and-psychological-sequelae.1001770/
https://www.physicsforums.com/threads/post-sars-cov-2-infection-psychiatric-diagnoses.996052/
https://www.physicsforums.com/threads/covid-and-the-brain.1004894/

A thread initially reporting incidence of myocarditis in a small group of college athletes who had COVID-19. Later studies did not show an increased incidence of cardiovascular problems following mild COVID-19:
https://www.physicsforums.com/threa...ptomatic-covid-19-in-college-athletes.994340/ -

 

[Ygggdrasil]

Here are two links I posted in earlier threads that are worth repeating in this thread. First, a news article in Nature that describes some research into the potential causes of the neurological symptoms of COVID-19.
In particular, the article highlights studies suggesting that SARS-CoV-2 can infect astrocytes in the brain, that SARS-CoV-2 can affect blood flow to the brain through infection of pericytes, and that COVID-19 can induce autoantibodies that attack the brain:

How COVID-19 damages the brain is becoming clearer. New evidence suggests that the coronavirus’s assault on the brain could be multipronged: it might attack certain brain cells directly, reduce blood flow to brain tissue or trigger production of immune molecules that can harm brain cells.

Infection with the Coronavirus SARS-CoV-2 can cause memory loss, strokes and other effects on the brain. The question, says Serena Spudich, a neurologist at Yale University in New Haven, Connecticut, is: “Can we intervene early to address these abnormalities so that people don’t have long-term problems?”

With so many people affected — neurological symptoms appeared in 80% of the people hospitalized with COVID-19 who were surveyed in one study1 — researchers hope that the growing evidence base will point the way to better treatments.

https://www.nature.com/articles/d41586-021-01693-6

Second, while it is fairly well documented that severe cases of COVID-19 can cause long lasting symptoms, the research is less clear about these symptoms from mild or asymptomatic cases. Here's an opinion piece from STAT News that questions some of the claims of long Covid in people with who had mild or asymptomatic disease:

First, consider that at least some people who identify themselves as having long Covid appear never to have been infected with the SARS-CoV-2 virus. In Yong’s influential article, he cites a survey of Covid long-haulers in which some two-thirds of them had negative Coronavirus antibody tests — blood tests that reveal prior SARS-CoV-2 infection. Meanwhile, a survey organized by a group of self-identified long Covid patients that recruited participants from online support groups reported in late December 2020 that around two-thirds of those surveyed who had undergone blood testing reported negative results.

Admittedly, while blood tests are reported as highly sensitive and specific, they are imperfect and can yield both false positives and false negatives. And there is some evidence that antibodies can wane over time. But only to an extent: study after study has found that antibodies remain positive in a majority of people with confirmed infections for many months. So it’s highly probable that some or many long-haulers who were never diagnosed using PCR testing in the acute phase and who also have negative antibody tests are “true negatives.”

Why does this matter? For one thing, if some proportion of long Covid patients were never infected with SARS-COV-2, it shows that it’s possible for anyone to misattribute chronic symptoms to this virus. That’s not particularly surprising, since the symptoms of acute SARS-CoV-2 are often not unique, and can be caused by other respiratory infections. But what’s more notable is that the late-December survey also found virtually no difference in the long-haul symptom burden between those with and without antibody evidence of prior SARS-CoV-2 infection (or any positive test), which undercuts the likelihood of a causative role for SARS-CoV-2 as the predominant driver of chronic symptoms in that cohort.

https://www.statnews.com/2021/03/22...re-critically-speaking-cautiously-long-covid/

For example, the article notes that many long COVID symptoms suffered by those with mild or asymptomatic cases (e.g. the brain fog described by the individual in the Nat Geo article) can also be attributed to depression, which is a symptom of the pandemic and the lockdowns (but not necessarily of COVID-19):

A New England Journal of Medicine report showed that, across multiple continents, about half of people with depression also had unexplained physical symptoms, which often predominated over their mental ones. Sleeping problems, physical and mental slowing, persistent fatigue, and concentration problems (aka “brain fog”) are among the actual criteria for major depression in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

The sad truth is that we are living through a time of incredible trauma, sorrow, and hardship. The loved ones of more than 500,000 Americans who have died of Covid-19 are in mourning. Tens of millions have lost their jobs. This has been a period of prolonged social isolation with no obvious parallel in history. We should expect a surge in both mental anguish and physical suffering that, while connected to the once-in-a-century pandemic, will not always be directly connected to SARS-COV-2 itself.

Given that COVID-19 can affect the brain through various different mechanisms, it's not implausible that mild infection could also cause longer-lasting psychological symptoms. However, more research is needed to see the extent to which these longer lasting symptoms result from mild and asymptomatic cases.

 

[Tom.G]

And a link to an article addressing Long COVID in the July 30, 2021 issue of Science Magazine:
https://science.sciencemag.org/content/373/6554/491

or alternate link to same:
DOI: 10.1126/science.abg7113

 

[atyy]

Summary by Alasdair Munro of Short Report on Long COVID by UK ONS

"They conclude that whist prolonged symptoms after #COVID19 do exist in children, they appear uncommon (no different to control groups in some studies)"

"Finally, some more evidence that #COVID19 is not that different to other respiratory infections Risks of serious complications in other organ systems are significantly higher after hospitalisation with covid, but not compared to hospitalisation for other pneumonias"

"Most importantly - vaccines taking the sting out of it's tail"

 

[jim mcnamara]

New Lancet article
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01755-4/fulltext

for 1276 patients in Wuhan, after 1 year
Interpretation>

Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population.

 

[Ygggdrasil]

The CDC released a new study on the prevalence of long term symptoms of COVID-19. The study is based on self reports from an internet survey, though, so the data may not be so high quality (like some of the other studies cited on this topic). Here's the summary of the results:

In a nonprobability-based sample of U.S. adults tested for SARS-CoV-2, symptoms often associated with SARS-CoV-2 infection were common; 65.9% of respondents whose SARS-CoV-2 test results were positive reported symptoms lasting >4 weeks compared with 42.9% of those whose test results were negative. More persons who received positive test results (76.2%) reported persistence (>4 weeks) of at least one initially occurring symptom compared with those whose test results were negative (69.6%).

https://www.cdc.gov/mmwr/volumes/70/wr/mm7036a1.htm

So, yes, people with COVID-19 often have symptoms that persist a long time after the initial infection. However, those symptoms are also very common among people who never tested positive for COVID-19.

 

[Tom.G]

A UK community prevalence study of over half a million people [Real-time Assessment of Community Transmission 2 (REACT-2) study] reported a prevalence among those who reported having COVID-19 of 38% (33% in males, 42% in females) with at least one symptom lasting 12 weeks or more, and 15% having at least three symptoms lasting 12 weeks or more (1).

"The road to addressing Long Covid"
https://www.science.org/lookup/doi/10.1126/science.abg7113

Small comfort, but at least you are not alone! And it's a 'work in progress.'

Hang in there Evo.

Tom