1/🧵 Long COVID Brain Science: 🧠
For ~100M suffering 🌎, let’s use data to combat myths & #Misinformation
COVID is biologically dangerous long after virus is gone
#LongCOVID affects our….
📍Olfactory & Limbic Systems
📍 Interferon Autoimmunity
📍PET scans
📍Astrocytes
How?
2/ First, Epidemiological comparisons…
FLU vs. COVID
Survivors of viral infxns like #Flu don’t complain of 200 long-term symptoms & ~90% ongoing mood disorders.
#LongCOVID pts do.
Flu kills 0.5M/year vs COVID has killed 10X that (5M) in just 2 years.
bit.ly/3mJTBK4
3/ Consider this:
A study of 150k COVID survivors, hospitalized & not.
COVID survivors had 10-15X ‼️higher risk of considering #suicide at 1 year than 11M control patients.
This is horrifying, yet people still deny #LongCOVID’s importance.
WHY?
bit.ly/3HnHZpB
4/ 💥 Animal Model of LC 💥
A @ScienceTM study provides fascinating data about realities of what #LongCOVID does to mammals. 🐁
@Justin_Frere & Team infected hamsters with Influenza A vs. COVID.
They compared long-term affects to human autopsies.
bit.ly/3zB7gLk
5/ Rodents won’t “dream up” symptoms or tissue changes.
An animal model of #LongCOVID helps STOP claims that this is just in patients’ minds.
Pts are too often victims of Testimonial #Injustice (being silenced) & asked, “Have you seen a psychiatrist?”
bit.ly/3zTJpqr
6/ Hamsters infected with COVID developed inflammation and glial priming that was not present in the Flu infected 🐁 .
Even when virus was not present any longer, ongoing problems in the kidneys, lungs, and olfactory lining were seen.
7/ Olfactory lining tissue was thinned out “permanently” in the COVID (not Flu) infected animals, which increases vulnerability to bacterial infections.
Similar findings were seen in autopsy findings of humans thought to be healed from COVID who went on to die of other causes.
8/ I think of all the ICU patients we watched die weeks & months after initial COVID infections.
It’s all adding up…ongoing lung, kidney & “body tissue” lining abnormalities in mice & humans…
This is a helpful yet scary next step in understanding the plight of #LongHaulers
9/ Interferon (IFN) biology seems key 🔑
It’s been known since early 2020 that autoantibodies to Type-1 IFN elevate risk in acute COVID
This is seen consistently (2 links👇 of many)
The heightened risk extends into long COVID…
bit.ly/3HokbSA
bit.ly/3b1mcry
10/ #LongCOVID in some pts is a disease of Auto-Immunity.
A person’s immune system fighting her body (💭 Lupus or Rheumatoid Dz).
Now we know there’s a link between these same Interferon Antibodies that predict severe acute dz & long term Autoimmunity.
bit.ly/3NUBdtU
11/ Frere found an #interferon response in hamsters that correlated w brain/behavioral changes extending a month after viral clearance (which is years in human time)
This supports LC as a biological disease.
That’s important because too many people are disbelieved at MD’s appt.
12/ #LongCOVID therapies will be difficult because it’s a family of problems, not just 1 disease.
Eg, targeting IFN as Cytokine Tx will be difficult because of its short half-life, difficulty targeting specific cells & knowing what stage of immune response for optimal delivery.
13/ Summary of things we are learning:
Chronic inflammation in the olfactory system affects our emotional, sensory, and brain function (cognition).
Hamsters, for example, after the virus is gone, have problems with normal behavior.
Guess what? So do people.
Let’s build more…
14/ The olfactory bulb is directly connected to the limbic system.
Smell is connected to emotion & memory‼️
This would explain (even when the virus is long gone) problems in #LongCOVID pts’ ability to heal fully from newly minted #brainfog & #mentalhealth disorders.
See 🧵👇
15/ This is precisely what was found in the UK Biobank study of N=401 people…
most with MILD #COVID & not hospitalized…
w MRIs before & after infection
had Olfactory cortex, limbic system, and brain “size” problems compared to N=384 control patients.
go.nature.com/3ILTN4Z
16/ Still with me?
If the brain is abnormal, we’d expect it’s cellular metabolism to be diseased as well.
Sadly, it is.
PET Scans of COVID survivors show hypometabolism in…
AGAIN…
the Olfactory & Limbic systems as well as brainstem & cerebellum.
bit.ly/3GWsl4c
17/ These clusters of PET-proven hypometabolism in different brain regions matter on a human level.
They are associated with more numerous functional complaints & symptoms of ongoing problems with smell, memory/cognitive disabilities, chronic pain, and sleep disorders.
18/ Brain PET studies in other #LongCOVID pts showed hypometabolism
(think hibernating/abnormal neurons)
in areas explaining problems with smell, fatigue, etc.
The authors ✍🏻 this supports a hypothesis of post-viral, persistent systemic inflammation.
bit.ly/3xcAWeT
19/ Neuropsychiatric manifestations more frequently seen in #longCOVID include…
depression, anxiety, PTSD, sleep disturbances, fatigue & debilitating cognitive deficits
These negatively affect patients’ well-being.
Here’s an alarming review: bit.ly/3xSonHg
20/ Here is an excellent, thoughtful synthesis of PET hypometabolism in 🧠 of patients suffering #LongCOVID.
Bottom line:
Think about #astrocytes - a type of glial cell (non-neuron) that gets “turned on” in LongCOVID.
bit.ly/3O1mayt
21/ In #EveryDeepDrawnBreath, I wrote: p.199
“Glial cells, namely microglia & astrocytes, are central figures in the story of our brain’s
well-being.
Microglia are recognized as regulating brain inflammation.
Astrocytes are thought of as glue that holds the brain together.
22/ “Astrocytes are critical to maintain the blood-brain barrier, regulate immune responses, and contribute to the health and growth of neurons.”
In #LongCOVID, the complex interplay between these cell types will be the key to unlocking patients’ 🧠 recovery after injury
#Hope
23/ These problems of brain cell metabolism from inflammation are seen in KIDS & adults.
We’re learning, sadly, how kids with mild COVID can also suffer #LongCOVID brain problems.
This supports a biological disease.
Protect your kids – vaxx & mask.
bit.ly/3Q0zvsz
24/ Astrogliosis: disease or repair?
Our thoughts on what it means when astrocytes increase in number are evolving.
📌 Old = an indicator of brain pathology, which it can be
📌 New = a natural defense mechanism for repair - a way to limit brain damage
bit.ly/39c7mxV
25/fin ✔️✔️
#LongCOVID is a REAL, multi-faceted syndrome
It has cognitive, mental health & physical impairments
It can persist years after the virus is gone
It has an emerging molecular basis
Never lose hope for recovery
Sit & Listen
Pts are the expert of their own disease
People are DMing me to ask where they can get other timely information on #LongCOVID to accompany this 🧵...4 leaders include @Dr2NisreenAlwan, @VirusesImmunity, @Bob_Wachter & @EricTopol
Follow them and reap the rewards - each has kept my brain working w LC data. TY.
Read 🧵👇 of must-read data that would’ve in my thread on Long-COVID 🧠 had I seen this yesterday.
Mild respiratory #COVID leads to brain disease in mouse model. Microglial priming & much more. The brain is vulnerable!
TY @michelle_monje @VirusesImmunity @PutrinoLab
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