Thread by @WesElyMD

1/🧵 Let’s talk Long COVID:

I’m grouping several important & interesting articles about the reality of #LongCOVID.

By studying brain fluid, viral persistence & MRIs, we’re building our understanding of the “how” & “why” of this devastating malady.

A train is coming, read on…

2/ Cerebrospinal Fluid Offers Clues to #BrainFog

Most pts w new “thinking problems” after mild #COVID had abnormalities in fluid from lumbar punctures (image); controls did not.

Delayed #LongCOVID was common in younger people who thought they were safe.

bit.ly/3pS0JWN

3/ Believing those with #LongCOVID complaints is our 1st basic show of support!

“If people tell us they have new thinking & memory issues, I think we should believe them rather than require that they meet certain severity criteria.”
Dr. Apple UCSF

bit.ly/3sUNczF

4/ The cause of #LongCOVID may be persistence of virus in the body.

This study N=29 found viral RNA in 51% (plasma, stool or urine) of those w fatigue, pain, lung & heart symptoms. 55% had only mild COVID.

Treating with antivirals helped & offers #hope.

bit.ly/3hOicet

5/ Imaging the brain before & after #COVID show changes.

Our @CIBScenter #LongCovid support group patients tell us daily that even "mild" COVID leaves people unable to work, care for families, or complete tasks in their job & daily life.

on.today.com/3IXjjV3

6/ In the now famous Mar 7, 2022 UK Biobank @NatureMedicine study, 401 people, most with MILD #COVID & not hospitalized, had MRIs before & after infection.

Startling findings were seen in comparison to 384 controls who never had COVID.

Let’s unpack…

go.nature.com/3ILTN4Z

7/ The abnormalities were found primarily in the limbic system & olfactory (smelling) areas.

The limbic system is involved in our behavioral & emotional responses for survival like feeding, caring for our young & fight or flight responses.

8/ The second scans were ~5 months after COVID.

These SCARY 😱 findings may be due to degenerative spread of the virus through olfactory nerve (think anosmia) & neuroinflammation.

The pts w MRI changes had more cognitive decline even after removing those who’d been in hospital.

9/ To give you a practical understanding of what these 🧠 brain changes did to these people, this figure shows that it increased the time to process cognitive tests by as much as 30%.

How frustrating would it be in daily life to think that slowly?

You don’t want this.

10/ For our #Neuroscience junkies, here’s what they saw on the MRIs:

Greater reduction in gray matter thickness & tissue contrast in orbitofrontal cortex, parahippocampal gyrus & olfactory cortex.

“REDUCTION IN GLOBAL BRAIN SIZE.”

Not good at all. 👎🤬

11/ Here’s how the article ends:

"This is the first longitudinal imaging study comparing brain scans acquired from individuals before & after SARS-CoV-2 infection to those scans from a well-matched control group…

12/ …It is one of the largest #COVID19 brain imaging studies, with 785 participants including 401 individuals infected by SARS-CoV-2.

Its unique design makes it possible to confidently tease apart pathogenic contribution associated, directly or indirectly…

13/ By using automated, objective & quantitative methods, we uncovered a consistent spatial pattern of longitudinal abnormalities in limbic brain regions forming a mainly olfactory network…

14/ Whether these changes are hallmark of spread of the pathogenic effects, or the virus itself in the brain, and whether these prefigure future vulnerability of the limbic system, including memory, remains to be investigated."

15/fin
Convinced yet⁉️

#LongCOVID is real.

Do not deny your friends & colleagues who say they are disabled.

They really can NOT do their jobs or remember things. They are physically suffering.

Let’s prepare to help them for the years ahead. Global effort.

#Vaccinate please!

I want to extend a H/T to @Dr_Dan_Markley who is an infectious disease expert and who helped relay his “read” of these data. Thanks Dan!