Researchers at the Medical College of Georgia report their findings in the journal “Science Direct.” “Our results confirm the emerging evidence that there are chronic neuropsychiatric effects following COVID-19 infections,” they write.
“There are many symptoms that we didn’t know what to do with in the early stages of the epidemic,” says Dr Elizabeth Rutkowski, MCG neurologist and corresponding author of the study. “But it’s now clear that this is a long-term disease of COVID and that many people are affected.”
The 200 patients who participated in the first visit of CONGA, the Neurological and Molecular Prospective Cohort Study of COVID-19 in Georgia, were recruited an average of about 125 days after testing positive for the COVID-19 virus. The published study presents preliminary findings from the first visit of these patients.
CONGA aims to enroll 500 people over five years and was developed at the MCG early in the pandemic in 2020 to study the severity and prognosis of neurological problems.
Eighty percent of the first 200 subjects reported neurological symptoms, with fatigue in 80.5 percent, followed by headache in 68.5 percent. Just over half of participants (54.5%) and tasters (54%) reported changes, with 47% meeting standards for mild cognitive impairment, 30% with vocabulary, and 32% with reduced working memory.
In addition to their COVID-19 experience, 21% of people also reported disorientation, with hypertension being the most common condition.
Although no participants reported having a stroke, coordination problems, muscle weakness, or inability to control speech muscles, these were some of the less commonly reported symptoms.
Twenty-five percent of participants met criteria for depression and were more likely to have diabetes, obesity, sleep apnea, and depression. 18% who met objective criteria for anxiety had anemia and depression.
While the results so far aren’t shocking and are in line with what other researchers have found, Rutkowski said it was interesting that participants’ symptoms often didn’t match what objective testing revealed. Moreover, it was reciprocal.
Most of the subjects claimed, for example, changes in the sense of taste and smell, but the results of empirical tests of these senses did not always support their claims. By objective measures, a greater percentage of people who reported no changes showed signs of functional decline, the researchers wrote. Although the reasons are unclear, according to Rutkowski, some of the differences may be due to a change in the quality of their taste and smell rather than an actual deterioration.
While the results so far aren’t shocking and are in line with what other researchers have found, Rutkowski said it was interesting that participants’ symptoms often didn’t match what objective testing revealed. Moreover, it was reciprocal.
Most of the subjects claimed, for example, changes in the sense of taste and smell, but the results of empirical tests of these senses did not always support their claims. By objective measures, a greater percentage of people who reported no changes showed signs of functional decline, the researchers wrote. Although the reasons are unclear, according to Rutkowski, some of the differences may be due to a change in the quality of their taste and smell rather than an actual deterioration.
Conversely, they argue that cognitive testing may exaggerate disability in disadvantaged populations.
At the beginning, 35.5 percent of those who registered were men, the majority of whom were women. Almost 40% of them were black, they were 44.6 years old on average, and 7% had been hospitalized due to the COVID-19 virus. Researchers argue that black participants were often disproportionately affected.
23.4 percent of white and 75 percent of black participants met standards for moderate cognitive impairment. The results most likely show that different ethnic groups are evaluated differently by means of cognitive testing. In addition, socioeconomic, psychological (problems such as family problems, depression, and sexual abuse) and physical health variables may disproportionately affect black people, the researchers wrote. They note that it may also mean that cognitive testing may exaggerate clinical impairment in disadvantaged people.
After COVID-19, black and Hispanic people are twice as likely to require hospitalization, and ethnic and racial minorities are more likely to live in places with higher rates of infection. They are also more prone to experience heightened effects of COVID due to genetics, just as they are more likely to develop hypertension and heart disease earlier in life and more severely.
One of CONGA’s main goals is to better understand how the heightened risk and impact of COVID-19 affects black people, who make up about 33 percent of the state’s population.
It’s possible that increased inflammation, the body’s normal response to infection, is one reason why fatigue appears to be such a significant concern in those with COVID-19. For example, blood tests done at the first consultation and at the follow-up visit again revealed that some people’s inflammatory markers were high and remained elevated.
According to these and other findings, some symptoms, such as fatigue, worsen as a result of prolonged inflammation, even though virus-specific antibodies may be waning. He notes that fatigue is a common symptom in people with autoimmune diseases such as multiple sclerosis and rheumatoid arthritis, both of which are characterized by high levels of inflammation.
They experience physical exhaustion that makes them short of breath, and when they go to do the dishes, they experience heart palpitations. According to Rutkowski, they need to sit down right away because their muscles feel like they just ran a mile or more.
Because patients also have brain fog and complain that it hurts to think about and read a single email, he speculates that it could possibly be neurological fatigue. Even mild to moderate disease has been shown in some studies to reduce brain volume.
Some health care facilities have established long-standing COVID clinics, where doctors with expertise in the various problems they face come together to treat each patient. This is due to many systems and ongoing challenges.
CONGA participants who reported more symptoms and problems were more likely to struggle with sadness and anxiety.
According to Rutkowski, these problems, moderate cognitive impairment and even impaired language use, may also be a result of the prolonged isolation that COVID-19 caused many people.
Activities that most people enjoy — like hanging out with friends — aren’t what you do, Rutkowski argues. “On top of that, you may be dealing with health issues, losing friends and family, and losing your employment.”
CONGA participants self-report their symptoms and answer inquiries about their general health, including whether they smoke, drink alcohol, exercise, or have known medical problems. But they also get a thorough neurological exam that checks things like motor control, reflexes and mental status. In addition, they perform validated tests to measure cognitive performance, with results adjusted for age. They also take in-depth tests at home, asking them to identify smells and test their ability to taste different tastes, including sweet, sour, bitter, salty and broth. In addition, a blood test is performed to look for oxidative stress and inflammatory markers, which are signs of ongoing infection.
Neuropsychiatric symptoms are observed during the acute phase of infection, but the researchers note that it is important to accurately characterize how symptoms change over time.
For some people in particular, the symptoms still bother them. According to Rutkowski, even previously high-functioning people who typically worked 80 hours a week and exercised every day would only be able to function for about an hour a day and spend the rest of the day in bed.
Researchers are looking for explanations of why and how, and while Rutkowski claims he can’t do so yet, he can assure them they’re not alone or “crazy.”
According to Rutkowski, one of the best things anyone can do moving forward is to continue to practice infection prevention, which includes getting vaccinated or a booster shot to help protect your brain and body from prolonged COVID symptoms and help protect others from infection. There is evidence that the likelihood of permanent problems increases with the number of infections.
Because the study is expected to involve many patients with problems, Rutkowski cautions that its results may be slightly skewed toward high percentages of persistent symptoms.
SARS-CoV-2, a coronavirus that has been linked to upper respiratory tract infections such as the flu in humans for many years, is expected to be infected for the first time in late 2019.
Since the onset of COVID-19, experience and research have shown that immediate neurological effects can include loss of taste and smell, brain infections, headaches and, less commonly, seizures, stroke and nerve damage or death. The researchers note that there is increasing evidence that conditions such as loss of taste and smell, as well as cognitive fog, excessive fatigue, melancholy, anxiety and insomnia, can become chronic. These and other persistent symptoms are now called “long Covid”.
Source: ANI
Source: The Nordic Page