Coronavirus can infect the brain, but not everyone: which increases the risk

Long-term symptoms of Covid may indicate that the virus is attacking the brain, reports NBC

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The new study, while considered preliminary, may shed light on why some people experience persistent neurological symptoms like brain fog.

Early research suggests that SARS-CoV-2 can easily enter the brain through a person's nose, invading brain cells where it hides, which can lead to persistent neurological symptoms such as thinking and memory problems.

Two new studies—from the California National Primate Research Center and the Rotman Institute of Research in Toronto—suggest that the virus directly attacks neurons in the brain, potentially offering clues to why some people suffer a range of symptoms long after their initial COVID infection .

None of the studies presented at the November 3 Society of Neuroscience meeting were peer-reviewed, and none answered all questions regarding long-term Covid.

But research in this direction is increasing as scientists around the world urgently try to learn more about the mysterious and debilitating disease that is estimated to affect at least one third of the more than 46 million people infected in the United States, as well as millions of others in all over the world.

Focusing on how the virus enters and affects the brain could shed light on the long-term Covid, a disease that doctors still haven't been able to properly identify, diagnose, or treat.

“We're still at the stage where it doesn't even have a name. This is a problem,” said Dr. Nir Goldstein, director of the Coronavirus Treatment and Recovery Center at National Jewish Health in Denver. Goldstein was not involved in the new study.

Invasion of the brain

The body's natural blood-brain barrier usually does a good job of keeping things like viruses off before they enter the brain, although viruses can still enter the brain. SARS-CoV-2 can do this, like other viruses such as viral encephalitis and HIV. When these disorders occur, the immune cells in the brain work to attack the invader.

But one of the new studies unveiled Wednesday suggests it's becoming increasingly clear that SARS-CoV-2 may also take a different, less secure route through the nose, heading straight to the brain.

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This study, conducted by the California National Primate Research Center, found that rhesus monkeys infected with the virus had significant evidence of infection inside brain neurons just seven days after infection. This was especially true for older diabetic animals.

Evidence that neurons can be infected will be a key finding. These brain cells send information from the brain to other parts of the body using electrical impulses. Since neurons are so important for the normal functioning of the body, the immune system does not want to attack even the sick.

After that, the virus that has passed through the neurons can move freely through the brain circuits.

“I think this is a much more dangerous type of infection,” said John Morrison, who led the study and is a professor of neurology at the University of California, Davis. If the virus can travel along brain circuits, he said, "it could reach multiple areas of the brain that mediate things like cognition and memory, emotion and mood."

These are exactly the problems that people with long-term Covid report so often.

Previous studies on nerve infection have been mixed, and not all experts agree that the results are conclusive evidence.

During a media briefing at a November 3 meeting, Dr. Walter Koroschets, director of the National Institute of Neurological Disorders and Stroke, said he was still not convinced that SARS-CoV-2 could infect neurons, adding that more research is needed.

Dr. Greg Vanichkachorn, an occupational medicine specialist who works with patients with long-term Covid at the Mayo Clinic in Rochester, Minnesota, said brain samples taken from people who died from Covid-19 earlier in the pandemic were largely unrevealed. kind of infection.

But, he added, it is possible that Covid-19 has affected these patients differently. Indeed, not all patients develop the same disease. And it may turn out that people with less severe illness, albeit smoldering months, become infected differently.

“From the very beginning, when I treated patients with this disease, I always felt that it was more than just a respiratory disease,” said Vanichkachorn, who was not involved in the new study. "I'm not surprised by these discoveries."

Everything is not only in the head

Another study, presented at Wednesday's meeting, provided additional evidence for neural infection. Researchers at the Rotman Research Institute in Toronto used electroencephalography, or EEG, to measure how well the brain is functioning in terms of its electrical signals.

The study was small, with only 41 Covid-positive patients and 14 others who had some symptoms, but ended up testing negative. All had mild illnesses and were never hospitalized.

EEGs showed different brain wave patterns in Covid patients that lasted for at least seven months after their initial infection.

“Simply put, their brains, on average, did not work as efficiently as those who did not have Covid,” said Allison Sekuler, who led the study and is also the Sandra A. Rothman Chair in Cognitive Neuroscience.

Sekuler's research should also be considered early and preliminary. And it's unlikely the new findings can fully explain the types of brain fog and other cognitive problems reported by people with long Covid. The results "clearly show" changes in brain function that lasted for several months.

If the results are confirmed in future analyzes, the results could reassure those who travel long distances, whose loved ones may be skeptical of ongoing ambiguous symptoms.

“It's very frustrating for a lot of my patients who say they have family members who don't believe Covid even exists,” Vanickachorn said. “Patients are often accused of faking it or making it up to get attention.”

Seculer has also dismissed the suggestions of those who argue that the long-term symptoms of Covid are simply thoughts and fears in a person's head.

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“Yes, okay, but that's because the brain controls everything. Your sense of smell, your memory, the way you see the world, even the way you feel,” she said.

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