Doctors struggle to treat long Covid patients in India; researchers point to inadequate studies
Dr. Arun Garg (The Medicity, Gurugram, India) said,
"[I notice] a spike in stroke cases among young patients not suffering from known risk factors such as diabetes, hypertension and obesity..
Similarly, we are seeing more cases of encephalopathy, swelling of the brain, without reason and having a confused state of mind following one or two days of fever.
Their MRI scans show no changes.
These patients have increased significantly after Covid..
[Currently,] Other than routine blood tests that measure inflammation, we do antibody tests to look for direct markers.
In many of these patients, we are finding rare antibodies which are very new to us and were not there pre-Covid."
Pioneering discovery and therapeutics at the brain-vascular-immune interface
A new paper in Cell, “Pioneering discovery and therapeutics at the brain-vascular-immune interface,” describes COVID-19 as a neurological disease alongside multiple sclerosis, Alzheimer’s, stroke and traumatic brain injury.
“COVID-19 can accelerate progression of dementia and induce BBB disruption and inflammatory blood clots causally linked with neuroinflammation and neuronal loss.8 In neurodevelopmental disorders, prematurity and perinatal hypoxia that trigger brain hemorrhage and BBB disruption are risk factors for cerebral palsy, intellectual disability, and autism. Collectively, these risk factors highlight the interconnected vascular and immune triggers of neurological diseases.”
Cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19: a longitudinal, prospective cohort study in the UK
“Participants had worse cognitive scores than would be expected on the basis of their sociodemographic characteristics across all cognitive domains tested (average score 0·71 SD below the mean [IQR 0·16–1·04]; p<0·0001). Most participants reported at least mild depression (263 [74·5%] of 353), anxiety (189 [53·5%] of 353), fatigue (220 [62·3%] of 353), or subjective cognitive decline (184 [52·1%] of 353), and more than a fifth reported severe depression (79 [22·4%] of 353), fatigue (87 [24·6%] of 353), or subjective cognitive decline (88 [24·9%] of 353). Depression, anxiety, and fatigue were worse at 2–3 years than at 6 months or 12 months, with evidence of both worsening of existing symptoms and emergence of new symptoms. Symptoms at 2–3 years were not predicted by the severity of acute COVID-19 illness, but were strongly predicted by the degree of recovery at 6 months”
Participants had worse cognitive scores than would be expected on the basis of their sociodemographic characteristics across all cognitive domains tested (average score 0·71 SD below the mean [IQR 0·16–1·04]; p<0·0001). Most participants reported at least mild depression (263 [74·5%] of 353), anxiety (189 [53·5%] of 353), fatigue (220 [62·3%] of 353), or subjective cognitive decline (184 [52·1%] of 353), and more than a fifth reported severe depression (79 [22·4%] of 353), fatigue (87 [24·6%] of 353), or subjective cognitive decline (88 [24·9%] of 353). Depression, anxiety, and fatigue were worse at 2–3 years than at 6 months or 12 months, with evidence of both worsening of existing symptoms and emergence of new symptoms. Symptoms at 2–3 years were not predicted by the severity of acute COVID-19 illness, but were strongly predicted by the degree of recovery at 6 months
