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Before contracting COVID-19, Cassandra Hernandez, 38, was in great shape – both physically and mentally.
“I’m a nurse,” she said. “I work with surgeons and my memory was vivid.”
Then, in June 2020, COVID-19 struck Hernandez and several other people in his unit at a large hospital in San Antonio.
“I got home after working 12 hours and sat down to eat a pint of ice cream with my husband and couldn’t taste it,” she says.
Loss of taste and smell can be an early sign that COVID-19 is affecting an area of the brain that helps us detect smells.
Hernandez then spent two weeks in the hospital and months at home, crippled by symptoms such as tremors, extreme fatigue, and problems with memory and thinking.
“I would literally fall asleep if I had a conversation or if I did something that involved my brain,” she says.
Alzheimer’s researchers share their findings on COVID-19
Now researchers at UT Health San Antonio are studying patients like Hernandez, trying to understand why their cognitive problems persist and whether their brains have been altered in a way that increases their risk of developing Alzheimer’s disease.
The San Antonio researchers are among teams of scientists from around the world who will present their findings on how COVID-19 affects the brain at the Alzheimer’s Association international conference, which begins Monday in Denver.
What scientists have found so far is concerning.
For example, PET scans taken before and after a person develops COVID-19 suggest that the infection can cause changes that overlap with those seen in Alzheimer’s disease. And genetic studies reveal that some of the same genes that increase a person’s risk of getting severe COVID-19 also increase the risk of developing Alzheimer’s disease.
Alzheimer’s diagnoses also appear to be more common in patients in their 60s and 60s who have had severe COVID-19, says Dr. Gabriel de Erausquin, professor of neurology at UT Health San Antonio. “It’s downright scary,” he says.
Loss of smell can signal a problem
And de Erausquin and his colleagues noticed that mental problems seem to be more common in COVID-19 patients who lose their sense of smell, possibly because the disease has affected an area of the brain called the olfactory bulb.
“Persistent lack of smell, it is associated with brain changes not only in the olfactory bulb, but also in places that are somehow connected to the sense of smell,” he says.
These places include areas involved in memory, thinking, planning, and mood.
The effects of COVID-19 on the brain also appear to vary with age, says de Erausquin. People in their 30s seem more likely to develop anxiety and depression.
“In the elderly, people over 60, the main manifestation is forgetting,” he says. “These people tend to forget where they put things, they tend to forget names, they tend to forget phone numbers. They also have language problems, they start to forget words.”
The symptoms are similar to those of early-onset Alzheimer’s disease, and doctors sometimes describe these patients as having Alzheimer’s-like syndrome which can persist for several months.
“These people look really bad right now,” says de Erausquin. “And it’s expected to behave like Alzheimer’s disease, in a progressive way. But the real answer is we don’t know.”
Dr. Sudha Seshadri, Founding Director of the Glenn Biggs Institute for Alzheimer’s Disease and Neurodegenerative Diseases at UT Health San Antonio, will present her research at the Alzheimer’s Disease Conference.
The possibility that COVID-19 may increase the risk of Alzheimer’s is alarming, Seshadri says. “Even though the effect is small, this is something we will have to take into account because the population is quite large,” she says.
In the United States alone, millions of people have developed persistent cognitive or mood problems after contracting COVID-19. It may take a decade to find out whether these people are more likely than uninfected people to develop Alzheimer’s disease in their sixties and sixties, Seshadri says.
Studies of people who have had COVID-19 may help scientists understand the role infections play in Alzheimer’s disease and other brain diseases. Previous research has suggested that exposure to certain viruses, including herpes, can trigger an immune response in the brain that can set the stage for Alzheimer’s disease.
“If we understand how the immune response to this virus is accelerating [Alzheimer’s] disease, we can learn more about the impact of other viruses, ”Seshadri says.
A long way back from COVID-19
Meanwhile, people like Cassandra Hernandez, the nurse, are just trying to get better. More than a year after falling ill, she says, her brain is still foggy.
“We were having dinner and I forgot how to use a fork,” she says. “It was embarrassing.”
Despite this, Hernandez says she is slowly improving.
“Before that, I was working on my masters,” she says. “Now I can do basic math, add and subtract, I can read at the fifth grade level. I still work hard every day. “
Hernandez worked with Dr Monica Verduzco-Gutierrez, chair of the department of physical medicine and rehabilitation at UT Health and director of the COVID-19 recovery clinic.
Verduzco-Gutierrez says his practice revolved around people recovering from stroke and traumatic brain injury. Now she spends a few days only seeing patients who are recovering from COVID-19.
The most common complaint is fatigue, says Verduzco-Gutierrez. But these patients also frequently suffer from migraines, forgetfulness, dizziness and problems with balance, she says.
Some of these patients may never make a full recovery, says Verduzco-Gutierrez. But she has high hopes for Hernandez.
“She has improved so much and I would love to have her return to nursing,” Verduzco-Gutierrez said. “But again, we don’t know what’s going on with this disease.”
Copyright NPR 2021.
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