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Shortly after the first wave of COVID-19 infections hit, doctors around the world began to notice something strange – a host of lingering effects that linger in patients, long after they seem otherwise have recovered from the virus.
These unusual neurological symptoms – including fatigue, memory loss, confusion, and other abnormalities – are sometimes referred to as “ brain fog ” or “ COVID brain, ” and new research may have identified an underlying cause. underlying disease.
“We were first approached by our colleagues in intensive care medicine who had observed severe delirium in many patients hospitalized with COVID-19,” says neuro-oncologist Jessica Wilcox of Memorial Sloan Kettering Cancer Center (MSK) At New York.
“This meeting turned into a great collaboration between Neurology, Critical Care, Microbiology and Neuroradiology to find out what was going on and see how we could better help our patients.”
As part of the new study, Wilcox and his fellow researchers examined the cerebrospinal fluid of 18 cancer patients who suffered from neurological dysfunction (aka encephalopathy) after being infected with the SARS-CoV-2 virus.
Initially, it was suspected that an ongoing viral infection could be the cause of their brain fog symptoms, but microbiological analysis of the fluid taken from lumbar straws revealed no signs of the virus, suggesting the patients had recovered from COVID-19.
Nonetheless, the research revealed an important clue as to what was going on.
“We found that these patients had persistent inflammation and high levels of cytokines in their cerebrospinal fluid, which explained the symptoms they were exhibiting,” says MSK researcher and co-first author of the study, Jan Remsik.
Cytokines are a large class of proteins involved in signaling in the immune system.
In some cases of coronavirus, overproduction of these molecules results in what is called a cytokine storm, which can cause excessive inflammation and is potentially fatal.
A similar phenomenon showing elevated levels of inflammatory cytokines is sometimes considered a side effect of chimeric antibody receptor (CAR) T cell therapy, an immunotherapy treatment, which can also produce confusion, delirium and other neurological effects that resemble COVID brain fog.
It is believed that the flood of these inflammatory chemicals in the immune system seeps into the brain, producing symptoms of encephalopathy as seen in patients.
While this is the largest study to date to demonstrate this potential link between COVID-19 and post-infection neurological effects, we will need a lot more data to unravel this association.
That said, the results here suggest that anti-inflammatory drugs may be helpful in alleviating brain fog in patients and may point to new directions in terms of diagnosing this strange lingering discomfort.
“We used to think of the nervous system as a privileged immune organ, which means that it had nothing to do with the immune system,” says Adrienne Boire, neuro-oncologist at MSK.
“But the more you look, the more connections you find between the two.”
The results are reported in Cancer cell.
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