Mental confusion, difficulty concentrating, memory problems that persist for a long time in the two groups of patients seem to have common inflammatory mechanisms. Here’s what is known so far about durability and care
From the mental fogliteral translation from English brain fogwhich affects an important share of the sick after Covid, little is known yet. Feeling confused and lost, difficulty concentrating, slowness in processing thoughts, memory problems: these are the symptoms most reported by patients, especially but not only hospitalized due to Sars-CoV-2 infection. Symptoms that, according to experts, are not very different from those experienced by those suffering from similar side effects after chemotherapy made to treat a tumor or by people with chronic fatigue syndrome, Alzheimer’s and other post-viral disorders. A research published in the scientific journal Nature
now adds a new piece: according to researchers at Oxford University, who studied the changes that occurred at the brain level in 785 participants in a large British study, the neurological inflammation underlying these disorders may in fact be a common explanation.
Similar inflammatory mechanisms
To date, the mechanisms that link the virus with the manifestation of cognitive fog are not fully known – he explains Valentina Di Mattei, professor at the faculties of Psychology and Medicine at the Vita-Salute San Raffaele University -. Most of the studies conducted so far “small”, therefore concern few people, and the data are preliminary: as for everything related to Covid and its long-term consequences, we still have many questions and few answers. We don’t know enough to be able to draw firm conclusions. Of course, like this latest study on Nature
also other investigations have now detected similarities between post Covid brain fog and symptoms experienced by patients receiving cancer chemotherapy. Similarities have also been found with multiple sclerosis, amyotrophic lateral sclerosis, Parkinson’s disease, Alzheimer’s and other post-viral syndromes following infections with influenza, Epstein-Barr, HIV or Ebola viruses. The analogy based on the analysis of apparently similar inflammatory processes – explains the expert -. Also based on the conclusions of the Oxford researchers it could be a neuro-inflammation caused by Sars-CoV-2 infection to explain the brain fog that affects so many people.
The impact on the brain after cancer and Covid
it has now been amply demonstrated how chemotherapy drugs for the treatment of cancer, over time and gradually, have repercussions on the cognitive abilities of patients, creating a sort of mental foga condition known as chemo-brain. This disorder mainly leads to memory difficulties, less concentration, greater difficulty doing multiple tasks at the same time and slowed thinking. The impact on the quality of life can be strong and the problem is about 15-20% of people undergoing chemotherapy – says Di Mattei -. It appears during treatment, but it can persist for years. The most recent studies show a deterioration of microglia, a set of brain cells that protect the brain from inflammation, just as also appears to emerge from this new British study in post Covid patients. Brain clouding in patients who became infected with Sars-CoV-2 is very similar with difficulty concentratingof logic, of problem solving and a loss of memory. The symptoms of Long Covid are now divided also taking into account the variant from which you were infected – specifies the expert -, the hypothesis is considered that there is a different long-term impact for the different variants and the brain fog appears to be associated with Delta, along with myalgia, insomnia, anxiety, depression. And she seems to care even those who have had mild Covid.
I study
In their investigation, British scientists analyzed brain changes among participants in the UK Biobank project, which involves over half a million UK citizens, in order to monitor and study the long-term consequences of Covid-19. They compared the neurological images of 785 people between the ages of 51 and 81: 401 had had a positive test for Covid and had undergone brain scans twice, before and after infection; 384 had not contracted the virus. The results indicate that in people who have become ill with Covid (both in those who have needed treatment in the hospital, and in those who have had mild forms treated at home) the shrunken gray matter, particularly in the areas related to the sense of smell, and more generally the entire size of the brain appears diminished. Also who got infected shows greater cognitive decline. Gray matter is a tissue made up of neurons thought to be responsible for thinking, white matter made up of cells that support and connect those neurons. All humans lose their gray matter as they agebut those with previous coronavirus infections in the study showed an additional reduction.
Duration and therapies
Until the mechanisms that cause brain fog are clear, it is difficult to answer the most common questions: how long does the problem last and how is it treated? It takes time to get directions and it is not yet known whether the damage will resolve itself or give people greater vulnerability. A research just published onEuropean Journal of Neurology by researchers of the University of Milan, of the ASST Santi Paolo e Carlo and of the Italian Auxological Institute indicate for example that, after a year, the mental fog from Covid clears but does not disappear. The study was conducted on a group of 76 patients admitted to the ASST Santi Paolo e Carlo and subjected to various oxygen therapies based on severity: 63% of patients manifested a cognitive deficit 5 months after hospital discharge and the disorder persisted even after 12 months in 50% of those affected. Our study confirms and expands the results of previous studies, showing that cognitive deficits like mental slowdown and memory difficulties they can be observed even one year after the infection and could interfere with work and daily life explains Roberta Ferrucciprofessor of Psychobiology and Physiological Psychology at the University of Milan, coordinator of the work.
Personalized care
As for the treatments, they must be personalized on the individual person, keeping in mind what ailments he suffers and what other pharmacological treatments he is already following, for the physical and mental consequences of Covid or for other pathologies. Researchers and doctors are mainly targeting treatments developed for stroke and traumatic brain injury, as well as video games that allow for cognitive training that is applicable on a large scale. After a brain injury, cognitive rehabilitation it typically involves tests to identify cognitive deficits that prevent you from carrying out daily activities: often the goal is to compensate for the deficits, not to eliminate them.
March 28, 2022 (change March 28, 2022 | 17:45)
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