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COVID-19 Infections Increase Risk of Long-term Brain Problems


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Kristina Sauerwein wrote . . . . . . . . .

A comprehensive analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows people who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection. Movement disorders, memory problems, strokes and seizures are among the complications.

If you’ve had COVID-19, it may still be messing with your brain. Those who have been infected with the virus are at increased risk of developing a range of neurological conditions in the first year after the infection, new research shows. Such complications include strokes, cognitive and memory problems, depression, anxiety and migraine headaches, according to a comprehensive analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.

Additionally, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions to epileptic seizures, hearing and vision abnormalities, and balance and coordination difficulties as well as other symptoms similar to what is experienced with Parkinson’s disease.

The findings are published in Nature Medicine.

“Our study provides a comprehensive assessment of the long-term neurologic consequences of COVID-19,” said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University. “Past studies have examined a narrower set of neurological outcomes, mostly in hospitalized patients. We evaluated 44 brain and other neurologic disorders among both nonhospitalized and hospitalized patients, including those admitted to the intensive care unit. The results show the devastating long-term effects of COVID-19. These are part and parcel of long COVID. The virus is not always as benign as some people think it is.”

Overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide, Al-Aly said.

Other than having a COVID infection, specific risk factors for long-term neurological problems are scarce. “We’re seeing brain problems in previously healthy individuals and those who have had mild infections,” Al-Aly said. “It doesn’t matter if you are young or old, female or male, or what your race is. It doesn’t matter if you smoked or not, or if you had other unhealthy habits or conditions.”

Few people in the study were vaccinated for COVID-19 because the vaccines were not yet widely available during the time span of the study, from March 2020 through early January 2021. The data also predates delta, omicron and other COVID variants.

A previous study in Nature Medicine led by Al-Aly found that vaccines slightly reduce — by about 20% — the risk of long-term brain problems. “It is definitely important to get vaccinated but also important to understand that they do not offer complete protection against these long-term neurologic disorders,” Al-Aly said.

The researchers analyzed about 14 million de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health-care system. Patients included all ages, races and sexes.

They created a controlled data set of 154,000 people who had tested positive for COVID-19 sometime from March 1, 2020, through Jan. 15, 2021, and who had survived the first 30 days after infection. Statistical modeling was used to compare neurological outcomes in the COVID-19 data set with two other groups of people not infected with the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same time frame; and a control group of more than 5.8 million people from March 2018 to December 31, 2019, long before the virus infected and killed millions across the globe.

The researchers examined brain health over a year-long period. Neurological conditions occurred in 7% more people with COVID-19 compared with those who had not been infected with the virus. Extrapolating this percentage based on the number of COVID-19 cases in the U.S., that translates to roughly 6.6 million people who have suffered brain impairments associated with the virus.

Memory problems — colloquially called brain fog — are one of the most common brain-related, long-COVID symptoms. Compared with those in the control groups, people who contracted the virus were at a 77% increased risk of developing memory problems. “These problems resolve in some people but persist in many others,” Al-Aly said. “At this point, the proportion of people who get better versus those with long-lasting problems is unknown.”

Interestingly, the researchers noted an increased risk of Alzheimer’s disease among those infected with the virus. There were two more cases of Alzheimer’s per 1,000 people with COVID-19 compared with the control groups. “It’s unlikely that someone who has had COVID-19 will just get Alzheimer’s out of the blue,” Al-Aly said. “Alzheimer’s takes years to manifest. But what we suspect is happening is that people who have a predisposition to Alzheimer’s may be pushed over the edge by COVID, meaning they’re on a faster track to develop the disease. It’s rare but concerning.”

Also compared to the control groups, people who had the virus were 50% more likely to suffer from an ischemic stroke, which strikes when a blood clot or other obstruction blocks an artery’s ability to supply blood and oxygen to the brain. Ischemic strokes account for the majority of all strokes, and can lead to difficulty speaking, cognitive confusion, vision problems, the loss of feeling on one side of the body, permanent brain damage, paralysis and death.

“There have been several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of the blood vessels and then then trigger a stroke or seizure,” Al-Aly said. “It helps explain how someone with no risk factors could suddenly have a stroke.”

Overall, compared to the uninfected, people who had COVID-19 were 80% more likely to suffer from epilepsy or seizures, 43% more likely to develop mental health disorders such as anxiety or depression, 35% more likely to experience mild to severe headaches, and 42% more likely to encounter movement disorders. The latter includes involuntary muscle contractions, tremors and other Parkinson’s-like symptoms.

COVID-19 sufferers were also 30% more likely to have eye problems such as blurred vision, dryness and retinal inflammation; and they were 22% more likely to develop hearing abnormalities such as tinnitus, or ringing in the ears.

“Our study adds to this growing body of evidence by providing a comprehensive account of the neurologic consequences of COVID-19 one year after infection,” Al-Aly said.

Long COVID’s effects on the brain and other systems emphasize the need for governments and health systems to develop policy, and public health and prevention strategies to manage the ongoing pandemic and devise plans for a post-COVID world, Al-Aly said. “Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated — but, so far, absent — global, national and regional response strategies,” he said.

Source: Washington University School of Medicine

 

 

 

 

Knee Trouble? Losing Weight May Help Slow Arthritis

Amy Norton wrote . . . . . . . . .

Losing excess weight may not only help prevent knee arthritis, but also slow its progression in people who already have the condition, a recent study suggests.

Researchers found that among over 9,000 middle-aged and older adults, those who managed to shed some extra weight benefited their knees in two ways: They were less likely to develop knee arthritis over the next several years; and if they already had knee arthritis, the joint damage progressed more slowly.

It has long been known that excess pounds are a risk factor for developing knee arthritis. And when people with the condition are overweight or obese, they are encouraged to lose weight to help ease their pain.

Experts said the new findings suggest that weight loss may not only curb pain, but also help protect the integrity of the knee joint itself.

“Even in overweight and obese patients who already have some structural knee osteoarthritis damage, there is still a role for weight loss in preventing further harm,” said Dr. Emily Carroll, a rheumatologist with the Mount Sinai Health System in New York City.

Dr. Linda Russell, a rheumatologist at the Hospital for Special Surgery, also in New York City, agreed.

“There’s no doubt that when you have knee osteoarthritis and you lose weight, you’ll have less pain,” Russell said. “This suggests that losing weight also slows the progression of the joint damage.”

The findings — from a team at the University of New South Wales in Australia — are not particularly surprising, according to Russell. In basic terms, excess weight places more pressure on the knees, especially the medial (or inner) side of the joint. In this study, Russell noted, weight changes were specifically related to the odds of joint space narrowing on the inner side of the knee.

“So this is confirming what we’ve suspected,” she said.

But that confirmation is important, Russell added, since it may give patients more motivation to shed extra pounds.

“If you have knee osteoarthritis and lose weight, you might be able to either avoid knee replacement surgery or delay it,” Russell said.

One point, though, is that it did take substantial weight loss to make a major difference. On average, the study found, people had to drop a whole body mass index (BMI) category — going from obese to overweight, for example — to reduce the odds of arthritis progression by 22%.

That is challenging, according to Russell. “The hard part is, patients with knee osteoarthritis often find it difficult to exercise because of pain,” she said.

Still, both doctors said, there are low-impact forms of exercise that get the heart pumping and burn calories — like swimming, walking, cycling and using elliptical machines.

“I do encourage patients to find activities they can do, and that they enjoy,” Russell said.

The Australian study included nearly 5,800 adults who were free of knee osteoarthritis, and just over 6,000 who already had the disease. Osteoarthritis refers to the common, “wear-and-tear” form of arthritis that involves a breakdown in the cartilage that cushions joints.

Overall, the study found, about one-fifth of participants managed to lower their BMI over four to five years. (BMI is an estimate of body fat based on height and weight.)

For each “unit” decrease in BMI, the risk of developing knee arthritis dipped by 5%, and the risk of further joint damage declined by a similar amount. When people with knee arthritis had a BMI decline of 5 units — enough to drop down to a new BMI category — their risk of progression decreased by 22%, the investigators found.

But while lesser weight loss brought a smaller benefit, it still matters, according to Carroll. “Every bit does count,” she said.

To both lose weight and keep it off, Carroll noted, exercise is only part of the equation: Healthy eating habits that can be kept up for the long haul are key.

Both doctors recommended that people with knee arthritis talk to their health care providers for help with weight loss: Some might benefit from physical therapy to help them get active. And some, depending on their BMI and other health conditions, might qualify for weight-loss treatments.

The findings were recently published online in the journal Arthritis & Rheumatology. Lead author Zübeyir Salis is a doctoral candidate at the University of New South Wales, in Australia.

Source: HealthDay

 

 

 

 

Tuna with Provencal Vegetables

Ingredients

1/2 cup extra-virgin olive oil
1 pound zucchini, halved lengthwise and thinly sliced
1 red bell pepper, cut into thin strips
1/2 small red onion, thinly sliced
4 thyme sprigs
4 garlic cloves-2 thinly sliced, 2 halved
salt and freshly ground pepper
1 tomato, coarsely chopped
1 small fennel bulb—halved, cored and sliced paper-thin
1/4 cup pitted kalamata olives, coarsely chopped
1 tablespoon drained capers
4 (5-ounce) tuna steaks (1 inch thick)

Method

  1. In a large, deep skillet, heat 1/4 cup of the olive oil. Add the zucchini, bell pepper, onion, thyme sprigs and sliced garlic and season with salt and pepper. Cook over high heat, stirring occasionally, until the vegetables are crisp-tender, about 7 minutes.
  2. Add the tomato, fennel, olives and capers, season with salt and pepper and cook, stirring, until the vegetables are tender, 2 to 3 minutes longer. Discard the thyme sprigs.
  3. In a medium skillet, heat the remaining 1/4 cup of oil with the halved garlic cloves.
  4. Season the tuna with salt and pepper, add it to the skillet and cook over moderate heat for 3 minutes, turning once.
  5. Cover the skillet and cook the tuna over very low heat for 2 minutes longer. The tuna should still be slightly rare in the center.
  6. Spoon the vegetables onto plates. Top with the tuna steaks and the browned garlic halves and serve.

Makes 4 servings.

Source: Chef Bruce Sherman


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