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Brain fog in patients with long Covid due to changes in blood vessels: study

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A team of scientists from Trinity College Dublin, Ireland, and researchers from FutureNeuro have discovered the cause of brain fog and cognitive decline seen in some long Covid patients.

In the months following the emergence of the novel coronavirus SARS-CoV2 in late 2019, a patient-reported syndrome called Long-Covid began to come to light as a long-lasting manifestation of the acute infection.

Up to 200 symptoms of long Covid have been reported so far, but generally patients report persistent symptoms such as fatigue, shortness of breath, memory and thinking problems, and joint/muscle pain.

Although the vast majority of those suffering from Covid-19 fully recover, any of these symptoms that persist for more than 12 weeks after infection can be considered long Covid.

In this sense, Covid has become a major public health problem since the outbreak of the pandemic in 2020. Although international incidence rates vary, it is estimated that up to 10 percent of patients infected with the virus are affected by SARS-CoV2. Almost 50 percent of these Long Covid patients report ongoing neurological effects such as cognitive impairment, fatigue and brain fog.

Now the results published by the Trinity team in Nature Neuroscience show that there is a change in the integrity of blood vessels in the brain of patients suffering from long Covid and brain fog. This blood vessel leak allowed patients with brain fog and cognitive impairment to be objectively differentiated from patients who had Long Covid but no brain fog.

The team, led by scientists from the Smurfit Institute of Genetics at Trinity School of Genetics and Microbiology and neurologists from the School of Medicine, has also discovered a novel form of MRI that shows how long-Covid affects the network of human blood vessels can affect the brain.

“For the first time, we have shown that leaky blood vessels in the human brain, together with an overactive immune system, could be the key factors behind brain fog associated with Long Covid. This is critically important, it is understood.” “The underlying cause of these diseases will allow us to develop specific therapies for patients in the future,” said Matthew Campbell, professor of genetics and head of genetics at Trinity and principal investigator of FutureNeuro.

“Conducting this complex clinical research study at a time of national crisis and when our hospital system has been under great strain is a testament to the skills and resources of our young physicians and staff. “The neurological symptoms of Long Covid are measurable through real and detectable metabolic and vascular changes in the brain,” said Colin Doherty, Professor of Neurology and Director of Trinity Medical School and lead researcher by FutureNeuro.


In recent years, it has become clear that in many neurological diseases, such as multiple sclerosis (MS), a viral infection is probably the triggering factor for the pathology. However, it has always been difficult to prove this direct connection.

“In this case, the Trinity team was able to demonstrate that all patients who developed Long Covid were diagnosed with SARS-CoV2 infection, as Ireland required all documented cases to be diagnosed using the most accurate PCR-based methods.” The concept that “Many other viral infections that lead to post-viral syndromes could result in leaky blood vessels in the brain could be groundbreaking and is being actively investigated by the team,” Campbell said.

“Our findings have laid the foundation for new studies examining the molecular events that lead to post-viral fatigue and brain fog. “There is no doubt that similar mechanisms are at play in many different types of viral infections, and we are now very close to understanding how and why they cause neurological dysfunction in patients,” concluded postdoctoral researcher and first author of the study, Chris Greene.

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