Lewis: Hello and welcome to Your Health Quickly, the Scientific American podcast series!
Fishman: This show focuses on the latest important health news and discoveries that affect your body and mind.
Each episode dives into one topic. Discuss diseases, treatments, and some controversies.
Lewis: It also demystifies medical research in ways you can use to stay healthy.
My name is Tanya Lewis.
Fishman: My name is Josh Fishman.
Lewis. We are the senior health editors of Scientific American.
fishman: Today we are talking about a new study on long COVID. This indicates that this mysterious and crippling condition may have roots in the brain.
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Rashid: I think the biggest challenge I faced with COVID was the pain in my legs to the point where I couldn’t walk. I used a wheelchair and a cane. I used to run races and marathons, but now I need a cane to walk around.
fishman: Ibrahim Rashid. He is his 23 year old from Chicago. I met him at a conference a few weeks ago. (You can hear some of the meeting topics in the background.)
Rashid: My life has never been the same since I had COVID in November 2020. In December 2020, I noticed that I was still having trouble breathing. I woke up in the middle of the night with severe heart palpitations. And I was having trouble breathing and was out of breath.
Lewis: Man, that sounds really rough. It seems that he has been through a lot.
fishman: He had a hard time. And he’s one of an estimated 16 million people in the United States who have long-term coronavirus infections, putting 2 million to 4 million out of work.
Lewis: In general, prolonged COVID means that symptoms such as pain and extreme fatigue persist months or years after infection. Or what’s called “brain fog,” when you have more (than usual!) difficulty concentrating or remembering things.
The lingering nature of these symptoms is one reason patients are often referred to as “long-distance travelers.” It is a difficult condition to manage and treat.
fishman: But recently, a common thread has begun to emerge within this maze of symptoms: the brain.
Lewis: teeth. The brain solves things like memory problems, but how does physical pain and fatigue relate to the brain?
fishman: Fair question. First of all, viral signs are appearing in the brain and central nervous system. We often think of COVID as an infection that primarily attacks the lungs, throat, and nose. But it also affects many other organ systems.
One study found evidence of the presence of viral particles in the brains of long-term COVID-19 infected individuals. Another researcher found viral genetic material in the brain for as long as 230 days after infection.
Lewis: oh. That’s almost… eight months.
fishman: yes. And it turns out that the nose is actually a possible route for the virus to reach the brain. reaches the brain to the areas that control breathing and heart.
Additionally, autopsies of the brains of people who died of COVID show signs of immune system activation, as if they were reacting to some kind of infection.
There are cells called macrophages that chase invading microbes. The problem is that macrophages are not very accurate. As they continue to attack, they produce chemicals that chew up nearby cells. There can be a lot of inflammation and damage.
Lewis: Immune cells also travel through the blood and spinal fluid, and the brain is filled with tiny blood vessels. Therefore, an ongoing immune response can damage those blood vessels and adjacent brain cells.
fishman: that’s right. That’s why William Pittman, a UCLA Health physician who works in a long-running COVID clinic, now says the condition is as much a neurological disorder as a respiratory one.
Lewis: That’s interesting. But how does that explain the wide variety of symptoms people experience?
fishman: Because of something called dysautonomia.
Lewis: Hmm, I’ve heard that. What did you find out about it?
fishman: Well, there are activities in the body such as breathing, blood pressure, heart rate, balance, etc., all of which are normally processed automatically by the brain and send signals along the nerves throughout the body.
Dysautonomia is a condition in which the brain loses its control. Ibrahim explained to me:
Rashid: If you try to move your legs. It feels like it’s taking a long time, like there was a few milliseconds of delay. And I’ll be watching it I’m moving it back and forth. But things are slowing down. And I feel unsteady, wait, why am I losing my stability?
fishman: This loss of control also occurs in the heart.
For many long COVID patients, standing or sitting starts their hearts pounding. You can speed up by 30 beats per minute!
And that, among other problems, causes fatigue. Many people who have been sick with COVID for a long time simply crash when they push themselves. He told me an episode when he was studying at After that, he could not get out of bed for ten days.
Lewis: Yeah. There are ways to treat this, right? Beta-blockers, a type of medicine that lowers heart rate, are effective in some people.
Fishman: yes. There are still many uncertainties about long-term treatment of COVID. What works for one person may not work for another, but viewing it as a brain-body disorder can help in intensive care.
Lewis: That is correct. For long-term COVID patients who may have nervous system inflammation, doctors have tried to administer a cocktail of proteins and antibodies called intravenous immunoglobulin (IVIg). weakens.
Fishman: Our colleague Stephani Sutherland wrote about that and other treatments in her March cover story for SciAm.
She said some long-lasting COVID cases may be due to the virus remaining in the body.
Lewis: For such people, it may make sense to treat them with antiviral drugs. there is.
And a Veterans Affairs study found that taking paxlobid when infected reduced the risk of developing a long-term COVID condition by 25%.
fishman: There is also some evidence that COVID vaccines reduce the risk of long-term COVID symptoms. However, it is not clear to what extent. One recent study said the risk was halved. But another showed a slight decrease of about 15%.
fishman: But it’s not just drugs. As with any disease that has no easy medical answers, for those who have had COVID for a long time, the big problem is finding someone who believes in you.
Doctors, friends, and even family members can easily say things like, “It’s all in your head.” Ibrahim heard it well.
Rashid: People didn’t understand why young people like me were still struggling. In just 6 months of being sick, I lost a friend who was sick of me being sick.
Lewis: What is he doing now?
fishman: Good, much better. When I saw him he was walking without a cane. He’s adjusting his diet and getting plenty of rest to reduce the chance of ongoing inflammation.
And he co-founded a company called Strong Haulers. They are developing apps that can pull data from wearables such as Fitbits and Apple Watches.
The idea is to provide people with chronic diseases with information about symptom-causing and symptom-reducing activities.
Lewis: that’s cool. It seems to help patients help themselves. It can also provide data you can share with your doctor to validate your symptoms.
fishman: And these symptoms are telling the medical community that COVID is long isn’t it All in your head. but, To do It seems to be in your brain.
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fishman: Your Health Quickly is written and edited by Kelso Harper, Tulika Bose, and Jeff DelViscio. Our music was composed by Dominic Smith.
Lewis: Our show is part of Scientific American’s podcast, Science, Quickly. You can subscribe anywhere you can get a podcast.
fishman: And don’t forget to visit Sciam.com for updated and in-depth health news.
Lewis: Tanya Lewis.
Fishman: My name is Josh Fishman.
Lewis: I will be back in 2 weeks. Thank you for listening!
