Researchers from Amsterdam UMC and UMC Utrecht saw inflammation throughout the brain in two patients with long-term symptoms after a coronavirus infection. This has not previously been demonstrated in living people with long Covid. “Additional research is needed to know what the connection is between these inflammations and long Covid,” says researcher Denise Visser from Amsterdam UMC. The findings have been published online 'in preprint'. “The fact that we are now seeing inflammations throughout the brain is striking and there may be a connection between long Covid and this global brain inflammation. A study with a larger number of patients will hopefully provide more clarity on this.”
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Brain inflammation in 2 patients with Long (long-term) COVID
Background
There are already indications that the presence of inflammatory cells in the brain may play a role in the long-term complaints of fatigue and cognitive complaints after a COVID-19 infection.
Research
Through the VeCosCO study, researchers from Amsterdam UMC (location VUmc and AMC) and University Medical Center Utrecht are investigating the neurobiological basis of these complaints. By using a special imaging technique, the TSPO PET scan, they are trying to look at the presence of inflammatory cells in the brain.
Notable findings
Although patient recruitment has only recently started and only two patients have been scanned, the findings are already striking. Inflammatory cells are observed diffusely distributed throughout the brain. It is striking that these are two patients with a completely different course of the disease, with the female patient, who experienced the COVID-19 infection at home with relatively mild symptoms and is still completely incapacitated for work, having more evident abnormalities than the male patient who was in the ICU, is somewhat older and has been able to partially resume work.
What now?
These findings support the theory of a possible neurobiological basis for the long-term fatigue and cognitive complaints after a COVID-19 infection. However, it is too early to determine on the basis of these findings whether the abnormalities found actually explain the persistent complaints. It is also not yet possible to say in which patients with Long COVID this may be the case. This needs to be confirmed in a larger patient population.
No, unfortunately, it is not possible to determine these abnormalities with the scans that are currently available in regular care. Special scans are required for this. These are quite burdensome, very limited in availability and also very expensive. Consideration is being given to how more accessible scans can be made. It is not useful to go to your GP or hospital practitioner with this question.
Unfortunately, it is not possible to register for the study. A pre-selection has already been made. The study group consists mainly of patients who were also involved in another part of the study. Whether and in what way the study group can be expanded is not yet clear. We will keep you informed via our website if there are any developments.
At this moment we still know too little about the nature of the inflammatory reaction and therefore do not know how to treat it. Furthermore, it is still unclear in which patients this is the case and whether there is a causal relationship. If there is more evidence for inflammatory cells as the cause of the persistent complaints, research into the treatment and prognosis of this could be a logical next step.
Unfortunately, we do not have an answer to this yet. This needs to be investigated in follow-up studies. If there is more evidence for inflammatory cells as the cause of the persistent complaints, then research into the treatment and prognosis of this could be a logical next step.
Complaints of tinnitus and dizziness are more often seen after a covid-19 infection. However, the exact connection and cause are not yet known. Theories include direct damage to the auditory nerve by the virus, damage due to an out-of-control reaction of the immune system or damage to small blood vessels in the ear.
The gastrointestinal tract consists of many bacteria, viruses, yeasts and fungi, which are collectively called the microbiome. There is increasing evidence that the microbiome not only helps to promote digestion, but may also play a role in training your immune system, among other things. Also in relation to Long COVID / post-covid, there is interest from the research community in a possible disruption of the microbiome as an explanation for the persistent complaints.
Unfortunately, not all aspects can be included in one study. In this specific study, other causes for the findings are certainly taken into account, but not specifically the microbiome.
The patients who participated in the study were not vaccinated. This is because they were infected quite early in the pandemic. At that time, there was no possibility of getting vaccinated. However, both patients were fully vaccinated afterwards. A direct link between the persistent complaints and the findings on the scans is still unclear. However, vaccination remains important to prevent serious illness due to a COVID-19 infection and possibly also to reduce the chance of Long COVID / post-covid.
Unfortunately, we will have to remain silent about the answers to many other questions, because more insights also require more research. This often takes some time. As soon as there are more insights, they will be shared on the C-support website, among others.
For other questions regarding the research, C-support can be reached via the email address:
