Damage to brainstem might be driving Long COVID

Damage to the brainstem could be behind the physical and psychological effects of Long COVID , a new study suggests.

Brain scans of 30 Long COVID patients found they had damage to the region of the brainstem associated with breathlessness, fatigue and anxiety, researchers reported Monday in the journal Brain .

"The brainstem is the critical junction box between our conscious selves and what is happening in our bodies," said co-lead researcher James Rowe , a senior research fellow with the University of Cambridge Department of Clinical Neurosciences. "The ability to see and understand how the brainstem changes in response to COVID-19 will help explain and treat the long-term effects more effectively."

Post-mortem studies of people who died of severe COVID-19 early in the pandemic showed changes in their brainstem, researchers said in background notes.

"People who were very sick early in the pandemic showed long-lasting brain changes, likely caused by an immune response to the virus. But measuring that immune response is difficult in living people," Rowe said. "Normal hospital type MRI scanners can't see inside the brain with the kind of chemical and physical detail we need."

So, the research team turned to more powerful MRI machines called 7-Tesla scanners, which found that COVID infection caused inflammation damage in multiple regions of the brainstem.

These abnormalities appeared several weeks after hospital admission, generally in regions of the brain associated with control of breathing, researchers said.

"The fact that we see abnormalities in the parts of the brain associated with breathing strongly suggests that long-lasting symptoms are an effect of inflammation in the brainstem following COVID-19 infection," said co-lead researcher Dr. Catarina Rua , a postdoctoral researcher with the University of Cambridge. "These effects are over and above the effects of age and gender, and are more pronounced in those who had had severe COVID-19."

The brain scans also showed damage in areas related to fatigue and anxiety, researchers said.

"Mental health is intimately connected to brain health, and patients with the most marked immune response also showed higher levels of depression and anxiety," Rowe said in a Cambridge news release. "Changes in the brainstem caused by COVID-19 infection could also lead to poor mental health outcomes, because of the tight connection between physical and mental health."

More information

The U.S. Centers for Disease Control and Prevention has more about Long COVID .

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