Neuroinflammation After COVID-19 With Persistent Depressive and Cognitive Symptoms

Written By Delainne Bond

ProMedView Strategic Clinical Solutions continues to gather information about Neuro COVID and resources for those experiencing post COVID condition.

It is well documented that inflammation plays a significant role in Post COVID Condition (PCC), aka Long COVID. This article offers insights as to how neuro COVID develops by detailing the pathophysiology in the brain that correlates with post COVID depressive and cognitive symptoms, including slowed motor speed, low motivation or energy, and anhedonia, after initially mild to moderate COVID-19 illness.

This information validates the need for early identification of new (acute) infections and post-acute phases to prevent or minimize the risks associated with long term damage that can occur when neural inflammation is left untreated.

SOURCE: Journal of the American Medical Association in Psychiatry

STUDY AUTHORS Joeffre Braga, BSc; Mariel Lepra, BSc; Stephen J. Kish, PhD; Pablo. M. Rusjan, PhD; Zahra Nasser; Natasha Verhoeff, BHSc; Neil Vasdev, PhD; Michael Bagby, PhD; Isabelle Boileau, PhD; M. Ishrat Husain, MBBS, MD; Nathan Kolla, MD, PhD; Armando Garcia, BSc; Thomas Chao, PhD; Romina Mizrahi, PhD; Khunsa Faiz, MD; Erica L. Vieira, PhD; Jeffrey H. Meyer, MD, PhD

IMPORTANCE Persistent depressive symptoms, often accompanied by cognitive symptoms, commonly occur after COVID-19 illness (hereinafter termed COVID-DC, DC for depressive and/or cognitive symptoms). In patients with COVID-DC, gliosis, an inflammatory change, was suspected, but measurements of gliosis had not been studied in the brain for this condition.

OBJECTIVE To determine whether translocator protein total distribution volume (TSPO VT), a marker of gliosis that is quantifiable with positron emission tomography (PET), is elevated in the dorsal putamen, ventral striatum, prefrontal cortex, anterior cingulate cortex, and hippocampus of persons with COVID-DC.

METHOD Symptoms were measured with neuropsychological and psychological tests, prioritizing outcomes related to striatal function.

CONCLUSIONS AND RELEVANCE In this case-control study, TSPO VT was higher in patients with COVID-DC. Greater TSPO VT is evidence for an inflammatory change of elevated gliosis in the brain of an individual with COVID-DC. Gliosis may be consequent to inflammation, injury, or both, particularly in the ventral striatum and dorsal putamen, which may explain some persistent depressive and cognitive symptoms, including slowed motor speed, low motivation or energy, and anhedonia, after initially mild to moderate COVID-19 illness.

MEANING These findings suggest that gliosis, especially in the ventral striatum and dorsal putamen, may reflect injury, ongoing inflammation, or both and provide directions for further therapeutic development.

Early diagnosis and early intervention are the keys to minimizing these risks. ProMedView has workforce resources and solutions to mitigate the risks associated with COVID and COVID complications.

Delainne Bond

Delainne Bond, BSN, RN, holds dual degrees in Nursing and Neuropsychology. She is the Principal Consultant with ProMedView, Founder of the covidCAREgroup, and a PRIMA Board Member with the Tampa, Florida chapter.

Recognized as a leader in clinical solutions for complex injuries and illnesses, Delainne has a broad spectrum of clinical experience including Workers’ Compensation, acute and critical care in the hospital setting, occupational medicine, and community health.

In the national Workers’ Compensation arena, Delainne is a CEU Educator, and her experience includes leadership, risk management, catastrophic case management, mass casualty incident response, critical incident management, and provider network development.

Since the event of the pandemic, Delainne has devoted her clinical expertise to researching Long COVID, offering education and resources on a global scale through the covidCAREgroup.

In addition to educating providers, clinicians, attorneys, case managers, and nurses, Delainne has published many articles about Long COVID with ~6 million views in 2022. She runs the largest clinical social media support groups in the world with followers and collaborators including physicians, clinicians, and business leaders from 110 countries.

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