Sudden memory loss as a long-term consequence of COVID-19?
It is now known that many patients suffering from Covid-19 experience neurological symptoms and even sudden memory loss. These people may also have a loss of smell, delirium, or an increased risk of stroke. In the long term, this also leads to longer-lasting consequences for the brain, such as myalgic encephalomyelitis, chronic fatigue or Guillain-Barré syndrome.
Sudden memory loss caused by coronavirus
The above negative effects can be caused by a direct viral infection of the brain tissue. However, growing evidence suggests that additional indirect actions triggered by infection of the epithelial cells and the cardiovascular system by coronavirus or by the immune system and inflammation contribute to permanent neurological changes after Covid-19. So will there be a Covid-19-related wave of memory deficits, cognitive decline and dementia in the future?
Many of the symptoms epidemiologists attribute to infection are actually due to the protective responses of the immune system. A runny nose during a cold is not a direct effect of the virus. Rather, this is a result of the immune system’s response to the cold virus. This also applies when it comes to feeling sick. The general malaise, fatigue, fever and social withdrawal are caused by the activation of specialized immune cells in the brain. These belong to neuroimmunology and are activated according to certain neurological signals. Such changes in the brain and in behavior may be annoying in everyday life, but they are extremely adaptable and beneficial. By resting patients, they let the energy-consuming immune response do its thing. The fever makes the body less hospitable to viruses and increases the efficiency of the immune system. In addition, social withdrawal can help reduce the spread of the virus.
In addition to changing behavior and regulating physiological responses during illness, the specialized immune system in the brain also plays a number of other roles. It has recently become clear that the immune cells, which sit at the junctions between brain cells (synapses) and provide tiny amounts of energy as inflammation signals, are essential for normal memory formation. Unfortunately, this also offers a possibility for diseases like Covid-19 to cause long-lasting problems in the brain like sudden memory loss.
How does inflammation affect the long term?
If the activation of neuroimmune cells is limited for the duration of the disease, how can inflammation cause long-lasting memory deficits or increase the risk of cognitive decline? Both the brain and the immune system have changed purposefully as a result of experience. Thus they can neutralize dangers and maximize survival. In the brain, people can store memories by changing the connections between neurons. As a result, they quickly change their behavior to escape threats or to look for food or social opportunities. The immune system has evolved to optimize the inflammatory response and antibody production against previously encountered pathogens. However, long-lasting changes in the brain after illness are also closely linked to an increased risk of age-related cognitive decline and Alzheimer’s disease.
The disruptive and destructive effects of neuroimmune cells and the inflammatory signals can permanently impair memory. It can do this through permanent damage to the neural connections or neurons themselves, and also through more subtle changes in how neurons work. So the possible link between COVID-19 and persistent effects on memory is based on observations of other diseases. For example, many patients recovering from a heart attack or bypass surgery report persistent cognitive deficits that become exaggerated as they age. Another serious illness with similar cognitive complications is sepsis – an inflammation-induced multi-organ dysfunction.
It will be many years before we know whether Covid-19 infection is causing an increased risk of cognitive decline or Alzheimer’s disease. However, prevention and treatment of Covid-19 can reduce or mitigate this risk. In addition, several emerging treatments for Covid-19 are drugs that suppress excessive immune activation and an inflammatory condition. Potentially, these treatments will also have the potential to reduce the effects of inflammation on long-term brain health.
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