The chronic neuropsychiatric sequelae of COVID‐19: The need for a prospective study of viral impact on brain functioning

Abstract

Introduction:The increasing evidence of SARS-CoV-2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia.Methods: The Alzheimer's Association and representatives from more than 30 countries-with technical guidance from the World Health Organization-have formed an international consortium to study the short-and long-term consequences of SARS-CoV-2 on the CNS-including the underlying biology that may contribute to AD and other dementias. This consortium will link teams from around the world covering more than 22 million COVID-19 cases to enroll two groups of individuals including people with disease, to be evaluated for follow-up evaluations at 6, 9, and 18 months, and people who are already enrolled in existing international research studies to add additional measures and markers of their underlying biology. Conclusions:The increasing evidence and understanding of SARS-CoV-2's impact on the CNS raises key questions on the impact for risk of later life cognitive decline, AD, and other dementia. This program of studies aims to better understand the long-term consequences that may impact the brain, cognition, and functioning-including the underlying biology that may contribute to AD and other dementias.

SARS-CoV-2 is associated with changes in brain structure in UK Biobank

“…The vertexwise visualisation on the cortical surface of this loss of grey matter in the insula spatially corresponds in particular to the area of consistent activation to all basic taste qualities 43 . Interestingly, early neurological signs in COVID-19 are hyposmia and hypogeusia, which appear to precede the onset of respiratory symptoms in the majority of affected patients 2,11,44 . In addition, a popular hypothesis has been that an entry point to the central nervous system is via the olfactory bulb 2,5 .…”

COVID-19 and HIV testing: different viruses but similar prejudices and psychosocial impacts

“…The framework of the reasons for non-testing and possible measures to tackle them cal readiness of patients to receive a COVID-19 diagnosis, are important but seemingly neglected issues. 14 If almost 1 in 5 people diagnosed with COVID-19 are diagnosed with a mental illness within 3 months of their positive test, 15 with prevalent neuro-psychiatric sequelae, 16 then our perception and the importance of this infection must be reconsidered. This is further aggravated by the negative consequences of loneliness and isolation, in addition to the disease itself, 17,18 suggesting that this is a real public health priority at a population level.…”

Network medicine links SARS-CoV-2/COVID-19 infection to brain microvascular injury and neuroinflammation in dementia-like cognitive impairment

“…While some studies have shown that SARS-CoV-2 may directly infect the brain [19][20][21], potentially through the olfactory bulb [19], others have shown that SARS-CoV-2 is absent from the brain [22] and cerebrospinal fluid (CSF) [13]. COVID-19 has also been suggested to cause inflammation within the central nervous system (CNS) [18,22,23], as well as microvascular injury [22]. For example, the SARS-CoV-2 spike protein, which readily crosses the blood-brain barrier (BBB) [24,25], induces an inflammatory response within microvascular endothelial cells, leading to BBB dysfunction [25].…”