Twelve individuals with persistent neurological symptoms after SARS-CoV-2 infection were intensely studied on the National Institutes of Health (NIH) and were found to have differences of their immune cell profiles and autonomic dysfunction. These data inform future studies to assist explain persistent neurological symptoms in Long COVID. The findings, published in Neurology: Neuroimmunology & Neuroinflammation, may lead to raised diagnoses and latest treatments.

Individuals with post-acute sequelae of COVID-19 (PASC), which incorporates Long COVID, have a big selection of symptoms, including fatigue, shortness of breath, fever, headaches, sleep disturbances, and “brain fog,” or cognitive impairment. Such symptoms can last for months or longer after an initial SARS-CoV-2 infection. Fatigue and “brain fog” are amongst essentially the most common and debilitating symptoms, and certain stem from nervous system dysfunction.

Researchers used an approach called deep phenotyping to closely examine the clinical and biological features of Long COVID in 12 individuals who had long-lasting, disabling neurological symptoms after COVID-19. Most participants had mild symptoms during their acute infection. On the NIH Clinical Center, participants underwent comprehensive testing, which included a clinical exam, questionnaires, advanced brain imaging, blood and cerebrospinal fluid tests, and autonomic function tests.

The outcomes showed that folks with Long COVID had lower levels of CD4+ and CD8+ T cells—immune cells involved in coordinating the immune system’s response to viruses—in comparison with healthy controls. Researchers also found increases within the numbers of B cells and other varieties of immune cells, suggesting that immune dysregulation may play a task in mediating Long COVID.

Consistent with recent studies, individuals with Long COVID also had problems with their autonomic nervous system, which controls unconscious functions of the body akin to respiratory, heart rate, and blood pressure. Autonomic testing showed abnormalities in command of vascular tone, heart rate, and blood pressure with a change in posture. More research is required to find out if these changes are related to fatigue, cognitive difficulties, and other lingering symptoms.

Taken together, the findings add to growing evidence that widespread immunological and autonomic nervous system changes may contribute to Long COVID. The outcomes may help researchers higher characterize the condition and explore possible therapeutic strategies, akin to immunotherapy.

The study was supported by the Intramural Research Program on the National Institute of Neurological Disorders and Stroke (NINDS) and is a component of an observational study going down on the NIH Clinical Center designed to characterize changes within the brain and nervous system after COVID-19 (NCT04564287).

Source:

National Institutes of Health

Journal reference:

Mina, Y., et al. (2023). Deep Phenotyping of Neurologic Postacute Sequelae of SARS-CoV-2 Infection. Neurology – Neuroimmunology Neuroinflammation. doi.org/10.1212/nxi.0000000000200097