Long COVID: A Neurological Perspective

The lingering effects of COVID-19, known as long COVID or post-acute sequelae of COVID-19 (PASC), have emerged as a complex and debilitating condition affecting millions worldwide. Research is now shedding light on its neurological dimensions and the ongoing efforts to tailor effective treatments.

The Human Face of Long-Standing COVID

Many people have transitioned from normal everyday life to one of long COVID.  Patients around the world cope daily with the mysterious and lasting impact of the virus. Struggling with persistent symptoms such as fatigue, cognitive dysfunction, and neurological issues, there are an estimated 15 million adults in the U.S. grappling with the aftermath of a COVID-19 infection.

COVID Symptom Persistence as a Neurological Disease

Recent research indicates a shift in perception, with long COVID increasingly recognized as a neurological disease. The most prevalent and disabling symptoms involve the brain and nervous system.  Symptoms range from cognitive dysfunction and brain fog to autonomic nervous system dysfunction.  They cause issues like postural orthostatic tachycardia syndrome (POTS). Insights from studying postviral syndromes related to other viruses, such as HIV, are guiding efforts to understand and address long COVID. 

Lingering COVID Symptoms Might Be an Indication of Another Post-Viral Disorder

There is another disease that proves quite similar in post-viral syndrome.  It is one that people with persistent COVID effects should consider looking at, is Mast Cell Activation Syndrome.  Many of the neurological symptoms are identical, but only a handful of studies have linked the two disorders thus far.  Consider finding an integrative health practitioner to help you get the testing you need.  They can help you to find out if MCAS is what you have.  MCAS is not limited purely to post-viral syndromes.  If you have had mold exposure, you may also want to be checked for MCAS in addition to running a mold test (mycotoxin test).  Many (if not most) functional medicine and integrative health professionals will run tests looking for mold, whereas conventional medicine providers almost never look for it.

Roots of Dysfunction

Neurological symptoms in long-standing COVID patients are linked to inflammation in the central nervous system rather than direct viral infection. Studies suggest that immune activation around blood vessels, not viral presence, may be responsible for persistent inflammation in the brain. Identifying markers of ongoing inflammation in patients could guide treatment approaches, with potential interventions including anti-inflammatory drugs and immunomodulatory therapies.

Viral Persistence and Autoimmunity

Evidence of viral persistence outside the lungs, particularly in the brain, raises questions about the role of antiviral medications in treating long COVID. Autoimmune components, such as autoantibodies interacting with nerve cells, have been identified in some patients, hinting at a potential link to autoimmunity. This autoimmune response keeps the immune system activated even after the virus has been cleared, contributing to prolonged symptoms.

Connections to Chronic Fatigue Syndromes

Long COVID shares striking similarities with chronic fatigue syndromes, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The overlap in symptoms and potential autoimmune mechanisms suggest a mechanistic relationship between the two conditions. Studying long COVID offers a unique opportunity to gain insights into ME/CFS, potentially aiding in the development of targeted treatments.

Potential Treatments for Long-Standing COVID Symptoms

Multidisciplinary Approaches and Ongoing Challenges

Comprehensive, multidisciplinary clinics, like the one at UCLA Health, are essential for treating long COVID patients. The team approach allows for tailored care, considering the diverse range of symptoms that patients present. Despite progress, challenges persist in understanding the varied manifestations of long COVID and setting realistic expectations for patients, whose lives have been dramatically altered by the condition.

The Role of Lymphatic Massage in Post-COVID Treatment

Research has shown that lymphatic massage can help people with lingering COVID symptoms such as chronic fatigue and brain fog improve.  When performed by a well-trained practitioner such as a lymphedema therapist, lymphatic massage helps to drain the cerebrospinal fluid from the brain (a process that happens in deep sleep), removing plaques, tangles, and other things such as debris left behind after a COVID infection that may be causing long-term inflammation.

The Road Ahead

While vaccination appears to reduce the risk of long COVID, the protection is not absolute. Ongoing research aims to unravel the complexities of long COVID, exploring the interplay of viral persistence, autoimmunity, and neurological dysfunction. As scientists and healthcare professionals continue to learn more, the journey to understand, treat, and support long COVID patients unfolds, emphasizing the need for compassion, interdisciplinary collaboration, and ongoing research efforts.