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How coronavirus can attack the brain

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how coronavirus can attack the brain

As if Covid-19‘s vicious toll of deaths and damaged lungs was not harmful enough, British experts are starting to warn of a second wave of serious neurological woes involving lasting damage to the brain and nerves.

They are causing mental problems including psychosis, confusion, mania, depression and fatigue, as well as rare but terrifying phenomena such as catatonia (physical and mental shutdown) and Guillain-Barre syndrome, where people’s immune defences destroy their own nerves.

Perhaps most worryingly of all, experts predict that neurological damage from Covid-19 may ultimately cause lasting epidemics of chronic fatigue and depression, even among younger people who had the virus comparatively mildly.

A UK-wide alliance has now been created to monitor such cases: CoroNerve — the National Surveillance Programme for Neurological Complications of Covid-19. It involves both the Association of British Neurologists and the Royal College of Psychiatrists.

British experts are starting to warn of a second wave of serious neurological woes involving lasting damage to the brain and nerves as a result of the coronavirus pandemic. (Stock image)

British experts are starting to warn of a second wave of serious neurological woes involving lasting damage to the brain and nerves as a result of the coronavirus pandemic. (Stock image)

British experts are starting to warn of a second wave of serious neurological woes involving lasting damage to the brain and nerves as a result of the coronavirus pandemic. (Stock image)

CoroNerve has gathered case studies of more than 150 British adults with symptoms that reflect these emerging problems. Almost a third have suffered from mood disorders and confusion. Significant numbers show evidence of damaging brain inflammation.

In a yet-to-be-published study, posted online last month in the electronic journal SSRN, CoroNerve members reported that, for example, ten patients developed psychosis, six had dementia-like symptoms and four had mood disorders such as depression.

Such altered states were ‘disproportionately represented in younger patients’ (aged 20 to 50), it warned.

Dr Benedict Michael, a consultant neurologist at the University of Liverpool, who is leading the CoroNerve initiative, told Good Health: ‘We are receiving clinical reports from across the UK of unexplained neurological symptoms in patients with Covid-19.

‘These range from forms of encephalitis [brain inflammation] through to psychosis and catatonia. It is quite a broad spectrum.’

Much of the damage seems to be wrought by patients’ immune systems overreacting to the virus and sparking harmful inflammatory reactions in brains and nerves, Dr Michael explains.

These may be seen as a neurological parallel to the lung damage wrought by immune cells in people with severe Covid-19, where a ‘cytokine storm’ sparks inflammation that destroys tissues.

But in rarer cases, the neurological problems seem to be caused by the coronavirus infecting the nervous system itself. The virus has been detected in the fluid in victims’ spines and brains.

Serious problems have been studied in Northern Italy, which felt the brunt of the coronavirus pandemic weeks before the UK.

Experts predict that neurological damage from Covid-19 may ultimately cause lasting epidemics of chronic fatigue and depression. (Stock image)

Experts predict that neurological damage from Covid-19 may ultimately cause lasting epidemics of chronic fatigue and depression. (Stock image)

Experts predict that neurological damage from Covid-19 may ultimately cause lasting epidemics of chronic fatigue and depression. (Stock image)

In mid-March, Alessandro Pezzini, an associate professor of neurology at the University of Brescia, opened a special neurology unit for Covid-19 patients who were also experiencing delirium, seizures and encephalitis.

Globally, the most common neurological symptom reported by Covid-19 patients has been a loss or distortion in smell and taste. Initially, doctors blamed this on the virus damaging smell receptors in the nose.

However, a report at the end of last month in the journal JAMA Neurology described a Covid-19 patient with anosmia (loss of sense of smell) whose MRI scans indicated that coronavirus had infected brain regions associated with smell — the right gyrus rectus and the olfactory bulbs. 

After the patient’s sense of smell returned, scans showed her brain was back to normal.

The researchers, at Humanitas University in Milan, warned that the virus might infect the brain by entering nerves in the nose.

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Commenting on this research in the same journal, Serena Spudich, a professor of neurology and infection specialist at Yale University, in the U.S., wrote: ‘If the virus has infected brain tissue, the question is, could this spread to other parts of the brain and cause other, more serious neurological effects?’

She added: ‘We know that [the previous epidemic viruses] SARS-1 and MERS have been shown to enter the central nervous system.

‘Several coronaviruses have been shown to cause direct brain effects. There is also some evidence that SARS-CoV-2 can do this too.’

So concerned are some neurologists that last week, in the Journal of Alzheimer’s Disease, they called for all Covid-19 patients in hospitals to be given MRI brain scans before they are discharged.

Dr Majid Fotuhi, a neurologist at Johns Hopkins Medicine in Baltimore, U.S., warned: ‘We need to monitor these patients over time as some of them may develop cognitive decline, brain fog or Alzheimer’s disease in the future.’

Neurological problems do not affect only adults. This month, paediatricians at Columbia University in the U.S. warned in the journal JAMA Pediatrics that among 50 children and adolescents in hospital in New York with Covid-19, 6 per cent had experienced ‘seizures or seizure-like activity’.

An online report, also published this month in the Journal of Neurology, Neurosurgery & Psychiatry, led by CoroNerve, even warned of international cases where Covid-19 patients had developed Guillain-Barre syndrome, in which the body’s immune system mistakenly attacks part of its own peripheral nervous system.

The effects of this rare syndrome (which can be triggered by other viruses) range from brief weakness to devastating paralysis, leaving those affected incapable of breathing independently.

And last week, three Harvard Medical School clinicians posted online the first published case study of a middle-aged Covid-19 patient developing catatonia, a brain condition that left him paralysed in a foetal position, unable to move or speak.

Fortunately, the catatonia was quelled by high doses of lorazepam, a benzodiazepine drug, said the report, which is scheduled to appear in the journal Psychosomatics. Other viral illnesses, including influenza, have been believed to spark catatonia.

‘We have already seen several cases of catatonia in the UK,’ says Dr Tim Nicholson, who is leading the Royal College of Psychiatrists’ work on Covid-19 complications. He told Good Health: ‘We are on the alert because of the history of encephalitis lethargica that followed the Spanish flu epidemic of 1919.’

A million people worldwide had encephalitis lethargica in the wake of that pandemic — it causes a high fever, headache, double vision and lethargy. In acute cases, patients went into comas and catatonic states.

‘We are also seeing cognitive problems, psychosis and a mixed bag of other stuff such as manic episodes and depressive episodes,’ says Dr Nicholson, a neuropsychiatrist and a clinical lecturer at the Institute of Psychiatry at King’s College London.

Dr Nicholson wonders if Covid-19 might cause a unique syndrome in a very few patients, where neurological effects emerge after the infection is apparently cured.

‘Some patients who have had mild infections with fluey symptoms have subsequently suffered from debilitating fatigue and chronic symptoms such as ‘brain fog’ that last more than a month after the illness,’ he explains.

‘In online communities, such patients are calling themselves ‘long-haulers’.’

Most of these people are younger adults — in their 20s and 30s — and were previously fit and healthy, says Dr Nicholson.

‘The first cases are emerging clinically. We need six months to diagnose such a syndrome definitively. But three months into the pandemic [in the UK], we have enough evidence to have a pretty clear idea what’s happening.’

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Dr Manoj Sivan, an associate clinical professor in physical and rehabilitation medicine at the University of Leeds, is also concerned for the future.

He told Good Health: ‘In our research on the SARS and MERS epidemics, we found patients complaining mainly of breathlessness and fatigue in the first six months post-discharge, and then psychological problems such as anxiety and depression.

‘The neurological problem of chronic fatigue was not much explored in SARS and MERS studies, but we believe it is likely in Covid-19.’

His work currently involves monitoring a sample of Covid-19 patients after they leave hospital.

‘Some have neurological problems such as neuropathy [nerve damage] and myopathy [muscle weakness]. 

‘We are seeing neurological complications from the infection in a small proportion of these patients — such as mood problems and encephalopathy,’ he says. ‘Patients are also experiencing depression, anxiety and post-traumatic stress disorder.

‘If problems such as these are addressed early, with timely rehabilitation, we can have good outcomes. The later you leave them, the worse they can end up.

‘This is why it makes economic sense to have resources across the country for the early screening of patients after discharge, to identify their emerging problems and manage them properly.’

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Beer belly raises the risk of early death from illnesses such as type 2 diabetes and heart disease

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beer belly raises the risk of early death from illnesses such as type 2 diabetes and heart disease

Having a beer belly raises the risk of premature death – even if the rest of your body is slim, research shows.

But having broad hips or larger thighs can help us to live longer, the study said.

Researchers looked at data from more than 2.5million people and found that every extra 4in (10cm) of waist size was associated with an 11 per cent higher chance of dying prematurely.

Many academics believe waist circumference is a more accurate indicator of obesity, and risk for illnesses such as type 2 diabetes and heart disease, than the commonly-used body mass index (BMI). 

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Researchers looked at data from more than 2.5million people and found that every extra 4in (10cm) of waist size was associated with an 11 per cent higher chance of dying prematurely (file image)

This is because fat around the waist – or ‘visceral fat’ – sits around vital organs including the liver, kidneys, intestines and pancreas.

The new study was published in the British Medical Journal.

Study author Tauseef Ahmad Khan, from the department of nutritional sciences at the University of Toronto, said: ‘People should be more concerned about their waist rather than focusing only on weight or BMI.

Is diabetes pill key to dementia fight? 

A common diabetes pill taken by more than three million Britons may prevent dementia, research has suggested.

A study found that patients who took metformin, sold under the name Glucophage, have slower rates of mental decline and dementia.

Metformin is used to treat type 2 diabetes, which affects nearly four million in the UK. The study looked at 1,037 Australians aged 70 to 90 of whom 123 had type 2 diabetes. Those taking metformin had much better brain function and lower dementia risk compared to those not taking the drug.

Author Professor Katherine Samaras, of the Garvan Institute in Sydney, said: ‘This study has provided promising initial evidence that metformin may protect against cognitive decline.’ 

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‘Waist is a better indicator of belly fat and while one cannot target where one loses fat from, losing weight through diet and exercise will also reduce waist and therefore belly fat.’

Dr Khan added: ‘Belly fat is the fat that is stored around the organs in the abdomen and its excess is linked to high cholesterol, high blood pressure, heart disease, diabetes, and stroke. Therefore, having more belly fat can increase the risk of dying from these diseases.’

The researchers found that most measures of abdominal fat were ‘significantly and positively associated with a higher all-cause mortality risk’ even after BMI was taken into account.

They said: ‘We found that the associations remained significant after body mass index was accounted for, which indicated that abdominal deposition of fat, independent of overall obesity, is associated with a higher risk.’

But their findings suggested that thigh and hip circumference were ‘inversely associated with all-cause mortality risk’. 

Each 10cm increase in hip circumference was associated with a 10 per cent lower risk of death from all causes – and each 5cm increase in thigh circumference was associated with an 18 per cent lower risk.

Dr Khan said hip fat is considered beneficial and thigh size is an indicator of the amount of muscle.

The risks of belly fat were the same when accounting for BMI, suggesting that it increases a person’s chances of death regardless of their overall weight.

More than 70 health studies, which followed more than 2.5million people for between three and 24 years, were analysed by the researchers. 

The NHS says that, regardless of height or BMI, men should try to lose weight if their waist is above 37in (94cm), while women should do so if their waist is above 31.5in (80cm). 

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CDC director says more than 90% of US susceptible to COVID-19 but vaccine predicted by spring 2021

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cdc director says more than 90 of us susceptible to covid 19 but vaccine predicted by spring 2021

The majority of Americans are vulnerable to contracting the novel coronavirus, the director of the Centers for Disease Control and Prevention (CDC) said on Wednesday.

Dr Robert Redfield was testifying during a Senate Health, Education, Labor, and Pensions Committee hearing when he revealed most of the US population is at risk of falling ill with the potentially deadly disease. 

‘The preliminary results in the first round [of testing] show that a majority of our nation, more than 90 percent of the population, remains susceptible,’ Redfield said.

‘A majority of Americans are still susceptible to this virus.’

Later in the hearing, Redfield and Dr Anthony Fauci, the nation’s top infectious disease expert, testified that they expect a vaccine to be widely available to the public by spring 2021.

Dr Robert Redfield revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Pictured: Redfield testifies before the Senate, Wednesday

Dr Robert Redfield revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Pictured: Redfield testifies before the Senate, Wednesday

Redfield and Dr Anthony Fauci (pictured) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021. Pictured: Fauci testifies before the Senate, Wednesday

Redfield and Dr Anthony Fauci (pictured) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021. Pictured: Fauci testifies before the Senate, Wednesday

Dr Robert Redfield (left) revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Redfield and Dr Anthony Fauci (right) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

During the hearing, Redfield said the CDC is currently conducting a study to determine how many Americans have been sickened with COVID-19.

He said infection rates have varied from state-to-state with one as high as 24 percent and others as low as less than one percent.  

‘Preliminary results appear to show that most Americans have not been infected with the virus and are still vulnerable to the infection, serious illness and death,’ Redfield said.

‘It varies in different geographic parts from states…We’ll have that finalized and probably published in the next week or so.’ 

The results seem to combat President Donald Trump’s opinion that the US could curb the pandemic with herd immunity, which would require up to 85 percent of the population having antibodies against the virus. 

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This is similar to an estimate Redfield made to reporters during a press conference in June, in which he revealed that the CDC believed the virus has infected 10 times more people in the US than the official count.

At the time, there were 2.3 million confirmed cases, with a 10-fold increase equating to 20 million cases, about six percent of the US population. 

Later in the hearing, Redfield testified that he predicted 700 million doses would be available of a coronavirus vaccine by late March or early April.

That would be enough doses to inoculate 350 million people.  

‘I think that’s going to take us April, May, June, you know, possibly July, to get the American public completely vaccinated,’ he said. 

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Fauci, director of the National Institute of Allergy and Infectious Diseases, said he also expects 700 million doses to be available by April 2021.

He added that if a vaccine is approved by year’s end, only about 50 million doses would be available in December, so ‘it is not going to be a large proportion of the population’ that receives the vaccine in 2020.

Fauci said those prioritized will ‘likely will be health care providers and likely will be those who are vulnerable with preexisting conditions.’ 

There are more than 170 coronavirus vaccine candidates in various stages of development around the globe, according to the World Health Organization.

At least 10 are currently in large-scale trials in humans in the US and around the world to prove the jabs are both safe and effective.   

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During his opening statement, Fauci said he expects results showing any vaccine’s efficacy by November or December.

‘We feel strongly that if we have a combination of adherence to the public health measures together with a vaccine…we may be able to turn around this terrible pandemic which we have been experiencing,’ he said.

Recently there have been fears that the US Food and Drug Administration (FDA) will approve a vaccine before there is enough data to review due to pressure from the Trump administration.

FDA Commissioner Hahn said an immunization will only be approved if FDA scientists find it is safe and effective.

‘I will fight for science. I will fight for the integrity of the agency,’ Hahn said. 

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Smoking marijuana during pregnancy increases risk of psychotic-like behaviors in children

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smoking marijuana during pregnancy increases risk of psychotic like behaviors in children

Using marijuana while pregnant increases the risk of psychotic-like behaviors and sleep problems in children, a new study suggests.

Researchers found expecting mothers who smoked or vaped cannabis were more likely to have children who had anxiety, difficulty concentrating and experienced hallucinations compared to children not exposed in utero.

If the woman continued using pot after learning she was pregnant, the higher the risk of detrimental effects. 

Cannabis use among pregnant women has become more common, doubling over the last two decades.

The team, Washington University School of Medicine in St Louis, says the findings confirm marijuana’s harmful effects on developing babies and advises that there are no safe levels when it comes to expecting mothers. 

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

For the study, published in JAMA Psychiatry, the team looked at data from the Adolescent Brain Cognitive Development.

It is self-described as ‘the largest long-term study of brain development and child health in the United States.’

Of the nearly 11,500 children looked at from June 2016 to October 2018, 655 of them were exposed to cannabis in the womb.

Researchers found that children with prenatal exposure to weed were more likely to suffer from psychosis, which occurs when someone has delusions and hallucinations, and is often a symptom of schizophrenia.

They were also likely to suffer from attention disorders, sleep issues and social problems such as bullying and drug abuse.

Children who were exposed before and after their mothers knew they were pregnant were more likely to have these issues than kids of mothers who only used marijuana before they knew they were expecting.  

‘This study suggests that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood,’ the authors wrote. 

‘Cannabis use during pregnancy should be discouraged.’ 

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

Recent research has shown that self-reported marijuana use among pregnant women has exponentially risen.

Between 2002 and 2017, use increased two-fold from 3.4 percent to seven percent, according to the National Institute on Drug Abuse.

The Centers for Disease Control and Prevention (CDC) states that cannabis use during pregnancy can lead to low birth weight, attention issues and development disabilities.

A study from April 2019 found that pregnant women who use marijuana heavily to treat morning sickness affect part of the baby’s brain associated with memory.

Another study from August 2020 found that expecting mothers who used pot were 1.5 times more likely to have a child diagnosed with autism. 

In light of the growing problem, US Surgeon Jerome Adams issued an advisory last year against using marijuana during pregnancy.

‘Recent increases in access to marijuana and in its potency, along with misperceptions of safety of marijuana endanger our most precious resource, our nation’s youth,’ he wrote. 

Adams referenced past research, which has found that tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana, can pass from mother to fetus.

‘THC has been found in breast milk for up to six days after the last recorded use. It may affect the newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences,’ he wrote.

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