COVID Research Moves Toward Neurological Impacts
by James Cavuoto, editor
December 2020 issue
The emergence of COVID-19 and the SARS-CoV-2 virus in 2020 created new opportunities for neurotech firms involved with devices treating respiratory or inflammatory disorders. In recent weeks, researchers and funding organizations have turned their attention to neurological and psychological impacts of the pandemic.
In a recent study of how COVID-19 affects a patient’s brain, NIH researchers consistently spotted hallmarks of damage caused by thinning and leaky brain blood vessels in tissue samples from patients who died shortly after contracting the disease. In addition, they saw no signs of SARS-CoV-2 in the tissue samples, suggesting the damage was not caused by a direct viral attack on the brain. The results were published in the New England Journal of Medicine.
“We found that the brains of patients who contract infection from SARS-CoV-2 may be susceptible to microvascular blood vessel damage. Our results suggest that this may be caused by the body’s inflammatory response to the virus” said Avindra Nath, clinical director at NINDS and the senior author of the study. “We hope these results will help doctors understand the full spectrum of problems patients may suffer so that we can come up with better treatments.”
Although COVID-19 is primarily a respiratory disease, patients often experience neurological problems including headaches, delirium, cognitive dysfunction, dizziness, fatigue, and loss of the sense of smell. The disease may also cause patients to suffer strokes and other neuropathologies.
New studies show that COVID can affect patients during two distinct phases of the disease process: the acute stage, characterized by fever, heart, or lung problems, and the post-COVID phase, in which neuropsychiatric symptoms, like fatigue, anxiety, and depression, can occur.
NeuroCOVID, as the second phase is called, is characterized by one or a combination of symptoms like vertigo, loss of smell, headaches, fatigue, and irritability as well as anxiety and depression. One in five COVID patients will develop these symptoms—a much higher rate than in patients with the flu or a lung infection.
This trend drew the attention of three investigators at Medical University of South Carolina: Mark George, an expert in brain stimulation and depression and professor of psychiatry, radiology, and neuroscience; Bashar Badran, a leading researcher in the field of VNS therapy and assistant professor in the College of Medicine; and Steve Kautz, professor and director of the Center of Biomedical Research Excellence in Stroke Recovery. The trio works closely together with the National Center for Neuromodulation for Rehabilitation Research and the stroke recovery COBRE, both housed at the MUSC College of Health Professions, studying brain stimulation.
George, Badran, and Kautz received funding from the NIH-funded Delaware Clinical and Translational Research Program to address neuroCOVID symptoms in patients. Their study uses a revolutionary noninvasive technique to stimulate the vagus nerve and reduce inflammation in 20 participants who report having neuroCOVID symptoms. By reducing inflammation, which is known to cause a host of problems in the body, the team hopes some or all of the symptoms that participants are experiencing will subside.
Meanwhile, a group of Brazilian and U.S. researchers recently authored a paper in Frontiers in Neurology that examined applications of noninvasive neuromodulation for COVID-19 related disorders. “Noninvasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19,” the authors concluded. The paper looked at rTMS, tACS, tDCS, and transcutaneous VNS. And investigators with Nemecheck Technologies authored a paper in the Journal of Clinical and Experimental Immunology that showed that tVNS is associated with lower mechanical ventilation and mortality in COVID-19.