"We'd like to know why people keep having fatigue symptoms and cognitive symptoms for so long after a coronavirus infection," says nuclear medicine specialist Bart van Berckel of Amsterdam UMC. "That we are now seeing inflammation throughout the brain is striking, and there may be a link between long covid and that global brain inflammation. A study with a larger number of patients will hopefully bring more clarity to this." Additional research is needed to know what link there is between these inflammations and long covid," said Denise Visser of Amsterdam UMC.
121% more inflamed brain cells
The two patients studied have different disease courses. The male patient was in the ICU and has partially returned to work. The younger female patient had mild corona complaints and is still on sick leave. In both, brain inflammation could be seen throughout the brain. The inflammations were 76% and 121% increased, respectively, compared to those in the brains of healthy people. For science, these are important starting points for follow-up research.
Advanced scan
The patients underwent a specific, advanced scan that was burdensome for them and showed an inflammatory response on image. These scans are not available in routine care. The researchers are considering how to make such a scan accessible. "It is currently not possible to request such a scan from a general practitioner or hospital," says nuclear medicine specialist Nelleke Tolboom of UMC Utrecht. "The selection of patients is made for additional research. One cannot sign up for this."
Additional research needed
It is still unknown how patients with these inflammations can be treated. It is also unknown whether every patient with long covid shows the same inflammatory response. This is what the researchers at Amsterdam UMC and UMC Utrecht will look at with additional research. "There is still a lot we don't know, but these were the first two patients with long-term covid to be included in this study, and we felt that these data were too important not to publish at this stage." Therefore, this study, funded by the ZonMw COVID-19 program, is now in preprint. A study in preprint gives other scientists around the world the opportunity to learn from it and collaborate for more research results.
Many questions about long covid
People with long covid often struggle with questions about this disease. On the website of C-support, which was commissioned by the Ministry of Health, Welfare and Sport to provide advice and support to long covid patients, you can find more information about long covid and frequently asked questions about this study. Questions can also be sent to:info@c-support.nu.
Read the pre-print: Long COVID is associated with extensive in-vivo neuroinflammation on [18F]DPA-714 PET