Cracking the cognitive effects of Long COVID

Tired female employee suffer from headache at workplace with long covid brain fog
© Fizkes

CEO of ViewMind Inc, Mark Edwards, discusses the cognitive effects of Long COVID, aiming to understand the science behind brain fog and other COVID symptoms

The question of which physical and cognitive effects can be conclusively associated with Long COVID has been notoriously difficult for researchers to pin down. A new Brookings report reveals that nearly 4 million Americans have been so impacted by Long COVID that they remain unable to return to work, with similar statistics reported in other parts of the world. The continued severity of the problem has put pressure on scientists to accelerate efforts to better understand the disease, and on health, agencies to offer more systemic support for its sufferers.

With a recent influx of findings from research on the symptoms and trajectories of Long COVID over the past two years, it is now becoming clearer which neurological symptoms may be linked to the lingering effects of COVID-19 infection rather than other factors.

An urgent need for answers

The Centers for Disease Control (CDC) define Long COVID as having lasting or recurring symptoms that last more than four weeks post-infection. As many as 35% of those who recover from an initial bout of COVID go on to develop Long COVID. Although the severity of Long COVID varies significantly from person to person, for many, the protracted disease has resulted in serious damage to at least one organ system, including the central nervous system.

A new study on Long COVID published in the Lancet shares an important finding about the categories of psychiatric and neurological conditions that may be associated with Long COVID. The researchers – who studied the de-identified medical records of nearly 1.5 million COVID patients of all ages – discovered that in the adult population evaluated, risk of mood and anxiety disorders shifted back to baseline after one to two months, but the risk of cognitive deficit, dementia, psychosis, and epilepsy remained elevated two years after infection. The risk of such disorders also remained fairly consistent between delta and omicron variants.

The sensation of “brain fog” often reported by Long COVID patients includes trouble concentrating, memory lapses, and delayed thinking. These are also known symptoms of dementia, and there’s a clear reason for the connection.

The protein connection

Cognitive effects of Long COVID often manifest quite similarly to those seen in forms of dementia such as Alzheimer’s disease. This is no coincidence: in both disorders, neuro-inflammation can cause the protein phosphorylated tau to accumulate in brain cells. Hyposmia, the inability to smell and taste, is also seen in both Long COVID and Alzheimer’s. And early research suggests that Long COVID can cause the brain to age ten to twenty years, increasing the risk of developing Alzheimer’s. The risk of developing Alzheimer’s above the age of 65 approximately doubles every 5 years. Some researchers have hypothesised that Long COVID could actually be a form of Alzheimer’s, although more research is needed to explore this possibility.

A promising partnership

Digital health and artificial intelligence company ViewMind has developed a breakthrough artificial intelligence application that correlates with well known diagnostic tests such as cerebral spinal fluid analysis CSF (lumbar puncture) and positron emission tomography PET, the gold standards used to detect proteins in the brain including Beta-Amyloid and Tau. ViewMind also correlates with magnetic resonance imaging MRI and provides a precise measurement of cognitive function by different brain regions. In a longitudinal study, ViewMind used visual exercises to study the eye movement patterns of individuals with mild cognitive impairment MCI and was able to accurately predict who would convert to Alzheimer’s and who would not.

By tracking individual eye movement responses to visual stimuli in a series of VR exercises lasting 20 minutes, ViewMind researchers were able to determine with 94% accuracy which individuals with MCI would go on to develop Alzheimer’s. As it turned out, the pattern that predicted Alzheimer’s had to do with the presence of Tau and other proteins in the brain cells.

Through a partnership with the Luxembourg Institute of Health, ViewMind will now use grant funding to apply its findings using the novel digital biomarker of eye movement to ‘accurately assess the impact of Long COVID on the brain, and put the solution into commercial practice’.

The 1.36 million euro grant, funded by the Luxembourg Ministry of the Economy, the Luxembourg National Research Fund, and Luxembourg’s National Innovation Agency, Luxinnovation, through Luxembourg’s first Joint Call for HealthTech Projects, will allow ViewMind to extend its ground- breaking AI protocol to the study of Long COVID. The joint call supports public-private partnerships that can provide resources for health technology companies to validate their products through technical and clinical trials before launching them on the market.

Fast-tracking solutions

Current diagnostic methods for Alzheimer’s typically detect the disease long after it has begun to develop, for several reasons. First, it can be very challenging to distinguish the signs of Alzheimer’s from those of normal aging. Second, diagnostic tests – such as CSF, PET brain scans and MRI – are invasive and or expensive, and are typically ordered only when symptoms have become grave. Last, tests measuring cognitive function often consist of a set of questions on a pen-and-paper test or mobile computer equivalent, and lack sensitivity.

Many factors can lead to an inaccurate reading of such tests. For one, the questions may fail to reveal the area of the brain that is impaired. Second, such tests are vulnerable to introductions of human error by the health provider who is interpreting them or the patient’s state of mind when being assessed. In contrast, AI solutions such as ViewMind’s digital biomarker tracking are a highly precise diagnostic method, capable of accessing data about the brain that humans cannot otherwise access, from the minor alterations of eye movement patterns in response to visual stimuli. ViewMind also and uniquely works on patients independent of their culture, age and educational levels unlike traditional assessment tests.

The accuracy of ViewMind’s digital biomarker raises the possibility of early detection and intervention for a variety of neurocognitive disorders, including Long COVID.

The substantial criticism that has been levied at many global initiatives to study Long COVID has centred on its inability to find conclusive evidence of the causes of a frustratingly nebulous disease. The faster a highly sensitive cognitive biomarker can be established, the more likely it is that researchers will be able to fast-track their efforts and create efficient and accessible testing that can lead to successful treatment and prevention of Long COVID and other neurocognitive diseases.

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