Some people's brain function still affected by Long COVID years after infection

July 21, 2023

Science Daily/King's College London

UK researchers have found that people with longer-term COVID-19 symptoms including brain fog showed reduced performance in tasks testing different mental processes up to two years after infection with the virus.

Researchers from King's College London looked at whether infection with COVID-19 affected performance in two rounds of online cognitive testing that took place in 2021 and 2022. Data was collected for over 3,000 participants of the COVID Symptom Study Biobank study, across 12 tasks that tested memory, attention, reasoning, processing speed and motor control.

The participants whose test scores were most affected by COVID-19 were those who had experienced symptoms related to the virus for 12 weeks or more. In these people, the effect of COVID-19 on test accuracy was comparable in size to the effect of a 10-year increase in age.

There was no significant improvement in these test scores between the two rounds of testing, which took place nine months apart. By the second round of testing, the average time since participants' initial COVID-19 infection was almost two years.

Digging deeper into the analysis, the researchers separated participants by whether they felt fully recovered following COVID-19 infection. People who felt fully recovered after COVID-19 infection performed similarly to those who had not had the virus at all. In contrast, participants who did not feel fully recovered after infection had lower task accuracy scores on average.

Lead author Dr Nathan Cheetham, a Senior Postdoctoral Data Scientist at King's College London said:

"Our findings suggest that, for people who were living with long-term symptoms after having COVID-19, the effects of the coronavirus on mental processes such as the ability to recall words and shapes are still detectable at an average of almost two years since their initial infection.

"However, the result that COVID had no effect on performance in our tests for people who felt fully recovered, even if they'd had symptoms for several months and could be considered as experiencing 'long COVID', was good news. This study shows the need to monitor those people whose brain function is most affected by COVID-19, to see how their cognitive symptoms continue to develop and provide support towards recovery."

Professor Claire Steves, a Professor of Ageing and Health at King's College London, added:

"We used sensitive tests to measure speed and accuracy across a range of brain challenges. This study shows that some individuals have measurable changes in these tests after COVID-19 going on for nearly two years. The fact remains that two years on from their first infection, some people don't feel fully recovered and their lives continue to be impacted by the long-term effects of the coronavirus. We need more work to understand why this is the case and what can be done to help."

https://www.sciencedaily.com/releases/2023/07/230721113224.htm

Getting a good night's sleep could boost your response to vaccination

March 13, 2023

Science Daily/Cell Press

We all know how important sleep is for mental health, but a meta-analysis publishing in the journal Current Biology on March 13 found that getting good shut-eye also helps our immune systems respond to vaccination. The authors found that people who slept less than six hours per night produced significantly fewer antibodies than people who slept seven hours or more, and the deficit was equivalent to two months of antibody waning.

"Good sleep not only amplifies but may also extend the duration of protection of the vaccine," says senior author Eve Van Cauter, professor emeritus at the University of Chicago who, along with lead author Karine Spiegel at the French National Institute of Health and Medicine, published a landmark study on the effects of sleep on vaccination in 2002.

When the COVID-19 pandemic hit, and mass-vaccination became an international priority, Spiegel and Van Cauter set out to summarize our current knowledge about the effect of sleep duration on vaccine response.

To do this, they combed the literature and then combined and re-analyzed the results of seven studies that vaccinated for viral infections (influenza and hepatitis A and B). In their analysis, the team compared the antibody response for individuals who slept a "normal" amount (7-9 hours, as per the National Sleep Foundation's recommendation for healthy adults) with "short sleepers" who slept less than 6 hours per night. They compared the effect for men versus women and adults over the age of 65 years versus younger adults.

Overall, they found strong evidence that sleeping less than 6 hours per night reduces the immune response to vaccination. When they analyzed men and women separately, though, the result was only significant in men, and the effect of sleep duration on antibody production was much more variable in women. This difference is probably due to fluctuating sex hormone levels in women, the authors say.

"We know from immunology studies that sex hormones influence the immune system," says Spiegel. "In women, immunity is influenced by the state of the menstrual cycle, the use of contraceptives, and by menopause and post-menopausal status, but unfortunately, none of the studies that we summarized had any data about sex hormone levels."

The negative effect of insufficient sleep on antibody levels was also greater for adults aged 18-60 compared with people over the age of 65. This was not surprising because older adults tend to sleep less in general; going from seven hours of sleep per night to less than six hours is not as big of a change as going from eight hours to less than six per night.

Some of the studies measured sleep duration directly, either via motion-detecting wristwatches or in a sleep lab, while others relied on self-reported sleep duration. In both cases, short sleep duration was associated with lower levels of antibodies, but the effect was stronger for the studies that used objective measures of sleep, likely because people are notoriously bad at estimating the amount of sleep they have had.

Knowing that sleep duration impacts vaccination might give people some degree of control over their immunity, the authors say. "When you see the variability in protection provided by the COVID-19 vaccines -- people who have pre-existing conditions are less protected, men are less protected than women, and obese people are less protected than people who don't have obesity. Those are all factors that an individual person has no control over, but you can modify your sleep," says Van Cauter.

However, there's a lot more to be known about sleep and vaccination, the authors say. "We need to understand the sex differences, which days around the time of vaccination are most important, and exactly how much sleep is needed so that we can give guidance to people," says Spiegel. "We are going to be vaccinating millions and millions of people in the next few years, and this is an aspect that can help maximize protection."

https://www.sciencedaily.com/releases/2023/03/230313121003.htm

Scientists find key reason why loss of smell occurs in long COVID-19

The inflammatory mechanism could also help explain other long COVID-19 symptoms

December 21, 2022

Science Daily/Duke University Medical Center

The reason some people fail to recover their sense of smell after COVID-19 is linked to an ongoing immune assault on olfactory nerve cells and an associated decline in the number of those cells, a team of scientists led by Duke Health report.

The finding, publishing online Dec. 21 in the journal Science Translational Medicine, provides an important insight into a vexing problem that has plagued millions who have not fully recovered their sense of smell after COVID-19.

While focusing on the loss smell, the finding also sheds light on the possible underlying causes of other long COVID-19 symptoms -- including generalized fatigue, shortness of breath, and brain fog -- that might be triggered by similar biological mechanisms.

"One of the first symptoms that has typically been associated with COVID-19 infection is loss of smell," said senior author Bradley Goldstein, M.D., Ph.D., associate professor in Duke's Department of Head and Neck Surgery and Communication Sciences and the Department of Neurobiology.

"Fortunately, many people who have an altered sense of smell during the acute phase of viral infection will recover smell within the next one to two weeks, but some do not," Goldstein said. "We need to better understand why this subset of people will go on to have persistent smell loss for months to years after being infected with SARS-CoV2."

In the study, Goldstein and colleagues at Duke, Harvard and the University of California-San Diego analyzed olfactory epithelial samples collected from 24 biopsies, including nine patients suffering from long-term smell loss following COVID-19.

This biopsy-based approach -- using sophisticated single-cell analyses in collaboration with Sandeep Datta, M.D., Ph.D., at Harvard University -- revealed widespread infiltration of T-cells engaged in an inflammatory response in the olfactory epithelium, the tissue in the nose where smell nerve cells are located. This unique inflammation process persisted despite the absence of detectable SARS-CoV-2 levels.

Additionally, the number of olfactory sensory neurons were diminished, possibly due to damage of the delicate tissue from the ongoing inflammation.

"The findings are striking," Goldstein said. "It's almost resembling a sort of autoimmune-like process in the nose."

Goldstein said learning what sites are damaged and what cell types are involved is a key step toward beginning to design treatments. He said the researchers were encouraged that neurons appeared to maintain some ability to repair even after the long-term immune onslaught.

"We are hopeful that modulating the abnormal immune response or repair processes within the nose of these patients could help to at least partially restore a sense of smell," Goldstein said, noting this work is currently underway in his lab.

He said the findings from this study could also inform additional research into other long-COVID-19 symptoms that might be undergoing similar inflammatory processes.

https://www.sciencedaily.com/releases/2022/12/221221154434.htm

Most British COVID-19 mourners suffer PTSD symptoms

July 5, 2022

Science Daily/Curtin University

More than eight out of 10 British people who are seeking support for having lost a loved one to COVID-19 reported alarming Post Traumatic Stress Disorder symptoms, new Curtin University-led research has found.

The study, based on data from people seeking help and guidance from the United Kingdom's National Bereavement Partnership in collaboration with researchers from the Portland Institute for Loss and Transition and Christopher Newport University in the United States of America, also found almost two-thirds of British COVID-19 mourners experienced moderate or severe symptoms of anxiety and depression.

Lead author Professor Lauren Breen, from the Curtin School of Population Health, said the results were alarming given more than six million people had died from COVID-19 across the globe.

"These survey results indicate a concerning 'shadow pandemic' in the wake of a COVID-19 death with the vast majority of British mourners reporting alarming rates of psychological distress including constantly feeling on guard or easily startled," Professor Breen said.

"The mourners who were seeking support from the National Bereavement Partnership also reported concerning symptoms of anxiety and depression, dysfunctional grief including wanting to die in order to be with their loved one, and functional impairment that was affecting their home and family responsibilities."

According to the UK's dedicated PTSD charity, PTSD UK, about 20 per cent of all PTSD cases worldwide are linked to the unexpected death of a loved one.

To date, there have been more than 175,000 COVID-19-related deaths in the United Kingdom.

Professor Breen said the findings had significant implications for counsellors in the UK, particularly in light of modelling that showed an average of nine family members were affected by each COVID-19 death.

"Counsellors in the UK should be alert to a broad band of pandemic-related psychological distress in people who have lost a loved one to COVID-19, and not concentrate solely on symptoms of grief," Professor Breen said.

"In particular, these findings underscore the need to screen for high levels of trauma as well as grief, for potential referral to counsellors with specialised skills in treating the intersection of trauma and bereavement."

Co-author Dr Robert Neimeyer, a leading bereavement researcher and the Director of the Portland Institute for Loss and Transition, said the study suggested a useful focus for support and therapy for COVID-19 loss survivors.

"We found that much of the struggle that mourners reported in terms of intense PTSD symptoms, anguishing grief, and perturbing depression and anxiety was explained by the difficulty they had in making sense of a senseless loss, and preserving their orientation in a bewildering, threatening and disempowering world," Dr Neimeyer said.

"Not only did they lose their loved ones, but they also lost a sense of predictability, justice and control over the circumstances of the loss -- all of which could be crucial themes to address in bereavement support and therapy."

The study was based on surveys completed by 183 people seeking support from the National Bereavement Partnership in the United Kingdom.

Of those surveyed, 83 per cent reported clinically elevated PTSD symptoms, 64 per cent experienced psychiatric distress, 57 per cent suffered functional impairment and 39 per cent reported clinically significant symptoms of dysfunctional grief.

https://www.sciencedaily.com/releases/2022/07/220705162239.htm

Many patients with severe COVID-19 recover consciousness, but recovery can take days or even weeks

Researchers find that low blood oxygen levels are linked with a longer time to regain consciousness

March 15, 2022

Science Daily/Massachusetts General Hospital

Researchers report on a multicenter study to better understand the recovery timeline and the causes of delayed recovery of consciousness in patients with severe COVID-19.

During the first wave of the COVID-19 pandemic, many patients in intensive care units did not recover consciousness after their breathing tubes were removed and their sedation was stopped, leaving clinicians and families with difficult decisions about whether to continue life-sustaining therapy. Remarkably, the majority of these patients ultimately recovered consciousness, but often after days or even weeks. To help provide accurate prognostic information moving forward, a team at Massachusetts General Hospital (MGH), NewYork-Presbyterian/Columbia University Irving Medical Center, Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center launched a multicenter study to better understand the recovery timeline and the causes of delayed recovery of consciousness in patients with severe COVID-19.

The study, which is published in the Annals of Neurology, involved a retrospective analysis of 795 patients with severe COVID-19 who were treated with mechanical ventilators in the intensive care units of the investigators' medical centers for at least six days. After respiratory support ended, clinicians performed daily assessments to see whether patients could respond purposefully to a verbal command, a standard measure of consciousness.

Of the 795 patients, 72% survived and ultimately recovered consciousness prior to hospital discharge. For those who survived, 25% recovered consciousness 10 or more days after ventilator support was stopped, and 10% took more than three weeks to recover.

"When we examined the potential causes of delayed recovery of consciousness, we found that low blood oxygen levels correlated with the time to recovery, even after accounting for other factors such as exposure to sedatives," says co-senior author Brian L. Edlow, MD, associate director of the Center for Neurotechnology and Neurorecovery at MGH and associate professor of neurology at Harvard Medical School. "This relationship was dose-dependent -- the more episodes of low blood oxygen that a patient experienced, the longer it took them to wake up."

Most patients had normal brain scans, suggesting that the prolonged time to recover consciousness was not related to stroke, swelling, or bleeding in the brain. "These observations were consistent across all three medical centers and during the first and second surges of the COVID-19 pandemic," says Jan Claassen, MD, a co-leader of the study and associate professor of neurology at Columbia University Vagelos College of Surgeons and Physicians.

Additional research is needed to understand the mechanisms behind the link between low blood oxygen levels and prolonged time to recover consciousness. "We've seen similar phenomena in rare patients with cardiac arrest who were treated with hypothermia," says Nicholas D. Schiff, MD, a co-leader of the study and the Jerold B. Katz Professor of Neurology and Neuroscience in the Feil Family Brain and Mind Research Institute and co-director of the Consortium for the Advanced Study of Brain Injury (CASBI) at Weill Cornell Medicine and an attending neurologist at NewYork-Presbyterian/Weill Cornell Medical Center. "Hypothermia appears to protect cardiac arrest patients from neurological damage in ways we still don't understand. We're now moving forward with studies aimed at uncovering common underlying mechanisms of neuroprotection that might connect these two groups of patients."

Regardless of the underlying mechanisms yet to be uncovered, the study's results could have an immediate clinical impact. "These findings provide us with more accurate information to guide families who are deciding whether to continue life-sustaining therapy in unconscious COVID-19 patients," says Edlow. "The fact that delayed recovery of consciousness was consistently seen at three different medical centers, across two surges of COVID-19, suggests that we should consider the possibility of delayed recovery when making life-of-death decisions for these patients in the intensive care unit."

The results may also be applied to critically ill patients with other medical conditions. "We are trying to determine whether the lessons learned from patients with severe COVID-19 can inform our approach to oxygenation targets and sedation management in the intensive care unit for the broad spectrum of patients who require mechanical ventilation," says co-author Emery N. Brown, MD, PhD, professor of anesthesia at Harvard Medical School, anesthesiologist at MGH, and professor of medical engineering and computational neuroscience at Massachusetts Institute of Technology.

Co-first author Megan E. Barra, PharmD, a clinical pharmacy specialist in neurocritical care at MGH, notes that additional research is also needed to determine the degree of functional recovery in patients with COVID-19 or other conditions who experience prolonged unconsciousness after ventilator support is stopped. "We did not look at long-term recovery of cognition or functional independence in our study, but this is an important consideration for patients and their families," she says.

https://www.sciencedaily.com/releases/2022/03/220315105611.htm

Exercise may treat long COVID-induced diabetes, depression

March 11, 2022

Science Daily/Pennington Biomedical Research Center

While no medically recognized treatment exists for Long COVID, exercise may break the vicious cycle of inflammation that can lead to developing diabetes and depression months after a person recovers from the virus.

"We know that Long COVID causes depression, and we know that it can increase blood glucose levels to the point where people develop diabetic ketoacidosis, a potentially life-threatening condition common among people with type 1 diabetes," said Candida Rebello, Ph.D., a research scientist at Pennington Biomedical Research Center. "Exercise can help. Exercise takes care of the inflammation that leads to elevated blood glucose and the development and progression of diabetes and clinical depression."

It's unclear how many people suffer from Long COVID. But estimates range from 15 percent to 80 percent of the people infected. Based on those figures, it's possible that as many as 1 million of Louisiana's residents suffer from Long COVID.

Long COVID causes what the Centers for Disease Control describes as "a constellation of other debilitating symptoms" including brain fog, muscle pain, and fatigue that can last for months after a person recovers from the initial infection.

"For example, a person may not get very sick from COVID-19, but six months later, long after the cough or fever is gone, they develop diabetes,' Dr. Rebello said.

One solution is exercise. Dr. Rebello and her co-authors describe their hypothesis in "Exercise as a Moderator of Persistent Neuroendocrine Symptoms of COVID-19," published in the journal Exercise and Sport Sciences Reviews.

"You don't have to run a mile or even walk a mile at a brisk pace," Dr. Rebello said. "Walking slowly is also exercising. Ideally, you would do a 30-minute session of exercise. But if you can only do 15 minutes at a time, try to do two 15-minute sessions. If you can only walk 15 minutes once a day, do that. The important thing is to try. It doesn't matter where you begin. You can gradually build up to the recommended level of exercise."

"We know that physical activity is a key component to a healthy life. This research shows that exercise can be used to break the chain reaction of inflammation that leads to high blood sugar levels, and then to the development or progression of type 2 diabetes," said Pennington Biomedical Executive Director John Kirwan, Ph.D., who is also a co-author of the paper.

https://www.sciencedaily.com/releases/2022/03/220311095317.htm

One in three young people say they felt happier during lockdown

February 22, 2022

Science Daily/University of Cambridge

One in three young people say their mental health and wellbeing improved during COVID-19 lockdown measures, with potential contributing factors including feeling less lonely, avoiding bullying and getting more sleep and exercise, according to researchers at the universities of Cambridge and Oxford.

As the COVID-19 pandemic swept the world, many countries imposed strict lockdown measures, with workplaces and businesses closing and people forced to remain at home. Measures also included school closures, with exceptions for young people whose parents were classified as essential workers and those considered 'vulnerable', for example children under the care of social services and those in families or social situations deemed by schools to be of concern.

Several studies have reported that the lockdown had a negative impact on the mental health and wellbeing of young people, but this effect has not been uniformly reported, with a number of studies suggesting that some young people may have benefited from lockdown.

Emma Soneson, a PhD student and Gates Scholar at the Department of Psychiatry, University of Cambridge, said: "The common narrative that the pandemic has had overwhelmingly negative effects on the lives of children and young people might not tell the full story. In fact, it seems as though a sizeable number of children and young people may have experienced what they felt was improved wellbeing during the first national lockdown of 2020.

"After hearing from patients in our clinical practice and informally from several parents and young people that they thought the lockdown was beneficial for their or their child's mental health, we decided to look at this trend."

Ms Soneson and colleagues explored this issue using the OxWell Student Survey, a large, school-based survey of students aged eight to 18 years living in England. More than 17,000 students took part in the June/July 2020 survey, during the tail end of the first national lockdown, answering questions about their experiences of the pandemic, school, home life, and relationships, among others. The results of their research have been published in European Child and Adolescent Psychiatry.

The team found that one in three students thought their mental wellbeing had improved during the first lockdown. In fact, an almost identical number of students fell into each of the three categories: their mental wellbeing had improved; there had been no change; or they had experienced a deterioration to their wellbeing.

The highest proportions of students who reported improved mental wellbeing were among those who were in school every day (39%) and most days (35%), while the highest proportion of students who reported worse wellbeing were those who attended just once or twice (39%).

Students who felt they had had better wellbeing during lockdown were more likely than their peers to report positive lockdown experiences of school, home, relationships, and lifestyle. For example, compared with their peers, a greater percentage of students reporting better wellbeing also reported decreases in bullying, improved relationships with friends and family, less loneliness, better management of schoolwork, more sleep, and more exercise during lockdown compared with before.

Professor Peter Jones, also from Department of Psychiatry at the University of Cambridge, said: "What we've seen is a complex mix of factors that affect whether a child's mental health and wellbeing was affected by the lockdown. These range from their mental health before the pandemic through to their relationships with their families and peers, and their attitudes towards school."

While previous studies have reported young people worrying about the impact of lockdown on friendships, nearly half of those who reported improved mental wellbeing in this new study reported feeling less left out and lonely and having better relationships with friends and family. In part, this may be because access to digital forms of social interaction can mitigate the negative effects of reduced face-to-face contact. With many parents and carers at home, there was also potential for improved family relationships.

One specific aspect of peer relationships that changed during the pandemic was bullying. The researchers found that most young people who had been bullied in the past year reported that the bullying had reduced. The proportion that reported that they were bullied less than before lockdown was higher for those who reported improved wellbeing (92%) than for those who reported no change (83%) or deterioration in their wellbeing (81%).

For approximately half of the young people who reported improved mental wellbeing, lockdown was associated with improvements in sleep and exercise -- for example, 49% of those who reported improved mental wellbeing reported sleeping more, compared with 30% of those who reported no change and 19% of those who reported deterioration.

Family relationships also clearly played a part: the proportion of students who reported that they were getting along with household members better than before lockdown was higher for the group who reported improved mental wellbeing (53%) than for the groups who reported no change (26%) or deterioration (21%), with a similar pattern for getting along with friends (41%, 26%, and 27% respectively).

Professor Mina Fazel from the Department of Psychiatry at the University of Oxford said: "While the pandemic has undoubtedly had negative consequences for many, it is important to keep in mind that this is not the case for all children and young people. We are interested in how we can learn from this group and determine if some of the changes can be sustained in order to promote better mental health and wellbeing moving forward."

Some of the school-related factors that may have influenced how a young person responded to the lockdown include: the increased opportunities for flexible and tailored teaching that encouraged different styles of learning; smaller class sizes and more focused attention from teachers for those attending school; and later waking times and more freedom during the school day.

https://www.sciencedaily.com/releases/2022/02/220222135415.htm

Depression and anxiety spiked in pregnant women during COVID-19 pandemic

January 31, 2022

Science Daily/University of Essex

The COVID-19 pandemic caused a spike in depression and anxiety in expectant mums, a new study by the University of Essex has revealed.

The research found social support protected against anxiety symptoms associated with the pandemic but highlighted changes to maternity services forced by lockdown and other restrictions likely hit mental health.

It is speculated in the BMC Pregnancy and Childbirth-published paper that the removal of appointments and other changes to face-to-face contact may have affected well-being.

The senior author, Dr Silvia Rigato, said it was vital to "protect maternal wellbeing during pregnancy and beyond" and "to ensure that all children, and their new families, are given the best possible start in life."

The study found there was a spike in reported depression rates of 30 per cent from pre-pandemic levels, from 17 per cent to 47 per cent -- with anxiety rates also jumping up 37 per cent in expecting mothers to 60 per cent.

The peer-reviewed study of 150 women took place during the height of the Coronavirus crisis between April 2020 and January 2021 -- before the vaccination programme rolled out -- and was led by Dr Maria Laura Filippetti and Dr Rigato, researchers at the Essex Babylab in the University of Essex.

The paper showed that prenatal trauma, such as the one experienced during the COVID-19 pandemic, can significantly amplify vulnerability to mental health problems.

It also emerged from the study that pregnant women with higher depressive symptoms reported feeling less attached to their unborn babies.

Dr Rigato said: "While this result is in line with previous observations that women's mood during pregnancy influences the early relationship with her child, it reinforces the need for authorities to support women throughout their pregnancy and the postnatal period in order to protect their health and their infants' development."

Importantly, the research also revealed the positive effect that social support plays in protecting expecting mothers' mental health.

The authors found women who considered the impact of COVID-19 to be more negative showed higher levels of anxiety.

Crucially though, help from partners, family and friends, and the NHS acted as a protective factor and was associated with fewer negative symptoms.

Dr Filippetti said more must be done to help women during this vulnerable time in their lives.

She said: "The high rates of depression and anxiety during the pandemic highlighted by our study suggest that expectant women are facing a mental health crisis that can significantly interfere and impair mother-infant bonding during pregnancy, and can potentially impact on childbirth outcome, as well as later infant and child development."

It is now hoped the research will be used to help understand how the pandemic affected children's development, mum's mental health post-partum and how dads coped through pregnancy and beyond.?

https://www.sciencedaily.com/releases/2022/01/220131110457.htm

Predicting Long COVID at initial point of COVID-19 diagnosis: Study finds several warning factors

January 25, 2022

Science Daily/Institute for Systems Biology

A study has identified four predictive factors of Post Acute Sequelae of COVID-19 (PASC), often called long COVID. These 'PASC factors' can be identified at the initial point of COVID-19 diagnosis and can anticipate if a patient is likely to develop long COVID. Additionally, researchers found that mild cases of COVID-19, not just severe cases, are associated with long COVID, and that administering antivirals very early in the disease course may potentially prevent some PASC.

A significant portion of people who contract the SARS-CoV-2 virus -- some estimates suggest more than 40 percent -- suffer chronic effects known as Post Acute Sequelae of COVID-19 (PASC), commonly referred to as long COVID. PASC symptoms include fatigue, brain fog, the loss of taste and smell, shortness of breath, and more.

Now, researchers have identified several factors that can be measured at the initial point of COVID-19 diagnosis that anticipate if a patient is likely to develop long COVID. These "PASC factors" are the presence of certain autoantibodies, pre-existing Type 2 diabetes, SARS-CoV-2 RNA levels in the blood, and Epstein-Barr virus DNA levels in blood.

"Identifying these PASC factors is a major step forward for not only understanding long COVID and potentially treating it, but also which patients are at highest risk for the development of chronic conditions," said ISB President, Dr. Jim Heath, co-corresponding author of a research paper that will be published by the journal Cell. "These findings are also helping us frame our thinking around other chronic conditions, such as post-acute Lyme syndrome, for example."

Additionally, researchers found that mild cases of COVID-19, not just severe cases, are associated with long COVID. They also suggest that administering antivirals very early in the disease course may potentially prevent some PASC.

"Long COVID is causing significant morbidity in survivors of COVID-19, yet the pathobiology is poorly understood," said Dr. Jason Goldman, co-corresponding author of the paper and an infectious disease expert at Swedish. "Our study pairs clinical data and patient-reported outcomes with deep multi-omic analyses to unravel important biological associations that occur in patients with PASC. Certain findings such as the low cortisol state in patients with long COVID have potential to translate rapidly to the clinic. Our results form an important foundation for the development of therapeutics to treat long COVID."

Researchers collected blood and swab samples from 309 COVID-19 patients at different time points to perform comprehensive phenotyping which was integrated with clinical data and patient-reported symptoms to carry out a deep multi-omic, longitudinal investigation.

A key finding from the study deals with viral load, which can be measured near diagnosis to predict long COVID symptoms. "We found that early blood viral measurements are strongly associated with certain long COVID symptoms that patients will develop months later," said Dr. Yapeng Su, a co-first and co-corresponding author of the paper.

In addition, researchers found the Epstein-Barr virus (EBV) -- a virus that infects 90 percent of the human population and is normally inactive in the body after infection -- is reactivated early on after SARS-CoV-2 infection, which is significantly associated with future long COVID symptoms. "This may be related to immune dysregulation during COVID-19 infection," Su added.

The team also found that PASC is anticipated by autoantibodies (which associate with autoimmune diseases like lupus) at diagnosis, and that as autoantibodies increase, protective SARS-CoV-2 antibodies decrease. This suggests a relationship between long COVID, autoantibodies and patients at elevated risk of re-infections.

"Many patients with high autoantibodies simultaneously have low (protective) antibodies that neutralize SARS-CoV-2, and that's going to make them more susceptible to breakthrough infections," said Daniel Chen, a co-first author of the paper.

The research project was a collaboration between ISB, Providence, Swedish the University of Washington, Fred Hutchinson Cancer Research Center, Stanford, UCLA, UCSF, and others.

https://www.sciencedaily.com/releases/2022/01/220120165100.htm

Why the Omicron variant causes less severe disease

Eight COVID-19 drugs remain active against Omicron in cell culture study

January 24, 2022

Science Daily/Goethe University Frankfurt

A new study shows that the SARS-CoV-2 Omicron variant is less effective than Delta at blocking a cellular defense mechanism against viruses, the so-called 'interferon response'. Moreover, cell culture findings indicate that eight important COVID-19 drugs and drug candidates remain effective against Omicron.

A new study by researchers from the University of Kent and the Goethe University Frankfurt shows that the SARS-CoV-2 Omicron variant is less effective than Delta at blocking a cellular defence mechanism against viruses, the so-called "interferon response." Moreover, cell culture findings indicate that eight important COVID-19 drugs and drug candidates remain effective against Omicron.

The SARS-CoV-2 Omicron variant causes less severe disease than Delta although it is better at escaping immune protection by vaccinations and previous infections. The reasons for this have so far remained elusive.

A new study by a research team with scientists from the University of Kent and the Goethe-University Frankfurt has now shown that Omicron variant viruses are particularly sensitive to inhibition by the so-called interferon response, an unspecific immune response that is present in all body cells. This provides the first explanation of why COVID-19 patients infected with the Omicron variant are less likely to experience severe disease.

The cell culture study also showed that Omicron viruses remain sensitive to eight of the most important antiviral drugs and drug candidates for the treatment of COVID-19. This included: EIDD-1931 (active metabolite of molnupiravir), ribavirin, remdesivir, favipravir, PF-07321332 (nirmatrelvir, active ingredient of paxlovid), nafamostat, camostat, and aprotinin.

Prof Martin Michaelis, School of Bioscience, University of Kent, said: "Our study provides for the first time an explanation, why Omicron infections are less likely to cause severe disease. This is due to Omicron, in contrast to Delta, does not effectively inhibit the host cell interferon immune response."

Prof. Jindrich Cinatl, Institute of Medical Virology at the Goethe-University, added: "Although cell culture experiments do not exactly reflect the more complex situation in a patient, our data provide encouraging evidence that the available antiviral COVID-19 drugs are also effective against Omicron."

https://www.sciencedaily.com/releases/2022/01/220124203747.htm

People who are depressed may be more susceptible to misinformation about COVID-19 vaccines

Among surveyed adults, those with depressive symptoms were more likely to believe false statements about COVID-19 vaccines

January 21, 2022

Science Daily/Massachusetts General Hospital

In a 50-state survey-based study, adults with depressive symptoms were twice as likely to support misinformation about COVID-19 vaccines. People who endorsed false statements were half as likely to be vaccinated against COVID-19.

A general bias toward negativity -- or the tendency to focus on negative rather than positive information -- may exacerbate the spread of misinformation. Because depression may contribute to such negativity bias, a team led by investigators at Massachusetts General Hospital (MGH) examined whether people who experience depressive symptoms may be more receptive to misinformation related to COVID-19 vaccines. Their findings are published in JAMA Network Open.

"One of the notable things about depression is that it can cause people to see the world differently -- sort of the opposite of rose-colored glasses. That is, for some depressed people, the world appears as a particularly dark and dangerous place," says lead author Roy H. Perlis, MD, MSc, associate chief of research in the Department of Psychiatry and director of the Center for Quantitative Health at MGH. "We wondered whether people seeing the world this way might also be more susceptible to believing misinformation about vaccines. If you already think the world is a dangerous place, you might be more inclined to believe that vaccines are dangerous -- even though they are not."

To investigate, Perlis and his colleagues examined responses from 15,464 adults from all 50 U.S. states and Washington, D.C., who completed an internet survey between May and July 2021 that included statements related to COVID-19 vaccines after answering a questionnaire that measured depressive symptoms.

The team found that levels of depression are at least three times higher than what they were before the COVID-19 pandemic. Participants with moderate or greater major depressive symptoms on the initial questionnaire were more likely to endorse at least one of four false statements about COVID-19 vaccines on the subsequent survey, and those who endorsed these statements were less likely to be vaccinated. Specifically, the presence of depression was associated with a 2.2-times higher likelihood of endorsing misinformation, and respondents endorsing at least one misinformation statement were half as likely to be vaccinated and 2.7 times more likely to report vaccine resistance.

Perlis and his colleagues also analyzed data from the subset of 2,809 respondents who answered a subsequent survey two months later. Those with depression in the first survey were twice as likely as those without depression to endorse more misinformation than they did in the prior survey.

"While we can't conclude that depression caused this susceptibility, looking at a second wave of data at least told us that the depression came before the misinformation. That is, it wasn't that misinformation was making people more depressed," Perlis notes. Because the study also included questions about social media and news sources, the investigators were also able to exclude the possibility that the effect of depression was a result of getting news from different places. They also found that the effect was not limited to people with particular political beliefs or members of particular demographic groups.

The researchers note that the findings provide an additional motivation to ensure that people have access to treatment for depression and anxiety. "Our result suggests that, by addressing the extremely high levels of depression in this country during COVID, we might decrease people's susceptibility to misinformation," says Perlis. "Of course, we can only show an association -- we can't show that the depression causes? the susceptibility, but it's certainly suggestive that it might."

Perlis stresses that the results in no way blame misinformation on people with depression but rather suggest that depression may cause people to be more vulnerable to believing this misinformation.

Co-authors include Katherine Ognyanova, PhD, Mauricio Santillana, PhD, Jennifer Lin, BA, James Druckman, PhD, David Lazer, PhD, Jon Green, PhD, Matthew Simonson, PhD, Matthew A. Baum, PhD, and John Della Volpe, BA.

This study was supported by the National Science Foundation, the National Institute of Mental Health, Northeastern University, Harvard Kennedy School of Government, and Rutgers University.

https://www.sciencedaily.com/releases/2022/01/220121124824.htm

Stress associated with an increased risk of getting COVID-19

January 12, 2022

Science Daily/University of Nottingha

A new study has found that people who experienced increased stress, anxiety and depression at the start of the pandemic, were at greater risk of getting Covid-19.

The research, published in Annals of Behavioral Medicine, found that greater psychological distress during the early phase of the pandemic was significantly associated with participants later reporting SARS-CoV-2 infection, a greater number of symptoms and also more severe symptoms.

Professor Kavita Vedhara in the School of Medicine at the University of Nottingham, led the study, along with colleagues from King's College London and the University of Auckland in New Zealand.

Previous research has shown that psychological factors such as stress and social support are associated with increased susceptibility to viral respiratory illnesses and more severe symptoms.

During the Covid-19 pandemic there has been a well-documented deterioration in psychological wellbeing and increased social isolation. The purpose of this study was to find out whether people who experienced these difficulties during the pandemic were more at risk of contracting and/or experiencing Covid-19 symptoms.

The team of experts conducted an observational study of nearly 1,100 adults, who completed surveys during April 2020 and self-reported incidence of Covid-19 infection and symptom experience across the pandemic through to December 2020.

Regression models were used to explore these relationships, taking into account demographic and occupational factors.

The results showed that Covid-19 infection and symptoms were more common among those experiencing elevated psychological distress.

Professor Vedhara says: "The significance of the work is in that it turns the debate regarding the mental health aspects of the pandemic on its head. Our data show that increased stress, anxiety and depression are not only consequences of living with the pandemic, but may also be factors that increase our risk of getting SARS-CoV-2 too.

"Further work is now needed to determine whether and how public health policy should change to accommodate the fact that the most distressed people in our communities appear to be at greatest risk of Covid-19 infection."

Professor Trudie Chalder, Professor of Cognitive Behavioural Psychotherapy from King's College London said: "Previous work has shown a clear relationship between distress and the development of viral infections indicating a vulnerability. Our study found that distress was associated with self-reported Covid-19 infection and the next step is to investigate whether this association is found in those with confirmed infection."

https://www.sciencedaily.com/releases/2022/01/220112145102.htm

Sleep disorders linked with more severe outcomes from COVID-19

November 10, 2021

Science Daily/Cleveland Clinic

A new Cleveland Clinic study found that people with certain sleep disorders have more severe outcomes from COVID-19, including a 31 percent higher rate of hospitalization and mortality.

The research team, led by Reena Mehra, M.D., analyzed retrospective data from 5,400 Cleveland Clinic patients. The findings, published in JAMA Network Open, showed that while patients with sleep-disordered breathing and sleep-related hypoxia do not have increased risk of developing COVID-19, they have a worse clinical prognosis from the disease.

"As the COVID-19 pandemic continues and the disease remains highly variable from patient to patient, it is critical to improve our ability to predict who will have more severe illness so that we can appropriately allocate resources," said Dr. Mehra, director of Sleep Disorder Research at Cleveland Clinic. "This study improved our understanding of the association between sleep disorders and the risk for adverse COVID-19 outcomes. It suggests biomarkers of inflammation may mediate this relationship."

Researchers used Cleveland Clinic's COVID-19 research registry, which includes data from nearly 360,000 patients tested for COVID-19 at Cleveland Clinic, of which 5,400 had an available sleep study record. Sleep study findings and COVID-19 positivity were assessed along with disease severity. The team also accounted for co-morbidities such as obesity, heart and lung disease, cancer and smoking.

The findings set the stage for additional studies to identify whether early effective treatments such as PAP (positive airway pressure) or oxygen administration can improve COVID-19 outcomes.

"Our findings have significant implications as decreased hospitalizations and mortality could reduce the strain on healthcare systems," said first author of the study Cinthya Pena Orbea, M.D, of Cleveland Clinic's Sleep Disorders Center. "If indeed sleep-related hypoxia translates to worse COVID-19 outcomes, risk stratification strategies should be implemented to prioritize early allocation of COVID-19 therapy to this subgroup of patients."

https://www.sciencedaily.com/releases/2021/11/211110131628.htm

Stress during pandemic linked to poor sleep

June 17, 2021

Science Daily/Washington State University

Many people likely lost sleep over COVID-19. A study of twins led by Washington State University researchers found that stress, anxiety and depression during the first few weeks of the pandemic were associated with less and lower quality sleep.

In a survey of more than 900 twins taken shortly after COVID-19 lockdown measures began, about half of the respondents reported no change in their sleep patterns, but around a third, 32.9%, reported decreased sleep. Another 29.8% reported sleeping more. In the analysis, the researchers found that any change in sleep was connected to self-reported mental health issues, though it was more strongly associated with decreased sleep.

"The results show that deviations from your typical sleep behavior may be associated with depression, anxiety and stress," said Siny Tsang, lead author on the study published in Frontiers in Neuroscience.

Tsang, a staff scientist with the WSU Elson S. Floyd College of Medicine, emphasized that this showed a connection, not a cause, but the study supports previous research that has found a two-way relationship between disrupted sleep patterns and poor mental health. In other words, when people don't sleep well, they are more likely to feel stress, anxiety and depression, and when they are dealing with those same problems, they are more likely to sleep less -- and sometimes more -- than the typical six to nine hours a night.

This study analyzes survey responses collected between March 26 and April 5, 2020 from participants in the Washington State Twin Registry. Since then, the same group has answered three more waves of survey questions. Researchers are particularly interested in studying twins, so they can investigate whether associations are mediated by genetic factors, shared environment, or both. The pandemic also offered an opportunity for a natural experiment to see how a stressful situation affects sleep amount and quality among individuals in the community, Tsang said.

The research relies on the self-reported perception of sleep length and quality, but the researcher said that when it comes to mental health, perception can matter more than the real amount of sleep.

"Even if your cell phone says you consistently sleep eight hours every day, you may feel that you slept less or slept poorly, and that may be linked to stressful or anxious feelings," Tsang said. "It may not matter whether or not the actual number has changed. It's how you are feeling that is associated with your mental health."

WSU researchers have also conducted twin-studies on COVID-19 lockdown effects on alcohol use and pandemic stress and exercise. These have all been initial studies taken at the early stages of the pandemic and associated social distancing measures. The scientists are still analyzing results of later surveys, but they are starting to see a common theme.

"A pattern that is consistent across these three studies is that people who reported change in physical exercise, alcohol use or sleep are more stressed, anxious and depressed than those who had said that they have had no change," Tsang said.

https://www.sciencedaily.com/releases/2021/06/210617082718.htm

Having a strong life purpose eases loneliness of COVID-19 isolation

Those who felt their life was guided by meaningful values or goals were more willing to engage in COVID-19 protective behaviors

June 16, 2021

Science Daily/University of Pennsylvania

Why can some people weather the stress of social isolation better than others, and what implications does this have for their health? New research from the Communication Neuroscience Lab at the Annenberg School for Communication at the University of Pennsylvania found that people who felt a strong sense of purpose in life were less lonely during the COVID-19 pandemic. Did they achieve less loneliness by flouting public health guidance? No. Although lonelier people were less likely to want to follow public health guidance, people with a stronger sense of purpose also expressed more willingness to engage in social distancing, hand washing, and other COVID-19 protective behaviors.

Purpose in life, or a sense that your life is guided by personally meaningful values and goals -- which could involve family ties, religion, activism, parenthood, career or artistic ambitions, or many other things -- has been associated in prior research with a wide range of positive health outcomes, both physical and psychological.

"In the face of adversity, people with a stronger sense of purpose in life tend to be more resilient because they have a clear sense of goals that motivate actions that are aligned with personal values," says Yoona Kang, Ph.D., lead author and a Research Director of the Communication Neuroscience Lab. "People with strong purpose may also experience less conflict when making health decisions. We felt that the COVID-19 pandemic was an important context to test whether purpose in life relates to individuals' willingness to engage in behaviors to protect themselves and others."

Based on their prior research, Kang and her collaborators expected that people with higher sense of purpose would be more likely to engage in COVID-19 prevention behaviors than individuals with a lower sense of purpose. In order to test their theory, the researchers surveyed more than 500 adult participants to capture their levels of purpose in life, their current and pre-pandemic levels of loneliness, and the degrees to which they intended to engage in behaviors known to prevent the spread of COVID-19.

They found that higher levels of loneliness made people be less focused on protecting themselves from COVID-19, and more skeptical that behaviors to prevent COVID-19 would be effective. However, having a stronger sense of purpose was associated with lower levels of loneliness and a greater desire to take action to protect themselves from COVID-19. Those with a higher sense of purpose also expressed a stronger belief that COVID-19 prevention behaviors would work. Even when people who had a strong sense of purpose did report being lonely, they still felt strongly about taking precautions to prevent COVID-19.

"When faced with extreme loneliness and social isolation, like during the COVID-19 pandemic, wanting to connect with other people, despite the health risks, is a natural response," Kang says. "And yet, amidst this drastic shift in social life, we found that people with a higher sense of purpose were more likely to engage in prevention behaviors. This is striking because it shows that purpose in life can empower people to make life-saving health decisions that protect their own health and those around them."

Additionally, the researchers found that older people expressed less loneliness during the COVID-19 pandemic than younger people. Kang sees this as a sign of the resilience of older adults, and she hopes to further study how to enhance purpose in life and resilience in aging populations.

"Having a stronger sense of purpose was associated with really important, positive outcomes across the lifespan," says Emily Falk, senior author, Director of the Communication Neuroscience Lab, and Professor of Communication, Psychology, and Marketing. "Our upcoming work will test interventions to increase their sense of purpose, in hopes of bringing these benefits to more people."

https://www.sciencedaily.com/releases/2021/06/210616154257.htm