Global consortium study aims to unravel long-term neurocognitive sequelae of SARS-CoV-2 infection

Debra Gutierrez from Von Ormy, Texas, near San Antonio has been an active person all her life. An ophthalmology technician at the University of Texas Health Sciences Center at San Antonio (UT Health San Antonio), she works in a clinic that sees dozens of patients daily. But things changed for her in the summer of 2020, the early days of the pandemic before COVID-19 vaccines became available.

“My diagnosis of COVID was July 3, 2020,” Gutierrez, 49, said. “The main problem I had was massive migraines accompanied by loss of smell, dizziness, body aches and blurred vision in my right eye.”

Although she never needed hospitalization and returned to work after a month, her recovery was just beginning. In fact, she still doesn’t feel like she did before the infection.

“I have episodes of disorientation, of not knowing where I am, including when I’m driving,” she said. “The longest episode was about 15 minutes long. I had to pick up my phone to give me directions home because I had no idea where I was.”

Gutierrez keeps a diary of her symptoms and in May 2022 she noticed she was starting to stutter. “I had never stuttered before,” she said.

The fog in his mind is persistent, endless. “I tend to empty myself even when I’m at work, and I’ve been doing this kind of work for 26 years. I forget what I’m doing,” she said.

Gabriel de Erausquin, MD, PhD, professor of neurology at the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio, sees Gutierrez in his clinic. He prescribed her medication to calm her down when episodes occur.

De Erausquin works at the Glenn Biggs Institute for Alzheimer and Neurodegenerative Disorders at UT Health San Antonio, where one of the projects he directs is the Alzheimer’s Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-Infection. CoV-2. It is an initiative of research and clinical teams around the world. Scientific leaders, including the Alzheimer’s Association and representatives from more than 25 countries, are working with technical advice from the World Health Organization to track the long-term impact of SARS-CoV-2 (also known as novel coronavirus, COVID-19) on the brain.

Debra Gutierrez is among the South Texas participants who will be evaluated at UT Health San Antonio upon entering the study and at specific times. Neuropsychological tests that assess aspects of learning and memory will be administered, and study volunteers will undergo brain imaging on the world’s most powerful MRI systems.

No available evidence supports the idea that cognitive impairment after SARS-CoV-2 infection is a form of dementia, whether Alzheimer’s disease or related dementias or another. cause. The multinational initiative of the Alzheimer’s Association Consortium will provide data to answer this question as clearly as possible in a globally diverse set of participants. »

Dr. Gabriel de Erausquin, MD, PhD, Professor of Neurology, Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio

Persistent loss of smell is associated with brain changes. The olfactory bulb, which contains brain cells that respond to smell, is primarily where the COVID-19 virus enters the nervous system, Dr. de Erausquin said. Building on this information, the consortium aims to understand the effects that SARS-CoV-2 triggers in the brain.

In a peer-reviewed article published Sept. 22 in Alzheimer & Dementia: Translational Research & Clinical Interventions, the consortium authors note: “It is incumbent on the scientific and medical community to attempt to understand the molecular and/or systemic factors linking COVID-19 to neurological disease, both short and long term.

The article provides the roadmap for how those who wish to use the methodology developed by this large global research community will achieve this ambitious undertaking across multiple continents, languages ​​and cultures.

Tailoring strategies and flexible study designs provide the opportunity to include large samples of underrepresented racial and ethnic groups, Dr. de Erausquin said. Sharing information, data and knowledge will allow future studies to have data generated by these diverse groups for years to come.

Debra Gutierrez, who still works full-time, has a supportive husband, six adult sons and stepsons, and six grandchildren. His experience, and the experiences of thousands of people around the world, will paint a more complete picture of what happens in the brain after COVID. Understanding how to treat cognitive problems caused by viral infections could lead to better outcomes in the future.

“I used to run marathons and work out several days a week,” Gutierrez said. “I have a lot of hope because I was a very active person.”

Funding for the consortium is provided in part by the Alzheimer’s Association.

Source:

University of Texas Health Sciences Center at San Antonio

Journal reference:

from Erausquin, Georgia, et al. (2022) Chronic Neuropsychiatric Sequelae of SARS-CoV-2: Protocol and Methods from the Alzheimer’s Association Global Consortium. Translational research and clinical interventions in Alzheimer’s disease and dementia. doi.org/10.1002/trc2.12348.

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