The coronavirus is on the rise in the summer. According to Professor of Epidemiology, Theodora Psaltopoulou more than 1700 people are still dying every week from the disease and vaccine coverage continues to decrease for the vulnerable.
In particular, according to WHO statistics, in the first quarter of 2024 only 0.42% of elderly people received some vaccination dose for the coronavirus worldwide. There have been over 775 million confirmed cases of Covid-19 and more than 7 million deaths worldwide since the virus was first identified in Wuhan.
It is noted that transmission is easier on long-haul long-distance air travel. And it seems that long-term air travel without the use of a mask increases by 25 times the probability of someone getting infected, compared to short-haul air travel.
Symptoms of Long Term Covid
According to a recent publication in the prestigious international journal the Lancet (July 2024), although 4 years have passed since the start of the COVID-19 pandemic, it is estimated that 10–20% of people infected with SARS-CoV-2 are still have symptoms after infection. Fatigue and cognitive impairment are the most common symptoms of long-term COVID.
Data from a multicenter cohort showed that at 9 months post-infection 176 (5.8%) of 3038 participants had both fatigue and cognitive deficits, as assessed by the Montreal Cognitive Assessment Scale and Functional Assessment of Chronic Illness Treatment–Fatigue, respectively.
Of those with longitudinal data, 197 (22.2%) of 889 participants had cognitive deficits and 468 (22.4%) of 2092 participants had fatigue at baseline. At 26-month follow-up, 84 (42.6%) of 197 participants with cognitive deficits and 254 (54.3%) of 468 participants with fatigue had persistent symptoms, suggesting that these conditions may be transient for some people but persistent for others. Fatigue was associated with headache and depression.
The effectiveness of vaccines
Vaccines against COVID-19 are effective in reducing the incidence of severe COVID-19, mortality and transmission in the community. A multinational study of the primary care records of 10 million people vaccinated against COVID-19 and 10 million people who were not vaccinated against COVID-19, published in The Lancet Respiratory Medicine in March 2024, revealed that vaccination against COVID- 19 reduced the risk of developing long-term COVID.
However, a prospective study of participants 6 months, 12 months, 18 months, and 24 months after infection with COVID-19, published in Scientific Reports in January 2024, found that the frequency of neuropsychiatric symptoms did not differ based on COVID-19 , vaccination status or number of doses of COVID-19 vaccine received.
Brain problems too
A growing body of evidence has shown that COVID-19 infection can affect the brain through different mechanisms affecting cognition and fatigue. For example, a prospective observational study of 50 participants with neurological symptoms for at least 3 months after COVID-19 infection published in April 2023 revealed characteristic structural-imaging alterations of the thalamus and basal ganglia underlying symptoms of persistent fatigue.
A control study of resting-state functional connectivity in 52 participants 27 months after infection with COVID-19 published in The Lancet Regional Health-Western Pacific in June 2024 showed that reduced brain activity in the left superior temporal gyrus was associated with an increased score mental fatigue and cognitive deficit.
Adding to this evidence, a prospective cohort study of 1,837 adults hospitalized with COVID-19 published in Nature Medicine in August 2023 identified two distinct conditions linking acute blood-biomarker profiles measured at admission, which predicted cognitive outcomes 6 months and 12 months after infection with COVID-19.
The first condition linked elevated fibrinogen relative to C-reactive protein with objective and subjective cognitive deficits, suggesting a possible role of direct effects of blood coagulation and fibrinogen on the brain. The second dimension linked elevated D-dimer, a protein fragment produced when blood clots break down, to C-reactive protein with only subjective cognitive deficits.
New disease due to coronavirus
A study published in Nature Neuroscience in February 2024 found evidence of blood-brain barrier disruption up to 1 year after infection with COVID-19 in the temporal lobes and frontal cortex of the brain.
There is currently no cure for brain fog and brain fatigue caused by long-term COVID-19, but international efforts are underway and significant funding is being given.
These aim to bring together clinicians, researchers, scientists, caregivers, patients and community members to understand and effectively treat long-term COVID.
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